Evaluation of individuals with acute coronary syndromes treated in the University Hospital of the University of São Paulo according to the first-contact health care unit

Abstract

Chest pain is common in primary health care (PHC). There is special interest on chest pain of cardiac etiology, because of its high morbidity and mortality. In our country, little is known about the health system of care for individuals with acute chest pain, and, more specifically, the role of PHC units in this system. Moreover, there are limited available data reporting the way to manage this demand and how to provide adequate access to treatment. The existence of the Strategy of Registry of Acute Coronary Syndrome (ERICO study) at the University Hospital of the University of São Paulo (HU-USP) and the Projeto Região Oeste of the University of São Paulo School of Medicine (PRO-FMUSP) create a favorable scenario to address these points. Objectives: To assess differences in clinical (death, re-hospitalization, angioplasty and/or surgical revascularization) and surrogate (time from symptoms onset to medical contact and to treatment) outcomes between patients with acute coronary syndromes (ACS) who directly searched for the HU-USP emergency department and those who initially went to PHC services. Methods: Individuals with diagnosed ACS in HU-USP who have agreed to participate in ERICO study will be assessed. Information on pre-hospital care in PHC units will be obtained. Participants will be stratified according to the unit initially searched for health care (PHC or hospital). Groups will be compared for (a) in-hospital, 30- and 180-days clinical outcomes (mortality, new hospital admission, coronary angioplasty or revascularization) and (b) elapsed time from symptoms onset until medical contact and treatment. Additionally, PHC teams will receive training on standard treatment of individuals with chest pain and suspected ACS. (AU)