Preditores clínicos e sociodemográficos da não reperfusão miocárdica de pacientes com IAMCSST em Sergipe

Abstract

Background: Myocardial reperfusion therapy is a central concern in Acute Myocardial Infarction with ST Segment Elevation (STEMI). In Sergipe, prior reports suggest the underuse of reperfusion therapy and the existence of access disparity between patients treated in the public and in the private health services. However, it’s not established which are the independent predictors of no-reperfusion in patients with STEMI. Objective: To identify clinical and sociodemographic predictors of not receiving reperfusion therapy in STEMI in Sergipe. Methods: This study is a subanalysis of VICTIM study involving 460 patients with STEMI who presented to four hospitals equipped to perform percutaneous coronary intervention (PCI) in Sergipe, between December 2014 and April 2016. Logistic regression was used to fit odds ratios, in order to determine the predictors of no-myocardial reperfusion. Results: In this analysis, the predictors of no-reperfusion included: (a) presentation to one [OR 6.06 (2.99 to 13.68); p <0.001] or more than one [OR 27.73 (11.73 to 72.33), p <0.001] institution before PCI-hospital; (B) history of angina pectoris [OR 1.75 (1.07 to 2.89); p = 0.030] and (c) previous heart failure [OR 2.66 (1.01 to 7.63); p = 0.041]. Additionally, less than half (48%) of the patients in the study underwent reperfusion therapies. Conclusion: The study findings may guide interventions in STEMI therapy strategies, in order to decrease morbimortality.