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Abstract
There is limited contemporary prospective real-world evidence of patients with chronic arterial disease in Latin America. The Network to control atherothrombosis (NEAT) registry is a national prospective observational study of patients with known coronary (CAD) and/or peripheral arterial disease (PAD) in Brazil. A total of 2,005 patients were enrolled among 25 sites from September 2020 to March 2022. Patient characteristics, medications and laboratorial data were collected. Primary objective was to assess the proportion of patients who, at the initial visit, were in accordance with good medical practices (domains) for reducing cardiovascular risk in atherothrombotic disease. From the total of patients enrolled, 2 were excluded since they did not meet eligibility criteria. Among the 2,003 subjects included in the analysis, 55.6% had isolated CAD, 28.7% exclusive PAD and 15.7% had both diagnoses. Overall mean age was 66.3 (± 10.5) years and 65.7% were male patients. Regarding evidence-based therapies (EBTs), 4% were not using any antithrombotic drug and only 1.5% were using vascular dose of rivaroxaban (2.5 mg bid). Only 0.3% of the patients satisfied all the domains of secondary prevention, including prescription of EBTs and targets of body-mass index, blood pressure, LDL-cholesterol, and adherence of lifestyle recommendations. The main barrier for prescription of EBTs was medical judgement. Our findings highlight that the contemporary practice does not reflect a comprehensive approach for secondary prevention and had very low incorporation of new therapies in Brazil. Large-scale populational interventions addressing these gaps are warranted to improve the use of evidence-based therapies and reduce the burden of atherothrombotic disease.
ClinicalTrials.gov NCT04677725
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Details
1 HCor Research Institute, São Paulo, Brazil (GRID:grid.477370.0) (ISNI:0000 0004 0454 243X); Brazilian Clinical Research Institute, São Paulo, Brazil (GRID:grid.477370.0); Hospital Samaritano Paulista, São Paulo, Brazil (GRID:grid.459658.3) (ISNI:0000 0004 0414 1038); Centro Universitário São Camilo, São Paulo, Brazil (GRID:grid.411378.8) (ISNI:0000 0000 9975 5366)
2 Hospital Regional de Presidente Prudente, São Paulo, Brazil (GRID:grid.490174.f)
3 Procape - Pronto Socorro Cardiológico de Pernambuco - Universidade de Pernambuco, Recife, Brazil (GRID:grid.26141.30) (ISNI:0000 0000 9011 5442)
4 Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil (GRID:grid.419029.7) (ISNI:0000 0004 0615 5265)
5 Hospital de Base de São José do Rio Preto, São Paulo, Brazil (GRID:grid.26141.30)
6 Clínica Procardio e Hospital Santa Isabel e Universidade Regional de Blumenau, Santa Catarina, Brazil (GRID:grid.412404.7) (ISNI:0000 0000 9143 5704)
7 Hospital Ana Nery, Bahia, Brazil (GRID:grid.490103.f) (ISNI:0000 0004 6005 1459)
8 Hospital Santa Lúcia - Hospital do Coração de Poços de Caldas, Minas Gerais, Brazil (GRID:grid.477370.0) (ISNI:0000 0004 0454 243X)
9 Sociedade Hospitalar Angelina Caron - Campina Grande do Sul, Campina Grande Do Sul, Brazil (GRID:grid.477370.0)
10 HCor Research Institute, São Paulo, Brazil (GRID:grid.477370.0) (ISNI:0000 0004 0454 243X)
11 InCor HCFMUSP, São Paulo, Brazil (GRID:grid.477370.0)
12 Clínica Cardioped, Espirito Santo, Brazil (GRID:grid.477370.0)
13 Hospital Albert Einstein, São Paulo, Brazil (GRID:grid.413562.7) (ISNI:0000 0001 0385 1941); Hospital Samaritano Paulista São Paulo, São Paulo, Brazil (GRID:grid.459658.3) (ISNI:0000 0004 0414 1038)
14 Universidade Federal de São Paulo, São Paulo, Brazil (GRID:grid.411249.b) (ISNI:0000 0001 0514 7202)
15 Instituto Atena de Pesquisa Clínica, Rio Grande Do Norte, Brazil (GRID:grid.411249.b)
16 InCor HCFMUSP, São Paulo, Brazil (GRID:grid.411249.b)
17 Centro de Especialidades de Valinhos II, São Paulo, Brazil (GRID:grid.411249.b)
18 Universidade Federal Do Maranhão, São Luiz, Brazil (GRID:grid.411204.2) (ISNI:0000 0001 2165 7632)
19 Universidade Federal Do Acre, Acre, Brazil (GRID:grid.412369.b) (ISNI:0000 0000 9887 315X); Centro de Pesquisa Clínica Silvestre Santé, Acre, Brazil (GRID:grid.412369.b)
20 Santa Casa de São Paulo, São Paulo, Brazil (GRID:grid.419014.9) (ISNI:0000 0004 0576 9812)
21 Hospital E Clínica São Roque, Bahia, Brazil (GRID:grid.419014.9)
22 Santa Casa de São Paulo, São Paulo, Brazil (GRID:grid.419014.9) (ISNI:0000 0004 0576 9812); Loyola University, Chicago, USA (GRID:grid.164971.c) (ISNI:0000 0001 1089 6558)
23 Brazilian Clinical Research Institute, São Paulo, Brazil (GRID:grid.164971.c); Duke University Medical Center, Durham, USA (GRID:grid.189509.c) (ISNI:0000 0001 0024 1216)
24 Hospital Universitário Cajuru da PUCPR, Paraná, Brazil (GRID:grid.512591.b) (ISNI:0000 0004 6005 2793)
25 Instituto D’or de Pesquisa e Ensino, Hospital Cardio Pulmonar, Bahia, Brazil (GRID:grid.472984.4)
26 Hospital do Rim, São Paulo, Brazil (GRID:grid.456661.6) (ISNI:0000 0004 0615 6153)
27 DASA Santa Paula, São Paulo, Brazil (GRID:grid.456661.6)
28 Hospital 9 de Julho, São Paulo, Brazil (GRID:grid.517844.b) (ISNI:0000 0004 0509 8924)
29 Clínica Campo Grande, Campo Grande, Brazil (GRID:grid.517844.b)