Time-To-Treatment of Acute Coronary Syndrome and Unit of First Contact in the ERICO Study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSANTOS, Rafael Caire de Oliveira dos
dc.contributor.authorGOULART, Alessandra Carvalho
dc.contributor.authorKISUKURI, Alan Loureiro Xavier
dc.contributor.authorBRANDAO, Rodrigo Martins
dc.contributor.authorSITNIK, Debora
dc.contributor.authorSTANIAK, Henrique Lane
dc.contributor.authorBITTENCOURT, Marcio Sommer
dc.contributor.authorLOTUFO, Paulo Andrade
dc.contributor.authorBENSENOR, Isabela Martins
dc.contributor.authorSANTOS, Itamar de Souza
dc.date.accessioned2017-02-16T12:41:38Z
dc.date.available2017-02-16T12:41:38Z
dc.date.issued2016
dc.description.abstractBackground: To the best of our knowledge, there are no studies evaluating the influence of the unit of the first contact on the frequency and time of pharmacological treatment during an acute coronary syndrome (ACS) event. Objectives: The main objective was to investigate if the unit of first contact influenced the frequency and time of aspirin treatment in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Methods: We analyzed the pharmacological treatment time in 830 ERICO participants - 700 individuals for whom the hospital was the unit of first contact and 130 who initially sought primary care units. We built logistic regression models to study whether the unit of first contact was associated with a treatment time of less than three hours. Results: Individuals who went to primary care units received the first aspirin dose in those units in 75.6% of the cases. The remaining 24.4% received aspirin at the hospital. Despite this finding, individuals from primary care still had aspirin administered within three hours more frequently than those who went to the hospital (76.8% vs 52.6%; p<0.001 and 100% vs. 70.7%; p=0.001 for non ST-elevation ACS and ST-elevation myocardial infarction, respectively). In adjusted models, individuals coming from primary care were more likely to receive aspirin more quickly (odds ratio: 3.66; 95% confidence interval: 2.06-6.51). Conclusions: In our setting, individuals from primary care were more likely to receive aspirin earlier. Enhancing the ability of primary care units to provide early treatment and safe transportation may be beneficial in similar settings.
dc.description.abstractFundamento: Em nosso conhecimento, não há estudos que avaliam a influência da unidade de primeiro contato na frequência e tempo para o tratamento farmacológico durante um evento de síndrome coronariana aguda (SCA). Objetivos: O principal objetivo foi investigar se a unidade de primeiro contato influencia a frequência e o tempo para tratamento com aspirina no estudo "Estratégia de Registro de Insuficiência Coronariana" (ERICO). Métodos: Analisamos o tempo para o tratamento farmacológico em 830 participantes do estudo ERICO - 700 indivíduos cuja primeira unidade de contato foi o hospital, e 130 que procuraram, num primeiro momento, unidades de atenção primária. Construímos modelos de regressão logística para estudar se a unidade de primeiro contato estava associada a um tempo de tratamento de menos de três horas. Resultados: Indivíduos que buscaram unidades de atenção primária receberam a primeira dose de aspirina nestas unidades em 75,6% dos casos. Os outros 24,4% receberam a aspirina no hospital. Apesar deste achado, indivíduos de unidades de atenção primária receberam aspirina em três horas mais frequentemente do que aqueles que foram ao hospital (76,8% vs 52,6%; p<0,001 e 100% vs, 70,7%; p=0,001 para SCA sem elevação do segmento ST e infarto agudo do miocárdio com elevação do ST, respectivamente). Em modelos ajustados, indivíduos vindos de unidades de atenção primária tinham mais probabilidade de receber aspirina mais rapidamente (razão de chances: 3,66; 95% intervalo de confiança: 2,06-6,51). Conclusões: Neste contexto, indivíduos provenientes de unidades de atenção primária tinham maior chance de receber aspirina mais rapidamente. O aprimoramento da capacidade das unidades de atenção primária para proporcionar tratamento precoce e transporte seguro pode ser benéfico em contextos similares.
dc.description.indexMEDLINE
dc.description.sponsorshipFAPESP
dc.identifier.citationARQUIVOS BRASILEIROS DE CARDIOLOGIA, v.107, n.4, p.323-330, 2016
dc.identifier.doi10.5935/abc.20160138
dc.identifier.issn0066-782X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/17813
dc.language.isoeng
dc.language.isopor
dc.publisherARQUIVOS BRASILEIROS CARDIOLOGIA
dc.relation.ispartofArquivos Brasileiros de Cardiologia
dc.rightsopenAccess
dc.rights.holderCopyright ARQUIVOS BRASILEIROS CARDIOLOGIA
dc.subjectAcute Coronary Syndrome / mortality
dc.subjectPrimary Health Care
dc.subjectAspirin / administration & dosage
dc.subjectAnticoagulants, Time-to-Treatment
dc.subjectCohort Studies
dc.subjectSíndrome Coronariana Aguda / mortalidade
dc.subjectAtenção Primária à Saúde
dc.subjectAspirina / administração & dosagem
dc.subjectAnticoagulantes
dc.subjectTempo para o Tratamento
dc.subjectEstudo de Coortes
dc.subject.otherelevation myocardial-infarction
dc.subject.otherassociation task-force
dc.subject.otherone-year mortality
dc.subject.otherst-elevation
dc.subject.otherheart-association
dc.subject.otheramerican-college
dc.subject.othermanagement
dc.subject.otheroutcomes
dc.subject.otherregistry
dc.subject.othercare
dc.subject.wosCardiac & Cardiovascular Systems
dc.titleTime-To-Treatment of Acute Coronary Syndrome and Unit of First Contact in the ERICO Study
dc.title.alternativeTempo para Tratamento durante Síndrome Coronariana Aguda e Unidade de Primeiro Contato no Estudo ERICO
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus3
hcfmusp.contributor.author-fmusphcRAFAEL CAIRE DE OLIVEIRA DOS SANTOS
hcfmusp.contributor.author-fmusphcALESSANDRA CARVALHO GOULART
hcfmusp.contributor.author-fmusphcALAN LOUREIRO XAVIER KISUKURI
hcfmusp.contributor.author-fmusphcRODRIGO MARTINS BRANDAO
hcfmusp.contributor.author-fmusphcDEBORA SITNIK
hcfmusp.contributor.author-fmusphcHENRIQUE LANE STANIAK
hcfmusp.contributor.author-fmusphcMARCIO SOMMER BITTENCOURT
hcfmusp.contributor.author-fmusphcPAULO ANDRADE LOTUFO
hcfmusp.contributor.author-fmusphcISABELA JUDITH MARTINS BENSEñOR
hcfmusp.contributor.author-fmusphcITAMAR DE SOUZA SANTOS
hcfmusp.description.beginpage323
hcfmusp.description.endpage330
hcfmusp.description.issue4
hcfmusp.description.volume107
hcfmusp.origemWOS
hcfmusp.origem.pubmed27849262
hcfmusp.origem.scieloSCIELO:S0066-782X2016004300323
hcfmusp.origem.scopus2-s2.0-84994588940
hcfmusp.origem.wosWOS:000388578700004
hcfmusp.publisher.cityRIO DE JANEIRO
hcfmusp.publisher.countryBRAZIL
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hcfmusp.scopus.lastupdate2024-05-17
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