BACKGROUND: Drug-eluting stents (DES) are still not accessible for patients from the Public Healthcare System (PuHS). This study aimed to evaluate how the availability of DES for use in PuHS patients could impact the conduct of the interventional cardiologist regarding the indication for percutaneous or surgical myocardial revascularization. METHODS: Retrospective analysis of PuHS patients undergoing surgical revascularization at Santa Casa de Misericórdia de Barra Mansa (Barra Mansa, RJ, Brazil) in 2010. Coronary angiographies classified by the SYNTAX score were submitted to the evaluation of 3 interventional cardiologists who answered the following questionnaire: 1) Do you agree with the initial indication for surgery? 2) If a DES was available, do you believe the percutaneous coronary intervention (PCI) would be as beneficial as or superior to surgical revascularization? 3) If you decide to use DES, how many would be used? 4) After using DES, would revascularization be complete? Patients submitted to previous surgical revascularization, concomitant valvoplasty/valve replacement and a negative answer to question 1 were excluded. RESULTS: A total of 67 patients were included, with mean age of 59.7 ± 9.8 years, 59.7% were male and 38.8% diabetics. PCI was the therapy of choice in 29.8%, with complete revascularization in 90% of the cases and a mean use of 1.82 ± 0.83 stents per patient. According to the SYNTAX score, PCI was indicated in 66.6% of the patients with a score < 23, in 23% of the patients with a score from 23 to 32 and none of the patients with a score > 32. CONCLUSIONS: The availability of DES for PuHS patients may significantly influence indications for percutaneous coronary revascularization, especially among those with a SYNTAX score < 23.
Cardiac surgical procedures; Coronary disease; Angioplasty; Stents; Drug-eluting stents; Unified Health System
