The system of provision of emergency medical aid to patients with acute myocardial infarction; the 30 year experience

Abstract

Aim. The aim of the study was to compare characteristics of the prehospital stage of acute myocardial infarction (AMI) in the residents of Tomsk in 1984 and, 30 years later, in 2013. Materials and methods. The study was based on the materials of research and information database of the WHO epidemiology program “Acute Myocardial Infarction Register” that has been operating in Tomsk since 1984. A total of 713 and 832 AMI cases, registered in 1984 and 2013 respectively were analyzed. The analysis did not include episodes of patient’s death at the prehospital stage. Results: The study revealed a significant increase in the number of AMI patients seeking medical help during the first hours and the first days after onset of the disease, improvement in the quality of AMI diagnosis by primary care physicians, and a significant increase in the number of patient hospitalized within the first six hours and the first days from initial medical examination. All these factors were responsible for a significant increase in the number of AMI patients admitted to the specialized cardiology department within the first six hours and the first days after the onset of AMI. Conclusion. Despite positive dynamics of certain parameters characterizing the system of emergency medical care for AMI patients at the prehospital stage in Tomsk, its activities during the period of interest cannot be considered satisfactory due to untimely provision of medical aid to many AMI patients and the unacceptably low hospital admission rate especially during the first hours after the onset of AMI. Further optimization of preventive health education at the population level is required to improve medical awareness first of all in regard to early clinical manifestations of AMI.