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You also need to first beat Act 3 with all 3 characters at least once.
There are some achievements for beating Act 4 (on any difficulty) as well as an unlock of the beta art for that character.
If you beat Act 3 with all three characters then the next time you play there will be opportunities to collect keys on your way up.
If you get all three keys in a run and beat Act 3, it takes you into Act 4. Act 4 only has two encounters: a very difficult elite fight followed immediately by the 'true' final boss. Beat that and you get the true ending and unlock the beta card art for that character (as well as the relevant achievement, e.g. Ruby+). Beat Act 4 with all characters and you get an additional achievement.
Trying to beat Act 4 is a bonus challenge on top of the normal win conditions. You still only need to beat Act 3 to unlock the next Ascension level so after you've done it once with a character it's really just an extra opportunity to test your deck.