title: Use of evidence-based interventions in acute coronary syndrome - Subanalysis of the ACCEPT registry.
abstract: BACKGROUND
  The recommendations in guidelines are based on evidence; however, there is a gap between recommendations and clinical practice.
  
  
  OBJECTIVE
  To describe the practice of prescribing evidence-based treatments for patients with acute coronary syndrome in Brazil.
  
  
  METHODS
  This study carried out a subanalysis of the ACCEPT registry, assessing epidemiological data and the prescription rate of acetylsalicylic acid, p2y12 inhibitors, antithrombotic drugs, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (IAT1RB), and statins. In addition, the quality of myocardial reperfusion in ST-segment elevation myocardial infarction was evaluated.
  
  
  RESULTS
  This study assessed 2,453 patients. The prescription rates of acetylsalicylic acid, p2y12 inhibitors, antithrombotic drugs, beta-blockers, angiotensin-converting enzyme inhibitors/IAT1RB, and statins were as follows: in 24 hours - 97.6%, 89.5%, 89.1%, 80.2%, 67.9% and 90.6%; and at six months - 89.3%, 53.6%, 0%, 74.4%, 57.6% and 85.4%, respectively. Regarding ST-segment elevation myocardial infarction, only 35.9% and 25.3% of the patients underwent primary angioplasty and thrombolysis, respectively, within the recommended times.
  
  
  CONCLUSIONS
  This registry showed high initial prescription rates of antiplatelet drugs, antithrombotic drugs, and statins, and lower prescription rates of beta-blockers and angiotensin-converting enzyme inhibitors/IAT1RB. Independently of the class, the use of all drugs decreased by six months. Most patients with ST-segment elevation myocardial infarction did not undergo myocardial reperfusion within the time recommended.
authors.affiliation: Hospital Vera Cruz, Belo Horizonte, MG, Brasil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Wang
authors.affiliation: Hospital Vera Cruz, Belo Horizonte, MG, Brasil.
authors.forename: Fernando Carvalho
authors.initials: FC
authors.lastname: Neuenschwander
authors.affiliation: Hospital Vera Cruz, Belo Horizonte, MG, Brasil.
authors.forename: Augusto
authors.initials: A
authors.lastname: Lima Filho
authors.affiliation: Hospital Vera Cruz, Belo Horizonte, MG, Brasil.
authors.forename: Celsa Maria
authors.initials: CM
authors.lastname: Moreira
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
authors.forename: Elizabete Silva dos
authors.initials: ES
authors.lastname: Santos
authors.affiliation: Hospital de Clínicas Gaspar Vianna, Belém, PA, Brasil.
authors.forename: Helder Jose Lima
authors.initials: HJ
authors.lastname: Reis
authors.affiliation: Hospital do Coração/ASS4, São Paulo, SP, Brasil.
authors.forename: Edson Renato
authors.initials: ER
authors.lastname: Romano
authors.affiliation: Rede D'or de Hospitais do Brasil, São Paulo/Pernambuco, Brasil.
authors.forename: Luiz Alberto Piva e
authors.initials: LA
authors.lastname: Mattos
authors.affiliation: Hospital do Coração/ASS4, São Paulo, SP, Brasil.
authors.forename: Otávio
authors.initials: O
authors.lastname: Berwanger
authors.affiliation: Sociedade Brasileira de Cardiologia.
authors.forename: Jadelson Pinheiro de
authors.initials: JP
authors.lastname: Andrade
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000704:Analysis of Variance; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001938:Brazil; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine / Q000592:standards*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D015425:Myocardial Reperfusion; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic / Q000592:standards*; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D001241:Aspirin