Acute Coronary Syndrome in Brazil: Registration of Predisposing Factors and Population Profile in a National Public
Kaliana Nascimento1, Hugo Ribeiro Ramadan1, Bruno Mendonça Baccaro1
1Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil.
Insights
Acute coronary syndrome (ACS) is a major global health concern. This study identified hypertension, obesity, and prior coronary artery disease as key risk factors in Brazilian patients, informing prevention strategies.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Acute coronary syndrome (ACS) is a leading cause of global mortality.
- Identifying predisposing factors for ACS is crucial for effective prevention strategies.
- This study focuses on the etiological and epidemiological profile of ACS patients in São Paulo.
Purpose of the Study:
- To characterize the etiological and epidemiological features of patients admitted with ACS.
- To analyze risk factors, risk scores, and adverse events associated with ACS.
- To provide data for developing public health policies for ischemic disease prevention in Brazil.
Main Methods:
- Prospective cohort study involving 5,580 patients hospitalized with ACS.
- Data collected from electronic medical records at a public cardiology institute in São Paulo, Brazil (August 2018 - October 2022).
- Evaluation of epidemiological characteristics, risk scores (GRACE, TIMI, HEART), and adverse events during hospitalization and 30-day follow-up.
Main Results:
- Key associated factors for ACS included hypertension (80.38%), obesity/overweight (72.47%), and previous coronary artery disease (CAD) (59.11%).
- Risk stratification showed most patients as low risk (GRACE: 65.10%) or moderate risk (TIMI: 81.34%, HEART: 71.16%).
- Thirty-day adverse events included major bleeding (3.10%), reinfarction (7.86%), stroke (5.55%), and mortality (2.53%).
Conclusions:
- This registry highlights the significant impact of modifiable risk factors on ACS occurrence in the Brazilian population.
- Findings underscore the need for targeted public health interventions to mitigate the burden of ischemic heart disease.
- The study provides valuable insights for national strategies in preventing and managing ACS.
Background:
Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide. Knowing the predisposing factors is essential for preventing it.
Objectives:
To describe the etiological and epidemiological characteristics of the population with ACS admitted to an emergency room in the State of São Paulo.
Methods:
The prospective cohort study, based on electronic medical records from a public cardiology institute located in the state of São Paulo, Brazil, describes 5,580 patients hospitalized with ACS between August 2018 and October 2022. The main epidemiological characteristics, the association between confirmed ACS and risk scores, and adverse events during hospitalization and in the 30-day follow-up after hospital discharge were evaluated. The significance level was set at 5%.
Results:
The main factors associated with ACS were hypertension (80.38%), obesity or overweight (72.47%), and previous coronary artery disease (CAD) (59.11%). In the GRACE score, 65.10% were considered low risk, while 81.34% in the TIMI and 71.16% in the HEART were identified as moderate risk. Catheterization represented 84.93% of the diagnostic methods. Clinical treatment was the strategy adopted in 46.47% of the cases. In the 30-day evolution, 3.10% presented major bleeding, 7.86% infarction/reinfarction, 5.55% stroke, and 2.53% evolved to death.
Conclusion:
The results of the largest Brazilian ACS registry to date highlight the impact of potentially modifiable risk factors on the occurrence of ischemic events in the local population. The findings may contribute to the development of public policies aimed at preventing and controlling the burden of ischemic disease in the country.
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