Kontsevaya Anna V, Bates Katie, Schirmer Henrik, Bobrova Natalia, Leon David, McKee Martin
Department of Non-Communicable Disease Epidemiology, National Research Centre for Preventive Medicine, Moscow, Russian Federation.
Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria.
Open Heart. 2020 Jan 23;7(1):e001134. doi: 10.1136/openhrt-2019-001134. eCollection 2020.
Russia has one of the highest cardiovascular mortality rates. Modernisation of the Russian health system has been accompanied by a substantial increase in uptake of percutaneous coronary intervention (PCI), which substantially reduces the risk of mortality in patients with acute ST-elevation myocardial infarction (STEMI). This paper aims to describe contemporary Hospital treatment of acute STEMI among patients in a range of hospitals in the Russian Federation.
This study used data from a prospective observational cohort of 1128 suspected patients with myocardial infarction recruited in both PCI and non-PCI hospitals across 13 regions and multiple levels of the health system in Russia. The primary objective was to examine the use of reperfusion strategies in patients with STEMI.
Among patients reaching PCI centres within 12 hours of symptom onset, the vast majority received angiography and PCI, regardless of age, sex and comorbidity, in line with current European Society of Cardiology guidelines.
Patients reaching Russian hospitals are very likely to receive appropriate treatment, although performance varies. The best hospitals can serve as beacons of good practice as PCI facilities continue to expand across Russia where geography allows.
俄罗斯是心血管疾病死亡率最高的国家之一。俄罗斯卫生系统的现代化进程伴随着经皮冠状动脉介入治疗（PCI）的使用大幅增加，这显著降低了急性ST段抬高型心肌梗死（STEMI）患者的死亡风险。本文旨在描述俄罗斯联邦一系列医院中急性STEMI患者的当代医院治疗情况。
本研究使用了来自一个前瞻性观察队列的数据，该队列包括在俄罗斯13个地区及卫生系统多个层面的PCI医院和非PCI医院招募的1128名疑似心肌梗死患者。主要目的是研究STEMI患者再灌注策略的使用情况。
在症状发作后12小时内到达PCI中心的患者中，绝大多数患者接受了血管造影和PCI治疗，无论年龄、性别和合并症如何，这符合当前欧洲心脏病学会的指南。
尽管治疗效果存在差异，但到达俄罗斯医院的患者很可能接受适当的治疗。随着PCI设施在俄罗斯地理条件允许的地区不断扩大，最好的医院可以成为良好实践的典范。
