National Registry of Acute Coronary Syndromes: results of the hospital phase in 2002.

The National Registry of Acute Coronary Syndromes (ACS) was designed to assess the situation in Portugal regarding the clinical profile, diagnostic and therapeutic management and medium-term prognosis of the entire clinical spectrum of ACS, as well as to evaluate compliance with clinical guidelines and to monitor temporal trends and the impact of actions implemented for its improvement. The National Registry of ACS is a continuous, observational and prospective clinical registry started on January 1, 2002, that includes 44 Departments of Cardiology distributed all over the country. During 2002, 7348 episodes were recorded. The mean age was 66 +/- 13 years and 69% were male. Admission diagnosis was ST-segment elevation acute myocardial infarction (STE-AMI) in 45.4%, non-ST-segment elevation acute myocardial infarction (NSTE-AMI) in 38.9% and unstable angina (UA) in 15.7% of the patients. Reperfusion therapy was performed in 60.5% of the STE-AMI cohort, mainly with fibrinolytic therapy (75% of patients undergoing reperfusion therapy). The great majority of the patients (99%) received oral antiplatelets during hospitalization and low molecular weight heparins were the preferred antithrombin therapy. The use of other drugs with a positive impact on prognosis, during hospital stay and on discharge respectively, was 68% and 67% for beta-blockers, 69% and 66% for ACE inhibitors and 74% and 79% for statins. The majority of patients (52%) underwent coronary angiography and coronary angioplasty was performed in 36% of patients with STE-AMI, 24% with NSTE-AMI and 29% with UA. In-hospital mortality was 10.2% in patients with STE-AMI, 5.6% with NSTE-AMI and 0.8% with UA. There was great variability in the rate of use of the main treatments among the participating centers. The results of the National Registry of ACS reveal that the overall diagnostic and therapeutic management of ACS in Portugal is similar to that observed in contemporary national and international clinical registries. Nevertheless, there is great variability among the participating centers.