Cargando…
Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register
BACKGROUND: There is a scarcity of knowledge as to whether rates of myocardial reperfusion use and 30‐day mortality for patients with ST‐segment–elevation myocardial infarction are similar among patients using the Brazilian Public Health System (SUS) and those using the private healthcare system. ME...
Autores principales: | , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6818046/ https://www.ncbi.nlm.nih.gov/pubmed/31581873 http://dx.doi.org/10.1161/JAHA.119.013057 |
_version_ | 1783463552317652992 |
---|---|
author | Oliveira, Jussiely Cunha Almeida‐Santos, Marcos Antonio Cunha‐Oliveira, Jeferson Oliveira, Laís Costa Souza de Carvalho Barreto, Ikaro Daniel Clair RemacreMunareto Lima, Ticiane Andreline Maia Arcelino, Larissa Andrade Prado, Luís Flávio Serra Silveira, Fábio Augusto da Silva Nascimento, Thiago Pereira Ferreira, Eduardo José Vasconcelos Barreto, Rafael Vieira Moraes, Enilson Teles de Mendonça, José Sousa, Antonio Carlos Sobral Barreto‐Filho, José Augusto |
author_facet | Oliveira, Jussiely Cunha Almeida‐Santos, Marcos Antonio Cunha‐Oliveira, Jeferson Oliveira, Laís Costa Souza de Carvalho Barreto, Ikaro Daniel Clair RemacreMunareto Lima, Ticiane Andreline Maia Arcelino, Larissa Andrade Prado, Luís Flávio Serra Silveira, Fábio Augusto da Silva Nascimento, Thiago Pereira Ferreira, Eduardo José Vasconcelos Barreto, Rafael Vieira Moraes, Enilson Teles de Mendonça, José Sousa, Antonio Carlos Sobral Barreto‐Filho, José Augusto |
author_sort | Oliveira, Jussiely Cunha |
collection | PubMed |
description | BACKGROUND: There is a scarcity of knowledge as to whether rates of myocardial reperfusion use and 30‐day mortality for patients with ST‐segment–elevation myocardial infarction are similar among patients using the Brazilian Public Health System (SUS) and those using the private healthcare system. METHODS AND RESULTS: A total of 707 patients were analyzed using the VICTIM (Via Crucis for the Treatment of Myocardial Infarction) register database; 589 patients from the SUS and 118 from the private network with ST‐segment–elevation myocardial infarction, who attended hospitals with the capacity to perform primary percutaneous coronary intervention (PCI) were investigated. The timeline, rates of use of PCI, and the 30‐day probability of death were investigated, comparing the SUS patients to those in the private system. The mean time between symptom onset and arrival at the PCI hospital was higher for SUS patients compared with users of the private system (25.4±36.5 versus 9.0±21 hours; P<0.001, respectively). Rates of primary PCI were low in both groups, but significantly lower for the SUS patients (45% versus 78%; P<0.001). The 30‐day mortality rate of SUS patients was 11.9% and of private patients was 5.9% (P=0.04). In the fully adjusted model, the odds ratio for 30‐day mortality for the SUS patients was higher (odds ratio, 2.96; 95% CI, 1.15–7.61; P=0.02). CONCLUSIONS: The delay in reaching a PCI hospital was almost 3 times higher for the SUS patients. Primary PCI was underused in both groups, especially in the SUS patients. The SUS patients were more likely to die during the 30‐day follow‐up. |
format | Online Article Text |
id | pubmed-6818046 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-68180462019-11-04 Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register Oliveira, Jussiely Cunha Almeida‐Santos, Marcos Antonio Cunha‐Oliveira, Jeferson Oliveira, Laís Costa Souza de Carvalho Barreto, Ikaro Daniel Clair RemacreMunareto Lima, Ticiane Andreline Maia Arcelino, Larissa Andrade Prado, Luís Flávio Serra Silveira, Fábio Augusto da Silva Nascimento, Thiago Pereira Ferreira, Eduardo José Vasconcelos Barreto, Rafael Vieira Moraes, Enilson Teles de Mendonça, José Sousa, Antonio Carlos Sobral Barreto‐Filho, José Augusto J Am Heart Assoc Original Research BACKGROUND: There is a scarcity of knowledge as to whether rates of myocardial reperfusion use and 30‐day mortality for patients with ST‐segment–elevation myocardial infarction are similar among patients using the Brazilian Public Health System (SUS) and those using the private healthcare system. METHODS AND RESULTS: A total of 707 patients were analyzed using the VICTIM (Via Crucis for the Treatment of Myocardial Infarction) register database; 589 patients from the SUS and 118 from the private network with ST‐segment–elevation myocardial infarction, who attended hospitals with the capacity to perform primary percutaneous coronary intervention (PCI) were investigated. The timeline, rates of use of PCI, and the 30‐day probability of death were investigated, comparing the SUS patients to those in the private system. The mean time between symptom onset and arrival at the PCI hospital was higher for SUS patients compared with users of the private system (25.4±36.5 versus 9.0±21 hours; P<0.001, respectively). Rates of primary PCI were low in both groups, but significantly lower for the SUS patients (45% versus 78%; P<0.001). The 30‐day mortality rate of SUS patients was 11.9% and of private patients was 5.9% (P=0.04). In the fully adjusted model, the odds ratio for 30‐day mortality for the SUS patients was higher (odds ratio, 2.96; 95% CI, 1.15–7.61; P=0.02). CONCLUSIONS: The delay in reaching a PCI hospital was almost 3 times higher for the SUS patients. Primary PCI was underused in both groups, especially in the SUS patients. The SUS patients were more likely to die during the 30‐day follow‐up. John Wiley and Sons Inc. 2019-10-04 /pmc/articles/PMC6818046/ /pubmed/31581873 http://dx.doi.org/10.1161/JAHA.119.013057 Text en © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Oliveira, Jussiely Cunha Almeida‐Santos, Marcos Antonio Cunha‐Oliveira, Jeferson Oliveira, Laís Costa Souza de Carvalho Barreto, Ikaro Daniel Clair RemacreMunareto Lima, Ticiane Andreline Maia Arcelino, Larissa Andrade Prado, Luís Flávio Serra Silveira, Fábio Augusto da Silva Nascimento, Thiago Pereira Ferreira, Eduardo José Vasconcelos Barreto, Rafael Vieira Moraes, Enilson Teles de Mendonça, José Sousa, Antonio Carlos Sobral Barreto‐Filho, José Augusto Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register |
title | Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register |
title_full | Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register |
title_fullStr | Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register |
title_full_unstemmed | Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register |
title_short | Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register |
title_sort | disparities in access and mortality of patients with st‐segment–elevation myocardial infarction using the brazilian public healthcare system: victim register |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6818046/ https://www.ncbi.nlm.nih.gov/pubmed/31581873 http://dx.doi.org/10.1161/JAHA.119.013057 |
work_keys_str_mv | AT oliveirajussielycunha disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT almeidasantosmarcosantonio disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT cunhaoliveirajeferson disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT oliveiralaiscostasouza disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT decarvalhobarretoikarodaniel disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT clairremacremunaretolimaticiane disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT andrelinemaiaarcelinolarissa disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT andradepradoluisflavio disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT serrasilveirafabio disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT augustodasilvanascimentothiago disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT pereiraferreiraeduardojose disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT vasconcelosbarretorafael disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT vieiramoraesenilson disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT telesdemendoncajose disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT sousaantoniocarlossobral disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT barretofilhojoseaugusto disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister AT disparitiesinaccessandmortalityofpatientswithstsegmentelevationmyocardialinfarctionusingthebrazilianpublichealthcaresystemvictimregister |