Heart intertwined with the Brazilian flag, symbolizing heart health in Brazil.

Heart Health in Brazil: Understanding PCI Procedures and Access to Care

Mira Elwood in Health & Wellness August 2025 • 4 min read.

"A closer look at percutaneous coronary intervention (PCI) within the Brazilian public health system and what it means for women's heart health."

Heart disease remains a leading health concern globally, and access to effective treatments is crucial for improving outcomes. In Brazil, the Brazilian Public Health System (SUS) plays a significant role in providing healthcare services, including percutaneous coronary intervention (PCI), a minimally invasive procedure used to treat coronary artery disease (CAD). Understanding the landscape of PCI within the SUS is essential for designing strategies to enhance heart health across the nation.

Percutaneous coronary intervention (PCI) has revolutionized the treatment of coronary artery disease (CAD) since its introduction in 1977. What started with simple balloon angioplasty has evolved into a sophisticated procedure involving stents, both bare-metal and drug-eluting. However, access to these advancements and the outcomes of PCI procedures can vary significantly within different healthcare systems.

This article delves into the results of PCI procedures performed within the SUS, shedding light on the challenges, successes, and disparities in access to care. By examining data from 2005 to 2008, we aim to provide a comprehensive overview of PCI practices in Brazil, with a particular focus on implications for women's heart health.

PCI in Brazil: A Statistical Overview

Heart intertwined with the Brazilian flag, symbolizing heart health in Brazil.

A study of data from 2005 to 2008 analyzed 166,514 PCI procedures performed in 180 hospitals within the SUS. The average hospital mortality rate was 2.33%, with significant variation across different regions. For example, the Southeast region had a lower mortality rate (2.03%) compared to the Northern region (3.64%).

The volume of PCIs performed by hospitals also showed an interesting trend. A quarter of the hospitals, classified as high-volume, accounted for over 60% of the PCIs. In contrast, another quarter, classified as low-volume, accounted for just over 4%. This indicates a concentration of PCI services in a smaller number of specialized centers.

Here are some key findings from the study:

Mortality rates varied significantly across hospitals, ranging from 0% to 11.35%.
High-volume hospitals performed the majority of PCI procedures.
Single stent implantation was the most common procedure.
Primary PCI, used in acute myocardial infarction (AMI), was associated with the highest mortality rate.

Mortality rates were notably higher in women and older adults (aged 65 and above). The mortality rate for acute myocardial infarction (AMI) was significantly higher (6.35%) compared to angina (1.03%). The type of PCI procedure also influenced mortality, with primary PCI (performed during a heart attack) showing the highest mortality rate (6.96%).

Implications and Future Directions

The study highlights the need for strategies to improve access to PCI services and reduce mortality rates within the SUS. Prioritizing high-volume hospitals, implementing quality control measures, and addressing disparities in access to care are crucial steps. Further research is needed to explore the reasons behind higher mortality rates in women and older adults and to develop targeted interventions.

About this Article -

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Everything You Need To Know

What is Percutaneous Coronary Intervention (PCI) and its role within the Brazilian Public Health System (SUS)?

Percutaneous Coronary Intervention (PCI) is a minimally invasive procedure used to treat Coronary Artery Disease (CAD). It has evolved from simple balloon angioplasty to include the use of bare-metal and drug-eluting stents. PCI is a crucial treatment option offered within the Brazilian Public Health System (SUS) to address heart-related conditions.

What do the PCI data from 2005 to 2008 reveal about mortality rates and procedure types within the Brazilian Public Health System (SUS)?

The data from 2005 to 2008 indicates that mortality rates following PCI procedures varied significantly, ranging from 0% to 11.35% across different hospitals. High-volume hospitals performed the majority of PCI procedures. Single stent implantation was the most common procedure, and primary PCI, used in acute myocardial infarction (AMI), was associated with the highest mortality rate.

Were there differences in mortality rates for PCI procedures based on patient demographics within the Brazilian Public Health System (SUS)?

Yes, mortality rates were notably higher in women and older adults (aged 65 and above) undergoing PCI procedures within the SUS. This disparity suggests that there are specific factors affecting these populations that need to be addressed through targeted interventions and further research to improve outcomes.

What might explain the observed variations in mortality rates for PCI procedures across different regions of Brazil, as seen within the Brazilian Public Health System (SUS)?

The variations in mortality rates for PCI procedures across different regions, such as the Southeast region having a lower rate (2.03%) compared to the Northern region (3.64%), suggest that regional disparities in healthcare infrastructure, access to specialized care, and quality control measures may exist within the SUS. Addressing these disparities is essential to ensure equitable access to effective heart care throughout Brazil.

What key strategies are recommended to enhance heart health outcomes and reduce mortality rates associated with PCI procedures within the Brazilian Public Health System (SUS)?

To improve heart health outcomes within the SUS, strategies should prioritize high-volume hospitals, implement stringent quality control measures, and address disparities in access to care. Further research is needed to understand the reasons behind higher mortality rates in women and older adults and to develop targeted interventions. Continuous monitoring and evaluation of PCI practices are essential to refine and improve the quality of care.