ABC | Volume 111, Nº4, Octuber 2018

Original Article de Souza e Silva et al Percutaneous coronary intervention in the State of Rio de Janeiro Arq Bras Cardiol. 2018; 111(4):553-561 Table 1 – Suvival proprabilities of patients submitted to a single percutaneous coronary intervention in the state of Rio de Janeiro paid by SUS between 1999-2010 according to age group and sex Follow-up 20-49 years old 50-69 years old ≥70 years old Men Women Men Women Men Women (n = 1,987) (n = 917) (n = 7,819) (n = 4,224) (n = 2,435) (n = 1,881) [% (95%Cl)] [% (95%Cl)] [% (95%Cl)] [% (95%Cl)] [% (95%Cl)] [% (95%Cl)] 1 day 98.9 (98.3–99.3) 98.6 (97.6–99.2) 98.5 (98.2–98.8) 98.5 (98.1–98.9) 96.8 (96.0–97.4) 96.4 (95.4–97.1) 30 days 98.2 (97.5–98.7) 98.0 (96.9–98.8) 97.7 (97.3–98.0) 97.7 (97.2–98.1) 95.3 (94.4–96.1) 95.2 (94.1–96.0) 180 days 97.1 (96.3–97.8) 95.8 (94.2–96.9) 96.1 (95.7–96.5) 96.1 (95.5–96.6) 91.2 (90.0–92.3) 91.1 (89.7–92.3) 1 year 96.2 (95.3–97.0) 95.0 (93.4–96.2) 94.5 (94.0–95.0) 94.7 (94.0–95.4) 88.7 (87.3–89.9) 89.6 (88.2–90.9) 2 years 94.4 (93.3–95.3) 93.2 (91.4–94.7) 92.3 (91.6–92.8) 92.7 (91.9–93.5) 83.0 (81.5–84.4) 86.2 (84.6–87.7) 3 years 92.9 (91.7–94.0) 91.7 (89.7–93.3) 89.7 (89.0–90.3) 90.7 (89.8–91.6) 77.7 (76.0–79.3) 82.6 (80.8–84.3) 4 years 91.1 (89.8–92.3) 90.1 (88.0–91.8) 87.4 (86.6–88.1) 88.4 (87.4–89.4) 73.7 (71.9–75.4) 79.2 (77.3–80.9) 5 years 89.4 (87.9–90.7) 88.4 (86.2–90.3) 84.9 (84.0–85.6) 85.9 (84.8–86.9) 69.5 (67.7–71.3) 75.8 (73.8–77.7) 6 years 87.8 (86.2–89.2) 86.7 (84.2–88.8) 82.4 (81.5–83.2) 83.5 (82.3–84.6) 64.1 (62.1–66.0) 71.9 (69.8–74.0) 7 years 85.7 (84.0–87.2) 84.9 (82.3–87.1) 79.9 (79.0–80.9) 81.4 (80.2–82.6) 59.9 (57.8–62.0) 68.5 (66.2–70.7) 8 years 83.5 (81.6–85.1) 82.8 (79.9–85.2) 76.7 (75.6–77.7) 79.4 (78.0–80.7) 55.5 (53.2–57.6) 65.4 (63.0–67.7) 9 years 81.9 (80.0–83.7) 81.7 (78.7–84.2) 73.7 (72.5–74.8) 77.4 (76.0–78.8) 51.6 (49.3–53.9) 61.8 (59.3–64.3) 10 years 79.3 (77.1–81.3) 79.3 (76.1–82.1) 70.6 (69.3–71.8) 74.6 (73.0–76.1) 47.9 (45.5–50.3) 55.8 (53.0–58.5) 11 years 77.5 (75.2–79.6) 78.2 (74.9–81.2) 67.8 (66.4–69.1) 71.8 (70.0–73.5) 44.3 (41.8–46.8) 51.8 (48.9–54.7) 12 years 75.9 (73.4–78.1) 77.3 (73.9–80.4) 64.7 (63.1–66.1) 68.8 (66.9–70.7) 42.3 (39.6–44.9) 47.9 (44.7–51.0) 13 years 73.8 (71.1–76.3) 75.5 (71.7–78.9) 61.4 (59.7–63.1) 66.5 (64.3–68.6) 39.1 (39.6–42.0) 45.8 (42.4–49.0) 14 years 71.4 (68.2–74.4) 73.2 (68.6–77.3) 59.7 (57.8–61.6) 64.2 (61.7–66.6) 35.6 (32.3–39.0) 44.6 (41.1–48.0) 15 years 69.6 (65.8–73.1) 72.3 (67.3–76.7) 57.7 (55.4–60.0) 61.9 (58.9–64.9) 35.6 (32.3–39.0) 42.0 (37.5–46.4) CI: confidence interval; SUS: Sistema Único de Saúde - Brazilian Public Healthcare System probability of survival (Table 1). In the oldest age group men tended to have higher probability of survival, up to 180 days, after which that tendency would also reverse (Table 1). Figures 1 and 2 show Kaplan-Meier curves and estimates of survival according to sex and age group in one-year and 15-year follow-up, respectively. Table 2 shows Cox proportional hazards risks and 95% CI referring to age group and sex. Concerning the type of PCI, patients who underwent PCI-P, PCI-WS and PCI-S were aged 61 ± 11, 60 ± 11, and 61 ± 10 years old, respectively (p < 0.05). A total of 175, 2,652 and 2,606 deaths occurred among patients submitted to PCI-P, PCI-WS, and PCI-S, respectively. Short-, medium- and long-term probabilities of survival for PCI-WS (n = 6,967) were 96.9% (96.5-97.3%), 93.4% (92.7-93.9%) and 68.6% (67.4-69.6%), respectively; for PCI-S (n = 11,600) were 97.8% (97.5-98.1%), 94.2% (93.7‑94.6%) and 68.4% (67.0‑69.7%), respectively; and for PCI-P (n = 696) were 89.8% (87.3-91.8%), 85.2% (82.3‑87.6%) and 59.7% (49.8‑68.2%), respectively. As PCI-S and PCI-P started to be paid by SUS in 2000 and 2004, respectively, long‑term survival for the three procedures were measured in a 10‑year follow‑up for comparison purposes. Figure 3 shows Kaplan‑Meier curves and estimates of survival and Table 2 presents Cox proportional hazards risks and 95% CI according to the type of PCI. In short- and medium-term follow-up, patients submitted to PCI-S had higher probability of survival than those submitted to PCI-WS, but after 2 years of follow-up their probabilities of survival became similar (HR 0.91, 95% CI 0.82-1.00, p = 0.062). IHD was considered the underlying cause of death of 66.7%, 44.1% and 26.9% of the deaths that occured within 30 days, one year and 15 years after hospital discharge, respectively. During the entire follow-up period, PCI-P had the higher percentage of deaths due to IHD (49.1%) compared to PCI-WS (25.9%) and PCI-S (26.4%), p < 0.05. Discussion This study has led to some important findings: 1) women tended to have slightly lower short- andmedium-termprobability of survival, but better long-term survival rates; 2) older patients had lower probabilities of survival; 3) differences in probability of survival changed slightly over time when PCI-P was compared to PCI with and without stent placement because the difference in the probability of survival was concentrated in the immediate period after the procedure; 4) although short- andmedium-term survival rates were higher for patients submitted to PCI-S than for those submitted to PCI-WS, no difference was observed in the long-term survival rates between them; 5) the probabilities of survival observed were lower than those observed in RCTs. 555