National registry of non-ST-segment elevation acute coronary syndromes in the Argentine Republic (RENASCA.AR)

Abstract

Introduction: cardiovascular diseases represent the leading cause of mortality and hospitalization worldwide. Among them, non-ST-segment elevation acute coronary syndromes are a common manifestation. In Argentina, disparities in access to specialized services hinder a uniform approach to this condition. Objective: the RENASCA.AR registry aimed to characterize the clinical, therapeutic, and evolutionary profile of patients with NSTEACS across different levels of healthcare in the country. Methods: a prospective, multicenter study was conducted, including 679 patients hospitalized in 31 centers between November 2022 and December 2024. Results: the mean age was 63 years, and 27.1% were women. The most frequent clinical presentation was NSTEMI (65%), followed by unstable angina (25%) and MINOCA (10%). Coronary angiography was performed in 90% of patients, with a median time to procedure of 22 hours. The overall rate of percutaneous coronary intervention (PCI) was 67%, significantly higher in men than in women (67% vs. 45%; p<0.001). In-hospital mortality was 1.4%, and the composite event rate (death and/or decompensated heart failure) was 11.1%, with a higher prevalence in women than men (15.2% vs 9.6%; p<0.04). Conclusions: RENASCA.AR revealed a high use of invasive strategies and low overall mortality, although with significant sex-related differences. This registry provides key insights into the current management of NSTE-ACS in Argentina and highlights the need to improve access and equity in cardiovascular care.