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Subanálisis del registro SCAR - Archivo PPCT

Influencia de la cobertura médica sobre el tratamiento y el pronóstico del infarto con supradesnivel del ST. Subanálisis del registro SCAR;
Influence of Medical Coverage on the Treatment and Prognosis of ST-segment Elevation Myocardial Infarction. SCAR Registry Subanalysis

Creators:Cohen Arazi, Hernán; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología, Blanco, Patricia; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología, Higa, Claudio; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología, Macin, Stella Maris; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología, García Aurelio, Mauro; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología, Dionisio, Gabriel; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología, Gómez, Gastón; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología, Ferrari, Jimena
2015-11-30

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Descripción

El objetivo de este estudio derivado del Registro SCAR fue determinar la influencia de variables socio-económicas en el pronóstico intrahospitalario del infarto de miocardio, haciendo especial foco en las diferencias relacionadas a la cobertura médica. El Registro SCAR fue un estudio transversal, prospectivo y multicéntrico, que incluyó 476 pacientes con diagnóstico de IAMST. Haber alcanzado estudio secundario o universitario se asoció a tener trabajo [OR 3.1 (2-4.7), p&lt; 0.001] y a tener cobertura con prepaga [OR= 6.6 (3.3-13.2), p&lt;0.001]. El 80% de los IAMST recibieron reperfusión, 75% por angioplastia primaria (PTCA). La PTCA fue más frecuente en quienes tenían  estudios universitarios [OR= 2 (1.06-3.7) p=0.035] y en quienes tenían prepaga [OR 5.5 (2.5- 12.4), p&lt;0.001] y menos frecuente en quienes tenían estudios primarios  [OR=0.39 (0.24-0.66) p&lt;0.001], eran analfabetos [OR=0.08 (0.008-0.72, p=0.025], o estaban desempleados [OR=0.38 (0.12-1.17) p=0.09]. Los pacientes con PAMI [OR 0.47 (0.24-0.87), p=0.02], o sin cobertura recibieron menos PTCA [OR=0.34 (0.2-0.6, p&lt;0.001)]. Trece porciento fueron derivados a otro centro, más frecuentemente si tenían  PAMI (p=0.002). El tiempo hasta la PTCA fue mayor en pacientes con PAMI, [240(88-370) min, p=0.0005] y menor si tenían prepagas, [80(42-120) min, p&lt;0.001]. La mortalidad intrahospitalaria del IAMST fue del 8%, 2.8% con prepaga, 4.3% con cobertura estatal, 6.88% con obra social y 25% con PAMI (ANOVA &lt;0.001). Tener prepaga se asoció a menor mortalidad [OR=0.27 (0.08- 0.91 ), p=0.035] y tener PAMI a mayor mortalidad, [OR=6 (2.9-12.3) p=&lt;0.0001]. Conclusión: El tratamiento y la mortalidad del IAMST fueron diferentes según la cobertura médica.

Background: The Acute Coronary Syndromes in Argentina (SCAR) registry analyzed in-hospital myocardial infarction outcomein patients with different medical coverage provided by the healthcare system; this has led to the present subanalysisderived from the SCAR registry.Objective: The aim of this study was to determine the influence of medical coverage on myocardial infarction in-hospitalprognosis.Methods: The SCAR registry was a cross-sectional, prospective, multicenter study including 476 patients with ST-segmentelevation acute myocardial infarction (STEMI). Medical coverage was classified in prepaid health insurance, social securityinsurance, PAMI and without medical coverage (except public coverage).Results: Eighty percent of STEMI patients received reperfusion therapy, 75% by primary transluminal coronary angioplasty(PTCA). PTCA was more frequent in those with prepaid health insurance [OR 5.5 (2.5-12.4); p&lt;0.001] and less frequent inPAMI patients [OR 0.47 (0.24-0.87), p=0.02] or in those without any medical coverage [OR=0.34 (0.2-0.6), p&lt;0.001]. Thirteenpercent of patients were transferred to another hospital, more frequently if they were PAMI patients (p=0.002). Time toPTCA was longer in patients with PAMI [240 (88-370) min, p=0.0005] and shorter in patients with prepaid health insurance[80 (42-120) min, p&lt;0.001]. Overall in-hospital STEMI mortality was 8%, 2.8% in patients with prepaid health insurance,4.3% in patients with public medical coverage, 6.88% in patients with social security insurance and 25% in patients coveredby PAMI (ANOVA &lt;0.001). Mortality was significantly lower in patients with prepaid health insurance [OR=0.27 (0.08-0.91),p=0.035] and higher in patients with PAMI, even after adjusting by sex, age and comorbidities [OR 2.40 (1.1-5.8), p=0.05].Conclusion: STEMI treatment and mortality were different according to the type of medical coverage.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 83, No 5 (2015); 406-411, Argentine Journal of Cardiology; Vol 83, No 5 (2015); 406-411

Citación

Cohen Arazi, Hernán; Area de Investigación de la Sociedad Argentina de Cardiología Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología et al., “Influencia de la cobertura médica sobre el tratamiento y el pronóstico del infarto con supradesnivel del ST. Subanálisis del registro SCAR,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8743.

Dublin Core

Autor

Cohen Arazi, Hernán; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología
Blanco, Patricia; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología
Higa, Claudio; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología
Macin, Stella Maris; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología
García Aurelio, Mauro; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología
Dionisio, Gabriel; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología
Gómez, Gastón; Area de Investigación de la Sociedad Argentina de Cardiología
Consejo de Emergencias Dr Rafael Bullrich, Sociedad Argentina de Cardiología
Ferrari, Jimena

Fuente

Revista Argentina de Cardiología; Vol 83, No 5 (2015); 406-411
Argentine Journal of Cardiology; Vol 83, No 5 (2015); 406-411

Editor

Sociedad Argentina de Cardiología

Fecha

2015-11-30

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Formato

Idioma

eng
spa

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion