Resultados Chilenos del registro internacional de factores de riesgo y tratamiento de angina inestable e infarto al miocardio sin supradesnivel del segmento ST: ACCORD (ACute CORonary syndrome Descriptive study)

• BENJAMÍN STOCKINS ^[5] ; FRANCISCO ALBORNOZ ^[6] ; DARÍO MARTÍNEZ ^[7] ; PABLA CAMPOS ^[8] ; JORGE GAJARDO ^[9] ; RUBÉN LAMICH ^[1] ; LEOPOLDO MANRÍQUEZ ^[10] ; VÍCTOR PÉREZ ^[2] ; PAMELA ROJO ^[11] ; PABLO SEPÚLVEDA ^[3] ; M. GABRIELA PUMARINO ^[12] ; RAMÓN CORBALÁN ^[4]
  1. [1] Hospital Barros Luco-Trudeau

     Hospital Barros Luco-Trudeau

     Santiago, Chile

     
  2. [2] Hospital del Salvador

     Hospital del Salvador

     Santiago, Chile

     
  3. [3] Hospital San Juan de Dios

     Hospital San Juan de Dios

     Santiago, Chile

     
  4. [4] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
  5. [5] Hospital Dr. Hernán Henríquez/Universidad de La Frontera
  6. [6] Hospital Higueras
  7. [7] Hospital San Borja-Arriarán
  8. [8] Hospital de Urgencias Posta Central
  9. [9] Sanatorio Alemán
  10. [10] Hospital Regional de Rancagua
  11. [11] Clínica Dávila
  12. [12] Sanofi-Aventis Chile

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 139, Nº. 1, 2011, págs. 19-26
• Idioma: español
• Títulos paralelos:
  • Chilean results of the international registry of risk factors and treatment of unstable angina and non ST elevation myocardial infarction: ACCORD (ACute CORonary syndrome Descriptive study)
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• Resumen

  • Background: Guidelines for the management of unstable angina (UA) and non ST elevation myocardial infarction (NSTEMI) have been issued, however cu-rrent practices are unknown in Chile. Aitn: To evalúate in a prospective cohort of NSTEMI patients the current practices, treatments and risk factors. Material and Methods: Oneyear prospective International non interventional registry, conducted in Chile between January 2005 and November 2006. Results: Two hundred thirty three Chilean NSTEMI patients were enrolled. Mortality was 5.5% at the end ofthe follow-up. Mean age was 61.6 years, and 30.6% were female. Most of the patients had at least one risk factor (98%): hypertension (84%), previous myocardial infarction (33%), dyslipidemia (54%), diabetes (33%), current smoking (30%). Main procedures duringthe hospitalization were coronary angiogram (67%), angioplasty (33%; 88% with stent) and coronary bypass surgery (7%). Duringprocedures, 31% of patients received clopidogrel, and 4.2% glycoprotein Ilb/IIIa antagonists. Medical management was selected for 60% of patients. In comparison to men, women received less interventional procedures despite havingmore risk factors. Treatments prescribed at discharge were aspirin (97%), clopidogrel (49%), beta blockers (78%), diuretics (21%), lipid lowering agents (78%), oral hypoglycemic agents (13%) and insulin (9%). At the end ofthe 1-year follow-up, treatments were aspirin (84%), beta blockers (72%), diuretics (19%), and dual antiplatelet therapy with clopidogrel (16%). Conclusions: A high prevalence of múltiple risk factors for cardiovascular disease in Chilean patients with NSTEMI was observed. More aggressive primary and secondary preventive measures are urgently needed. Use of therapies proposed in the guidelines is high, but dual antiplatelet therapy is less than 50% at discharge and decreases during the one year-follow-up.