Abstract 15766: Patient Profile, Treatment and Outcomes in Patients With Acute Coronary Syndrome: Preliminary Results From the Get With the Guidelines Mexico Project Initiative at the National Institute of Cardiology

Abstract

Introduction: Acute coronary syndromes represent the first cause of cardiovascular mortality. However, important heterogeneity exists in patient profile, access to treatment and outcomes, especially in developing countries. Hypothesis: Barriers to improve outcomes in patients with ACS may differ in developing countries. Individualized strategies may be needed to improve adoption of guideline recommendations. Aims: To describe baseline characteristics, treatments and outcomes in patients with ACS in Mexico. Methods: Prospective study including patients with ACS who were either transferred from eight referring hospitals or arrived directly at a referral center in Mexico City between October 2022-April 2023. The data was collected as part of the GWTG-Coronary Artery Disease Mexico Project, powered by the American Heart Association. Continuous variables are reported as mean±standard deviation (SD), or median and interquartile range (IQR), according to their distribution. Results: A total of 206 patients were included, 73.5% with STEMI and 26.5% with NSTEMI & UA. The mean age of the study population was 60 (54-69) years and 79.9% were male. The prevalence of diabetes was (56.8%), hypertension (41.6%) and smoking (62.5%). Median time from symptom onset to first medical contact was 8.4 (3.2-15.8) hours and 99.5% of patients arrived as walk-ins (mostly private vehicles). Among those transferred from a non-PCI center, 70% were transported by ambulance, 20% used private vehicles and 10% were transported by air. Amid STEMI patients, 86.6% received reperfusion during the first 12 hours since symptom onset: 36.4% primary PCI & 52.0% pharmacoinvasive strategy; in patients with NSTEMI/UA, 62% underwent PCI. Prescription of guideline recommended medications at discharge was high: high intensity statins (97.3%), beta-blockers (84.2%), ASA (96.3%), ACEI/ARB (93.1%). The overall hospital survival was 95.1%. Conclusions: In these preliminary results from the GWTG Mexico Project Initiative, we observed high reperfusion rates and a high prescription of guideline recommended therapies at discharge; however, important deficiencies exist in the pre-hospital setting. These results may influence future healthcare policies to reinforce prehospital care.