Síndrome Coronariana Aguda: morbimortalidade e prática clínica em pacientes do município de Niterói (RJ) Acute Coronary Syndromes: morbidity / mortality and clinical practice in patients of Niterói, Rio de Janeiro State, Brazil

Background: Cardiovascular diseases are the major cause of death in Brazil. Objective: To evaluate epidemiological and clinical characteristics, diagnostic and therapeutic procedures and in-hospital morbidity and mortality rates for patients with acute coronary syndromes (ACS) in the Niterói Municipality, Rio de Janeiro State, Brazil. Methods: 411 patients with ACS admitted to three public and two private hospitals were monitored throughout their stays in hospital. Data collected: social and economic status, previous medical history, cardiovascular risk factors, previous medications, supplementary examinations, procedures in-hospital management and treatment and clinical outcomes. Results: Unstable angina was diagnosed in 41.4% and acute myocardial infarction (AMI) in 58.6%. Age ≥60 years was present in 55% and male gender in 63.7%. The more prevalent risk factors were: physical inactivity (87.3%), hypertension (87.1%), dyslipidemia (85.6%), smoking (68.3% current and former), body mass index above normal (56.9%). Previous myocardial infarction was present in 29.9%. Coronary arteriography and revascularization procedures were more frequent in private hospitals. In AMI with ST segment elevation 33.8% of the patients received thrombolytic therapy and 14.2% primary angioplasty. The mortality rate was higher in AMI than for unstable angina. There was no significant difference in mortality among public and private hospitals. The mortality rate for women was higher than for men, but of borderline statistical significance. Conclusion: We found high prevalence of risk factors and high mortality in our study, with low use of thrombolytic therapy. Wider use of invasive procedures