Introduction
The coronavirus disease 2019 (COVID‐19) pandemic has been a worldwide challenge, and efforts to “flatten the curve,” including restrictions imposed by policymakers and medical societies, have forced a reduction in the number of procedures performed in the Brazilian Health Care System. The aim of this study is to evaluate the outcomes of coronary artery bypass graft (CABG) from 2008 to 2020 in the SUS and to assess the impacts of the COVID‐19 pandemic in the number of procedures and death rate of CABG performed in 2020 through the database DATASUS.
Methods
This study is based on publicly available material obtained from DATASUS, the Brazilian Ministry of Health's data processing system, on numbers of surgical procedures and death rates. Only isolated CABG procedures were included in our study. We used the TabNet software from the DATASUS website to generate reports.
Results
We identified 281,760 CABG procedures performed from January 2008 to December 2020. The average number of procedures until the end of 2019 was of 22,104. During 2020 there was a 25% reduction CABG procedures, to 16,501. There was an increase in the national death rate caused by a statistical significant increase in death rates in Brazil's Southeast and Central‐west regions.
Conclusion
The COVID‐19 pandemic remains a global challenge for Brazil's health care system. During the year of 2020 there was a reduction in access to CABG related to an increase in the number of COVID‐19 cases. There was also an increase in the national CABG death rate.
Background
Brazil is an upper middle‐income country in South America with the world's sixth largest population. Despite great advances in health‐care services and cardiac surgical care in both its public and private health systems, little is known on the volume, outcomes, and trends of coronary artery bypass grafting (CABG) in Brazil's public health system.
Objective
The aim of this study was to evaluate the outcome of CABG on the public health system from January 2008 to December 2017 through the database DATASUS.
Methods
This study is based on publicly available material obtained from DATASUS, the Brazilian Ministry of Health's data processing system, on numbers of surgical procedures, death rates, length of stay, and costs. Only isolated CABG procedures were included in our study. We used the TabNet software from the DATASUS website to generate reports. The χ2 test was used to compare death rates. A p < .05 was considered statistically significant.
Results
We identified 226,697 CABG procedures performed from January 2008 to December 2017. The overall in‐hospital mortality over the 10‐year period was 5.7%. We observed statistically significant differences in death rates between the five Brazilian macro‐regions. Death rates by state ranged from 2.6% to 13.1%. The national average mortality rate remained stable over the course of time.
Conclusion
Over 10 years, a high volume of CABG was performed in the Brazilian Public Health System, with significant differences in mortality, number of procedures, and distribution of surgeries by region. Future databases involving all centers that perform CABG and carry out risk‐adjusted analysis will help improve Brazilian results and enable policymakers to adopt appropriate health‐care policies for greater transparency and accountability.
Increased understanding about the mechanisms of coronary thrombosis in humans has been limited by the lack of imaging modalities with resolution sufficient to characterize fibrous cap tissue and determine its thickness in vivo. Intravascular optical coherence tomography (IOCT) provides images with micrometer axial (10-15µm) and lateral resolution (40µm), enabling detailed visualization of micro-structural changes of the arterial wall. This article describes a fully automated method for identification and quantification of fibrous tissue in IOCT human coronary images based on spatial-frequency analysis by means Short-Time Fourier transform. Forty IOCT frames from nine IOCT in-vivo datasets were annotated by an expert and used to evaluate the proposed fibrous tissue characterization method.
Background: Brazil is an upper-middle-income country in South America
with the world’s sixth largest population. Little is known on the
volume, outcomes and trends of coronary artery bypass grafting (CABG) in
Brazil’s public health system. Objective: The aim of this study was to
evaluate the outcome of CABG in the public health system in from January
2008 to December 2017 through the database DATASUS. Methods: This study
is based on publicly available material obtained from DATASUS, the
Brazilian Ministry of Health’s data processing system, on numbers of
surgical procedures, death rates, length of stay, and costs. Only
isolated CABG procedures were included in our study. We used the TabNet
software from the DATASUS website to generate reports. Chi-square test
was used to compare death rates. A p-value of <0.05 was
considered statistically significant. Results: We identified 226,697
CABG procedures performed from January 2008 to December 2017. The
overall in-hospital mortality over the 10-year period was 5.7%. We
observed statistically significant differences in death rates between
the five Brazilian macro regions. Death rates by state ranged from 2.6%
to 13.1%. The national average mortality rate remained stable over the
course of time. Conclusion: Over 10 years, a high volume of CABG was
performed in the Brazilian Public Health System with significant
differences in mortality, number of procedures, and distribution of
surgeries by region. Future databases involving all centers that perform
CABG and carry out risk-adjusted analysis will help improve Brazilian
results, and enable policymakers to adopt appropriate health care
policies for greater transparency and accountability.
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous group of conditions that include both atherosclerotic (coronary plaque disruption) and non-atherosclerotic (spontaneous coronary artery dissection, coronary artery spasm, coronary artery embolism, coronary microvascular dysfunction, and supply–demand mismatch) causes resulting in myocardial damage that is not due to obstructive coronary artery disease. Failure to identify the underlying cause may result in inadequate and inappropriate therapy in these patients. The cornerstone of managing MINOCA patients is to identify the underlying mechanism to achieve the target treatment. Intravascular imaging is able to identify different morphologic features of coronary plaques, while cardiac magnetic resonance is the gold standard for detection of myocardial infarction in the setting of MINOCA. In this review, we summarize the relevant clinical issues, contemporary diagnosis, and treatment options of MINOCA.
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