[Acute coronary syndromes in Latin America: lessons from the ACCESS registry].
BACKGROUND
Evidence of the clinical characteristics, treatment and outcomes among Latin American (LA) patients with acute coronary syndromes (ACS) is scarce.


METHODS
ACCESS, international prospective multicenter registry to evaluate risk stratification, management and outcomes in ACS (unstable angina or non-ST elevation myocardial infarction [UA/NSTEMI] or ST elevation myocardial infarction [STEMI]) in developing countries. Primary endpoint: all-cause death at 1 year; all-cause mortality within 30 days was also recorded, Patients with acute ischemic symptoms within 24 hours of symptoms onset and electrocardiographic evidence of ischemia were enrolled. Coronary artery disease was proved by positive invasive or non-invasive tests.


RESULTS
Between 2007 and 2008, 4436 patients with ACS (2562 UA/NSTEMI and 2374 STEMI) from eight LA countries. On admission, acute symptoms were identified in 79 % and 90%, respectively. Both groups had a long delay from symptom onset to hospital arrival. Low access to pharmacological (29%) and mechanical reperfusion (32%) were observed. At admission, rates of evidence-based treatment were low in all groups. The most common in-hospital complications were heart failure (10% UA/NSTEMI and 20% STEMI) and recurrent ischemia (8% and 11%). Mortality at 30 days was 2% and 8% at 1 year.


CONCLUSIONS
ACCESS registry provides contemporary information of patients with ACS in LA and their hospital management and subsequent clinical outcomes.
Servicio de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología "Ignacio Chávez", Ciudad de México, México. jerjes@prodigy.net.mx.
Carlos
C
Martínez-Sánchez
Carlos
C
Jerjes-Sánchez
José Carlos
JC
Nicolau
Oscar
O
Bazzino
Norka
N
Antepara
Ricardo
R
Mármol
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D000328:Adult; D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007843:Latin America / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries
Acute coronary syndrome; Ischemic heart disease; Myocardial infarction; Unstable angina