title: Acute coronary syndrome behavior: results of a Brazilian registry.
abstract: BACKGROUND
  Brazil lacks published multicenter registries of acute coronary syndrome.
  
  
  OBJECTIVE
  The Brazilian Registry of Acute Coronary Syndrome is a multicenter national study aiming at providing data on clinical aspects, management and hospital outcomes of acute coronary syndrome in our country.
  
  
  METHODS
  A total of 23 hospitals from 14 cities, participated in this study. Eligible patients were those who came to the emergency wards with suspected acute coronary syndrome within the first 24 hours of symptom onset, associated with compatible electrocardiographic alterations and/or altered necrosis biomarkers. Follow-up lasted until hospital discharge or death, whichever occurred first.
  
  
  RESULTS
  Between 2003 and 2008, 2,693 ACS patients were enrolled, of which 864 (32.1%) were females. T he final diagnosis was unstable angina in 1,141 patients, (42.4%), with a mortality rate of 3.06%, non-ST elevation acute myocardial infarction (AMI) in 529 (19.6%), with mortality of 6.8%, ST-elevation AMI 950 (35.3%), with mortality of 8.1% and non-confirmed diagnosis 73 (2.7%), with mortality of 1.36%. The overall mortality was 5.53%. The multiple logistic regression model identified the following as risk factors for death regarding demographic factors and interventions: female gender (OR=1.45), diabetes mellitus (OR=1.59), body mass index (OR=1.27) and percutaneous coronary intervention (OR=0.70). A second model for death due to major complications identified: cardiogenic shock/acute pulmonary edema (OR=4.57), reinfarction (OR=3.48), stroke (OR=21.56), major bleeding (OR=3.33), cardiopulmonary arrest (OR=40.27) and Killip functional class (OR=3.37).
  
  
  CONCLUSIONS
  The Brazilian Registry of Acute Coronary Syndrome data do not differ from other data collected abroad. The understanding of their findings may help promote better planning and management of acute coronary syndrome care in public and private health services.
authors: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil. lpiegas@uol.com.br
authors: Leopoldo Soares
authors: LS
authors: Piegas
authors: Alvaro
authors: A
authors: Avezum
authors: Hélio Penna
authors: HP
authors: Guimarães
authors: Antonio José
authors: AJ
authors: Muniz
authors: Helder J L
authors: HJ
authors: Reis
authors: Elizabete Silva dos
authors: ES
authors: Santos
authors: Marcos
authors: M
authors: Knobel
authors: Roberta de
authors: Rd
authors: Souza
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D019468:Disease Management; D004812:Epidemiologic Methods; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D055815:Young Adult