Background
Primary angioplasty (PA) with placement of either bare metal or drug-eluting
stents (DES) represents the main strategy in the treatment of ST-elevation
myocardial infarction (STEMI). Diabetic patients, however, represent a
special population in STEMI, with high rates of restenosis and unfavorable
clinical outcomes, and with the use of DES, level of evidence A and
indication class II, being indicated to reduce these damages.
Objectives
To evaluate the DES rate of use in patients with STEMI and in the subgroup of
diabetics assisted in the public versus private health network in
Sergipe.
Methods
This is a population-based, cross-sectional study with a quantitative
approach using the data from the VICTIM Register. These were collected in
the only four hospitals with capacity to perform PA in Sergipe, from
December 2014 to March 2017.
Results
A total of 707 patients diagnosed with STEMI were evaluated, of which 589
were attended at SUS and 118 at the private network. The use of DES in PA
was lower in SUS compared to the private network in both the total sample
(10.5% vs 82.4%, p<0.001) and in subgroup diabetic patients (8.7% vs
90.6%, p < 0.001), respectively. In all hypotheses tested, the level of
significance was 5% (p < 0.05).
Conclusions
The study reveals a disparity in the use of DES during the performance of PA
between the public and private network, both in the total sample and the
subgroup for diabetics, with lower rates for SUS users, demonstrating the
challenges that need to be overcome in order to achieve quality improvements
of the services provided.