ABC | Volume 112, Nº5, May 2019

Original Article Oliveira et al Stents for diabetic patients – VICTIM Register Arq Bras Cardiol. 2019; 112(5):564-570 Table 2 – Pathological background of STEMI patients attended at Sergipe State Hospitals with capacity to undergo primary angioplasty (SUS x Private care) Pathological background SUS (n = 589) Private network (n = 118) p value Cardiovascular risk factors, n (%) Hypertension 358 (39.2) 84 (71.2) 0.033 Diabetes 199 (33.8) 42 (35.6) 0.705 Dyslipidemia 214 (36.3) 66 (55.9) < 0.001 Smoking 200 (34.0) 11 (9.3) < 0.001 Number of risk factors, n (%) 0 75 (12.7) 14 (11.9) 0.534 1 191 (32.5) 31 (26.2) 2 207 (35.1) 48 (40.7) ≥ 3 116 (19.7) 25 (21.2) Previous coronary disease, n (%) AMI 42 (7.1) 19 (16.1) 0.002 Angina pectoris 94 (84.0) 22 (18.6) 0.472 Previous Angioplasty 29 (4.9) 12 (10.2) 0.026 Revascularization Previous 5 (0.8) 6 (5.1) 0.001 Family history of early CAD, n (%) 173 (29.4) 52 (44.1) 0.002 Stroke previous, n (%) 41 (7.0) 7 (5.9) 0.685 Peripheral vascular disease, n (%) 31 (5.3) 18 (15.3) < 0.001 AMI: acute myocardial infarction; CAD: coronary artery disease. stent in 90.6% of this subgroup of patients (p < 0.001) (Table 4). The mean and standard deviation of the port-balloon time of diabetics seen at SUS versus the private system were 114 (± 91) and 133 (± 67), respectively (p = 0.26). Discussion A disparity between the public and private services regarding the performance of PA and the use of DES for patients with STEMI, especially for diabetics, is observed. It is also worth noting a remarkable overuse of bare metal stents with higher utility rates for the public service, which is in disagreement with the guidelines recommendations. 1,3 The value found for performing PA at the Unified Health System (SUS) was below the expected average in relation to procedures performed in the North-Northeast (52.5%), according to a study by Nicolau et al. in 2012. 8 Primary PCI with the use of stents is considered the gold standard in the treatment of STEMI, 1,2 and these findings reflect the underuse of this therapy at SUS, which may directly contribute to these patients’ prognosis. Table 3 – Percutaneous coronary angioplasty and use of stents in STEMI patients attended in tertiary Hospitals in the State of Sergipe (SUS x Private network) Coronary angioplasty SUS (n = 589) Private network (n = 118) p value Door-to-balloon time, min 121.2 ± 107.1 129.8 ± 90.2 0.48 Primary Angioplasty, n (%) 267 (45.3) 94 (79.7) < 0.001 Type of stent used, n (%) Bare metal 229 (89.5) 16 (17.6) < 0.001 Drug-eluting 27 (10.5) 75 (82.4) Non-Primary Angioplasty, n (%) 193 (32.8) 21 (17.8) 0.001 Type of stent used, n (%) Bare metal 166 (90.7) 3 (14.3) < 0.001 Drug-eluting 17 (9.3) 18 (85.7) 567