[Analysis of Brazilian Public Health System values for complete percutaneous myocardial revascularization in multi-arterial patients].
BACKGROUND
The Brazilian Public Health System (SUS, acronym in Portuguese) establishes that coronary angioplasty with the double implant stent must not exceed 20% of the angioplasties, resulting in the need of assigning most of the procedures in patients with multiarterial disease.


OBJECTIVE
The objective of the present study was to assess the paid values by the SUS in order to obtain the complete percutaneous myocardial revascularization in the SUS patients with the multiarterial disease, related to the number of necessary procedures and of implanted stents.


METHODS
A total of 141 patients with multiarterial coronary disease, submitted to a successful complete revascularization, were included by the stent implant with coronariography in a 6-month period of post-implant. The complete revascularization was defined as the percutaneous treatment of all stenosis > 70% in vessels with diameter > 2 mm. For the costs analysis, the values from the Sistema de Informações Hospitalares (SIH) of the SUS table were considered as R$ 2,263.77, for the procedure; and R$ 2,034.23, per implanted stent.


RESULTS
In the period from 7/2006 to 12/2007, 416 stents were implanted in 141 patients. The mean age was of 59.7 +/- 9.9 years old, prevailing the male sex (68.1%). The number of vessels was 356 and the lesions number corresponded to 416. In order to obtain the complete revascularization by the coronary stent implant, it was necessary to stagger in up to four procedures. The mean time between the 1st and 2nd, 2nd and 3rd and 3rd and 4th angioplasties was of 45.8 +/- 37.7; 55.4 +/- 55.3 and 33.5 +/- 19.1 days, respectively.


CONCLUSIONS
The complete percutaneous revascularization in patients from the SUS with the multiarterial coronary disease, carried out in most of them staggered, causes considerable elevation of public expenses due to the increase of procedures' number.
Meireles
George César Ximenes
GC
Hospital Stela Maris, São Paulo, SP - Brasil. gcxm@cardiol.br
Sumita
Marcos Kiyoshi
MK
Forte
Antonio Artur da Cruz
AA
Favarato
Desidério
D
Quintão
Rodrigo Costa
RC
Abreu Filho
Luciano Maurício de
LM
D000368:Aged; D001938:Brazil; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003327:Coronary Disease / Q000191:economics / Q000601:surgery*; D005260:Female; D006291:Health Policy / Q000191:economics*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D009313:National Health Programs; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents / Q000191:economics* / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome