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Revista Médica del Uruguay

On-line version ISSN 1688-0390

Abstract

GAMBOGI, Rosana  and  FONDO NACIONAL DE RECURSOS et al. Efectividad de un programa de prevención secundaria cardiovascular en Uruguay. Rev. Méd. Urug. [online]. 2013, vol.29, n.2, pp.74-84. ISSN 1688-0390.

Abstract Background: secondary prevention programs for patients with heart disease reduce mortality, the risk of recurrence of coronary events and improve the quality of life. The Fondo Nacional de Recursos (National Resources Fund) implemented a program for patients who underwent coronary revascularization. Objective: to compare survival and the incidence of a new revascularization in patients included in this program with a cohort control. Method: the intervention cohort was made up by the patients who underwent revascularization from December, 2003, through June 2007 and were around 70 years old. The cohort control was made up by the patients who underwent revascularization from January, 2003 through May, 2007 and received conventional treatment. Two controls were matched to each case by means of a propensity score matching, stratification being based on healthcare and revascularization procedure subsectors. Death, new revascularization or a combination of both events in a four years term were studied. Survival was analysed through the Kaplan-Meier, stratified Cox regression and competitive risk analysis methods. Results: 1.348 patients were admitted and they were matched with 2.696 controls. Both cohorts evidenced a good matching. Survival free of the combined event (death or new revascularization) within a four years term was 81.2% and 79.3% in the program and control groups respectively (HR = 0.83, p = 0.028). Survival in patients of the public sector was 93.2% and 88.5% in the program and control groups respectively (HR = 0.62, p = 0.023). Conclusion: the program was effective in terms of reducing the occurrence of combined events in the entire population, as well as in reducing global mortality in the short and mid-term in the group made up by patients of the public sub-sector.

Keywords : CARDIOVASCULAR DISEASES [prevention and control]; RISK FACTORS; SECONDARY PREVENTION; MYOCARDIAL REVASCULARIZATION; COHORT STUDIES.

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