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Impact of public health initiatives on acute coronary syndrome fatality rates in Portugal

2020-03-03Journal article Open access
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dc.contributor.authorAbreu, Daisy
dc.contributor.authorSousa, Paulo
dc.contributor.authorMatias Dias, Carlos
dc.contributor.authorPinto, Fausto
dc.date.accessioned2021-04-09T14:55:24Z
dc.date.available2021-04-09T14:55:24Z
dc.date.issued2020-03-03
dc.descriptionArticle in English, Portuguesept_PT
dc.description.abstractIntroduction and objective: Every year cardiovascular disease (CVD) causes 3.9 million deaths in Europe. Portugal has implemented a set of public health policies to tackle CVD mortality: a smoking ban in 2008, a salt reduction regulation in 2010 and the coronary fast-track system (FTS) for acute coronary syndrome (ACS) in 2007. Our goal in this study was to analyze the impact of these three public health policies in reducing case-fatality rates from ACS between 2000 and 2016. Methods: The impact of these policies on monthly ACS case-fatalities was assessed by creating individual models for each of the initiatives and implementing multiple linear regression analysis, using standard methods for interrupted time series. We also implemented segmented regression analysis to test which year showed a significant difference in the case-fatality slopes. Results: Separate modeling showed that the smoking ban (beta=-0.861, p=0.050) and the FTS (beta=-1.27, p=0.003) had an immediate impact after implementation, but did not have a significant impact on ACS trends. The salt reduction regulation did not have a significant impact. For the segmented model, we found significant differences between case-fatality trends before and after 2009, with rates before 2009 showing a steeper decrease. Conclusions: The smoking ban and the FTS led to an immediate decrease in case-fatality rates; however, after 2009 no major decrease in case-fatality trends was found. Coronary heart disease constitutes an immense public health problem and it remains essential for decision-makers, public health authorities and the cardiology community to keep working to reduce ACS mortality rates.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2020 Jan;39(1):27-34. doi: 10.1016/j.repc.2019.05.010. Epub 2020 Mar 3.pt_PT
dc.identifier.doi10.1016/j.repc.2019.05.010pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.18/7676
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier/ Portuguese Society of Cardiologypt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0870255119304974?via%3Dihubpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nd/4.0/pt_PT
dc.subjectPublic Healthpt_PT
dc.subjectCardiovascular Healthpt_PT
dc.subjectAcute Coronary Syndromept_PT
dc.subjectCase-fatality Ratept_PT
dc.subjectEstados de Saúde e de Doençapt_PT
dc.subjectDoença Cardiovascularpt_PT
dc.subjectLetalidadept_PT
dc.subjectPublic Healthpt_PT
dc.subjectSaúde Públicapt_PT
dc.subjectSíndrome Coronária Agudapt_PT
dc.titleImpact of public health initiatives on acute coronary syndrome fatality rates in Portugalpt_PT
dc.title.alternativeImpacto das medidas de saúde pública na mortalidade intra-hospitalar por síndrome coronária aguda em Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage34pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage27pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume39pt_PT
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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