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 1. Piegas LS, Timerman A, Feitosa GS, Nicolau JC, Mattos LAP, Andrade MD, et al. VDiretriz da Sociedade Brasileira de Cardiologia sobre Tratamento do Infarto Agudo do Miocárdio com Supradesnível do Segmento ST. Arq Bras Cardiol. 2015;105(2):1-105. 2. StegPG, JamesSK,AtarD,BadanoLP,Blömstrom-LundqvistC,BorgerMA,et al. Task Force on themanagement of ST-segment elevation acutemyocardial infarction of the European Society of Cardiology (ESC). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33(20):2569-619. 3. Lima VC, Mattos LA, Caramori PR, Perin MA, Mangione JA, Machado BM, et al. Consenso de especialistas (SBC/SBHCI) sobre o uso de stents farmacológicos: recomendações da sociedade brasileira de cardiologia/ sociedade brasileira de hemodinâmica e cardiologia intervencionista ao sistema único de saúde. Arq Bras Cardiol. 2006;87(4):e162–7. 4. Yang TH, Park SW, Hong MK, Park DW, Park KM, Kim YH, et al. Impact of diabetes mellitus on angiographic and clinical outcomes in the drug-eluting stents era. Am J Cardiol. 2005;96(10):1389-92. 5. Moreira AC, Sousa AG, Costa JJ, Costa AR, Maldonado GA, Cano MN, et al. Evolução tardia após intervenção coronária percutânea com stents farmacológicos em pacientes diabéticos do Registro DESIRE (Drug-Eluting Stents In the REal world). Revista Brasileira de Cardiologia Invasiva. 2008;16(2):185-92. 6. Rassi Jr A. Análise econômica dos Stents coronarianos farmacológicos no Brasil: para todos ou para poucos pacientes?. Arq Bras Cardiol. 2007;88(4):376-7. 7. Brasil. Ministério da Saúde. Tecnologia e Insumos Estratégicos. Portaria nº 29 de 27 de agosto de 2014. Disponível em: <http://www.saude.gov.br/ conitec> Acesso em: junho de 2017. 8. Nicolau JC,Franken M, Lotufo PA, Carvalho CA, Marin Neto JA, Lima FG, et al. Utilização de terapêuticas comprovadamente úteis no tratamento da coronario patiaaguda:comparaçãoentrediferentesregiõesbrasileiras.análise do registro brasileiro de síndromes coronarianas agudas (BRACE – Brazilian RegistryonAcuteCoronarySyndromes).ArqBrasCardiol.2012;98(4):282-9. 9. Cardoso CO, Quadros AS, Mattos LA, Gottschall CA, Sarmento-Leite RE, Marin-Neto JA. Perfil de uso dos stents farmacológicos no Brasil: dados da Central Nacional de Intervenções Cardiovasculares (CENIC). Arq Bras Cardiol. São Paulo. 2007;89(6): 356-61. 10. AminAP,SpertusJA,CohenDJ,ChhatriwallaA,KennedyKF,VilainK,etal.Use ofdrug-elutingstentsasafunctionofpredictedbenefit:clinicalandeconomic implications of current practice. Arch InternMed. 2012;172(4):1145-52. 11. Steinberg DH, Mishra S, Javaid A, Slottow TL, Buch AN, Roy P, et al. Comparison of effectiveness of baremetal stents versus drug-eluting stents in large (>or =3.5mm) coronary arteries. Am J Cardiol. 2007;99(5):599-602. 12. Beohar N, Davidson CJ, Kip KE, Goodreau L, Vlachos HA, Meyers SN, et al. Outcomes and complications associated with off-label and untested use of drug-eluting stents. JAMA. 2007; 297(18):1992-2000. 13. ColomboA,GianniniF,BriguoriC.Shouldwestillhavebare-metalstentsavailable inourcatheterization laboratory?JAmCollCardiol.2017;70(5):607-19. References Conclusion The study reveals a disparity in the use of DES during coronary angioplasty among patients attended at SUS and at the private network, either in the total sample or in the subgroup of diabetic patients, since lower rates of DES use were observed at SUS in both populations. This fact shows failure to follow an adequate protocol in the use of DES and their classic indications, which increases treatment cost‑effectiveness. In addition, the diabetics in the public network have been mostly receiving bare metal stents, even after legislation has been in place to regulate the use of DES in this special subgroup of patients. Therefore, it is necessary to monitor the proper implementation of health policies, and to reassess therapeutic strategies and their real cost-effectiveness. Author contributions Conception and design of the research: Oliveira JC, Oliveira JC, Barreto-Filho JAS; Acquisition of data: Oliveira JC, Oliveira LCS, Oliveira JC, Lima TCRM, Arcelino LAM, Silva ISBS, Barreto-Filho JAS; Analysis and interpretation of the data: Oliveira JC, Oliveira LCS, Barreto IDC, Almeida‑Santos MA, Sousa ACS, Barreto-Filho JAS; Statistical analysis: Oliveira JC, Barreto IDC, Barreto-Filho JAS; Obtaining financing: Oliveira JC, Barreto‑Filho JAS; Writing of the manuscript: Oliveira JC, Lima TCRM, Arcelino LAM, Silva ISBS, Sousa ACS, Barreto‑Filho JAS; Critical revision of the manuscript for intellectual content: Oliveira JC, Oliveira LCS, Oliveira JC, Almeida-Santos MA, Lima TCRM, Barreto-Filho JAS. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by CNPq. Study Association This article is part of the thesis of Doctoral submitted by Jussiely Cunha Oliveira, fromUniversidade Federal de Sergipe. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Universidade Federal de Sergipe under the protocol number 483.749. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 569