Angioplastia primária em pacientes do Sistema Único de Saúde e da Saúde Suplementar em Sergipe

Abstract

Background: Primary percutaneous coronary intervention (PCI) is the reperfusion therapy of choice for acute myocardial infarction (AMI) and its success depends on multiple factors related to the patient, performance of the intervention centers and the efficiency of health systems. Objectives: To compare the clinical characteristics and 30-day mortality of patients undergoing primary PCI between users of the Unified Health System (SUS) and the Supplementary Health (SH) . Methods: Observational study with consecutive inclusion of patients undergoing PCI primary and stratified according to the health system. Results: From January to December 2011, 179 patients underwent primary PCI, 129 (72 %) SUS users and 50 (28 %of SS. SUS patients were younger and smokers while the SS had a higher frequency of multivessel disease and dyslipidemia. SUS group, there was greater delay in arrival at the referral hospital (14.4 ± 7.8 hours vs . 9.9 ± 7.8 hours , p = 0.001) and an increase of 6 % in the unadjusted mortality 30 days, although no significant difference between groups ( 12.2% vs . 6.2%, p = 0.25) . In multivariate analysis, treatment by SUS, the value of the Syntax Score and Killip - Kimball class > 1 were independent factors associated with mortality. Conclusions: In Sergipe, the SUS underwent primary PCI arrived later at the referral hospital and had an increase of 6 % in mortality at 30 days. These findings suggest differences in the systems of health care.