Treatment of patients with acute coronary syndrome in real clinical practice in the Republic of Karelia: 10-years registry results

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Abstract

Aim. To present the treatment of Acute coronary syndrome (ACS) in clinical practice in the Republic of Karelia and the results of Cardiovascular centers working.

Material and methods. The prospective study included 9949 patients successively hospitalized from 01.01.2020 to 01.01.2020 in the Regional cardiovascular center (Petrozavodsk, Russia), 6335 were included in Federal register. Risk factors, clinical features, reperfusion strategy as well as the rate of clinical complications, drug therapy and outcomes were assessed.

Results. 9949 patients were treated in Regional cardiovascular center from 01.01.2010 to 01.01.2020 due to acute coronary syndrome, and 6335 were included to the Federal registry. 40.2% of patients had ST-elevation Myocardial Infarction and 59.8% – ACS without ST elevation. The first group was younger (the average age was 69) than the second (the average age was 74). The drug therapy of ACS in the hospital was following: 98.7% of patients took aspirin; b-blockers – 92.3%, statins – 97.4%. The outcomes of ACS during the hospital discharge were following: Q-wave myocardial infarction (MI) was diagnosed in 34.2% cases, non-Q-wave MI – in 23.4%, unstable angina – 20.5%, repeated MI – 18.7% and 2.5% MI unspecified localization.

The analysis of the clinical features of ACS shows that significant number of patients (24.8%) had severe complications. So, ventricle arrhythmias were diagnosed in 17.3% of cases, acute left ventricle insufficiency – in 7.6%, cardiogenic shock – in 3.0%, cardiac arrest– in 1.9%, myocardial rupture – in 0.4%. The hospital mortality rate reached 6.38%.

Conclusion. The article presents data about treatment of patients with acute coronary syndrome in real clinical practice in the Republic of Karelia based on 10-years register. Difficulties of management and reperfusion interventions, the volume of drug therapy, the frequency of complications, as well as outcomes and hospital mortality are discussed. The presented data show the results of modernization of the medical care program for patients with acute coronary syndrome in practical healthcare in the region.

About the authors

Inga S. Skopets

Petrozavodsk State University

Author for correspondence.
Email: ingas@karelia.ru
ORCID iD: 0000-0002-5157-5547

Cand. Sci. (Med.)

Russian Federation, Petrozavodsk

Natalia N. Vezikova

Petrozavodsk State University

Email: ingas@karelia.ru
ORCID iD: 0000-0002-8901-3363

D. Sci. (Med.), Prof.

Russian Federation, Petrozavodsk

Tamazi D. Karapetian

Baranov Republican Hospital

Email: ingas@karelia.ru

Chief doctor

Russian Federation, Petrozavodsk

Andrew V. Malafeev

Baranov Republican Hospital

Email: ingas@karelia.ru
ORCID iD: 0000-0002-5371-7043

Deputy Chief doctor

Russian Federation, Petrozavodsk

Aleksandr N. Malygin

Baranov Republican Hospital

Email: ingas@karelia.ru

head of Cardiology Department

Russian Federation, Petrozavodsk

Violetta A. Litvinova

Baranov Republican Hospital

Email: ingas@karelia.ru

cardiologist

Russian Federation, Petrozavodsk

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Supplementary files

Supplementary Files
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1. JATS XML
2. Figure: 1. Location of RSC and PSC in the Republic of Karelia.

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3. Figure: 2. The number of patients with ACS transferred to the RS for chKv.

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4. Figure: 3.Dynamics of the number of hCvs for ACS for 2009–2019

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5. Figure: 4. Reperfusion strategy in patients admitted to the RSs for STEMI (n = 2384).

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6. Figure: 5. dynamics of the number of patients hospitalized in the RS for ACS and the volume of reperfusion interventions.

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7. Figure: 6. dynamics of the volume of reperfusion interventions and hospital mortality in patients with OIM.

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8. Figure: 7. the incidence of life-threatening complications in ACS.

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