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Otimização da Terapia de Reperfusão no Infarto Agudo do Miocárdio com Supradesnível do Segmento ST por Meio de Telemedicina Baseada no WhatsApp®
Authors:Alessandra Batista Teixeira  Leonardo Fiaschi Zancaner  Fernando Fonseca de Frana Ribeiro  Jos Paulo Pinty  Andr Schmidt  Benedito Carlos Maciel  Jos Antnio Marin  Neto  Carlos Henrique Miranda
Abstract:Background About 40% of patients with ST-segment elevation myocardial infarction (STEMI) in Brazil do not receive reperfusion therapy.Objective The use of a telemedicine network based on WhatsApp® could increase the percentage of patients receiving reperfusion therapy.Methods A cross-sectional study analyzed outcomes before and after the organization of a telemedicine network to send the electrocardiogram via WhatsApp® of patients suspected of STEMI from 25 municipalities that are members of the Regional Health Department of Ribeirão Preto (DRS−XIII) to a tertiary hospital, which could authorize immediate patient transfer using the same system. The analyzed outcomes included the percentage of patients who received reperfusion therapy and the in-hospital mortality rate. A p value < 0.05 was considered statistically significant.Results The study compared 82 patients before (February 1, 2016 to January 31, 2018) with 196 patients after this network implementation (February 1, 2018 to January 31, 2020). After implementing this network, there was a significant increase in the proportion of patients who received reperfusion therapy (60% vs. 92%), relative risk (RR): 1.594 95% confidence interval (CI) 1.331 – 1.909], p < 0.0001 and decrease in the in-hospital mortality rate (13.4% vs. 5.6%), RR: 0.418 95%CI 0.189 – 0.927], p = 0.028.Conclusion The use of WhatsApp®-based telemedicine has led to an increase in the percentage of patients with STEMI who received reperfusion therapy and a decrease in the in-hospital mortality rate.
Keywords:Infarto do Miocá  rdio com Supra Desní  vel do Segmento ST (IAMCSST    ndrome Coronariana Aguda  Telemedicina/tendê  ncias  Reperfusã  o/terapia
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