Myocardial infarction

History

2023

Reduction of mortality due to myocardial infarction in Russia over 5 years by 23.7%

Mortality from myocardial infarction in Russia in 5 years - from 2018 to 2023. - in hospitals decreased by 23.7%. The head of the Ministry of Health of the Russian Federation cited such statistics at the end of February 2024 as part of his presentation on the implementation of the national project "Healthcare."

According to TASS with reference to this document, in 2019-2023. in Russia, 100 new vascular centers were opened that accept patients with heart attack.

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The drug therapy they receive at discharge is a guarantor that we minimize the attack of repeated heart attack and stroke. And this year, the government expanded the list of recipients of drug therapy from this category of patients, which gives the result of reducing mortality rates, - said the Minister of Health of the Russian Federation.

According to the co-chairman of the All-Russian Union of Patients (VSP) Yuri Zhulev, post-covid complications in patients who underwent the coronavirus COVID-19 even in a mild form still had a negative impact on the general statistics of mortality from myocardial infarction by 2023.

In fact, after the pandemic, the entire range of cardiovascular diseases fell into a high risk group, so there is every reason for a more serious attitude of the state and the medical community to the health of those who have undergone coronavirus infection, "he said in a conversation with the publication" Medical Bulletin.

According to the World Health Organization (WHO), about 75% of heart attacks and strokes can be prevented with timely prevention combined with medical control. In October 2023, the deputy head of the Ministry of Health, Sergei Glagolev, cited data according to which in Russia over the past four years there has been a decrease in mortality from myocardial infarction by almost 65% of cases.^[1]

Heart attacks are most common on Monday

Heart attacks are most common on Monday. This was announced in early June 2023 by experts from the Belfast Health and Social Care Foundation and the Royal College of Surgeons of Ireland.

Comparing data on 10,528 patients, Irish experts concluded that ST-segment elevation myocardial infarction (IMpST), in which the main coronary artery is completely blocked, occurred more frequently on Monday than on any other day of the week. Also, an increased level of a heart attack of this type was observed on other days of the beginning of the working week and on Sunday. It is assumed that the pattern is associated with circadian rhythms - sleep and wake cycles.

ST-segment elevation myocardial infarction (IMpST), in which the main coronary artery is completely blocked, occurred more on Monday than on any other day of the week

We found a strong statistical correlation between the start of the working week and the incidence of myocardial infarction. The cause is probably multifactorial. So far, we cannot establish it accurately, however, based on previous studies, it is reasonable to assume a circadian element, the authors concluded.

The attack requires emergency evaluation and treatment to minimize damage to the heart, usually performed with emergency angioplasty - a procedure to reopen a blocked coronary artery. Professor Nilesh Samani, medical director of the British Heart Foundation, said the following:

Someone is hospitalized every five minutes for a life-threatening heart attack... therefore, vital research continues to shed light on how and why heart attacks occur. This study adds to the timing of particularly serious heart attacks, but now we need to find out what exactly makes them more likely on certain days of the week. This could help doctors better understand the deadly disease to save more[2]

2022

Mortality from myocardial infarction decreased in Russia

At the end of 2022, mortality from myocardial infarction in Russia was 34.2 people per 100 thousand population. For comparison, a year earlier this figure was 38.3 people per 100 thousand citizens, and in 2020 - 39.7 people. Such indicators are given in the report of the Federal State Statistics Service (Rosstat), published in early January 2024.

According to Rosstat estimates, the highest mortality rate from myocardial infarction was recorded in 2010 - 67.4 thousand people, or 47.2 people per 100 thousand population. In 2022, 50.2 thousand people died from this disease in the Russian Federation, in 2021 - 55.8 thousand, in 2020 - 58.1 thousand.

Mortality from myocardial infarction in Russia amounted to 34.2 people per 100 thousand population

The cause of myocardial infarction and stroke is usually the presence of a combination of risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and excessive alcohol consumption, high blood pressure, diabetes and hyperlipidemia.

Cardiovascular diseases, which include myocardial infarction, are the leading cause of death for people worldwide, according to the World Health Organization (WHO). In order to preserve and extend the life of patients with such ailments in Russia in 2019, the federal project "Fight against cardiovascular diseases" was initiated. Under this program, in particular, the material and technical base of regional vascular centers and primary vascular departments is being updated. So, in 2019, 4772 units of medical equipment were commissioned, in 2020 - 5660 units, in 2021 - 4779 units. In 2022, this figure was 6446 units, including 92 units of "heavy" equipment.

It is also noted that since 2020, within the framework of this project, measures have been implemented to prevent the development of cardiovascular diseases and cardiovascular complications in high-risk patients under medical supervision. During 2022, more than 824 thousand high-risk patients received the necessary drugs free of charge.^[3]

In the Stavropol Territory, a tool was created to restore the patency of the heart arteries in acute infarction

Stavropol doctors have created a new medical tool - coronary bouge. With its help, you can perform operations on the arteries of the heart during operations for acute myocardial infarction. The development will make it possible to more effectively preserve the life and health of patients and increase the availability of high-tech treatment, Governor of the Stavropol Territory Vladimir Vladimirov said in early November 2022. Read more here.

2017: U.S. leader in post-hospitalization deaths

According to the International Collaboration for the Study of Health Systems, which uses participant data to compare care processes, revealed that the United States is the leader in mortality after hospitalization due to a heart attack. The study was prepared based on results and performance indicators in countries with highly developed health systems but different methods of organizing and funding them.

In a study on - Difference in revascularization use and outcomes in inpatient patients with acute myocardial infarction in six high-income countries. The study compared treatments and outcomes among patients hospitalized with heart attack, or acute myocardial infarction (AMI), in the United States, Canada, England, Israel, the Netherlands and Taiwan between 2014 and 2017. The study found significant differences in outcomes despite established international diagnostic criteria and consensus on evidence-based treatments for AMI. The total number of hospitalizations with myocardial infarction from 2014 to 2017 ranged from 19,043 in Israel to 1,064,099 in the United States.

The United States became the leader in mortality after hospitalization due to a heart attack

The study authors considered three categories of AMI outcomes: coronary bypass procedures, mortality, and efficacy (measured by length of hospital stay and 30-day readmission rates). In the procedure category, they found large differences in the use of percutaneous coronary intervention (PCI), despite numerous studies demonstrating its benefits. Between 65% and 80% of patients hospitalized with a heart attack in 2017 in the US, Israel and Canada had PCI, compared with 35% in England and 50% in the Netherlands.

The study also found that another procedure, coronary artery bypass surgery, was used 50% to 100% more often in the U.S. than in other countries, despite current guidelines recommending it only for a small subset of patients, such as those with diabetes and extensive coronary artery disease. The authors suggest that the difference is due to a unique combination of a permissive regulatory environment in the United States and a high level of reimbursement for program costs. Medicare

Taiwan and the United States ranked worst in the mortality category, where deaths within one year of hospitalization for segment-elevation myocardial infarction were 32.3% and 27.8%, respectively. While the Netherlands took the best place at 18.9%.^[4]

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