Ischemic heart disease: medical certificate of cause of death analysis

Abstract

Aim. According to data from the Moscow Oblast civil registry office in 2020, to analyze medical certificates of cause of death (MCCD), where the code from “Ischemic heart disease” (IHD) (I20-I25) group is indicated as underlying cause of death (UCD).Material and methods. A total of 23193 deaths with I20-I25 codes (UCDs) were included. We assessed the prevalence of individual IHD types, the frequency and patterns of complications, the average age of deceased persons, the proportion of women and men, place of death registration.Results. The average age of the deceased was 73,6±12,5 (men, 68,8±10,5; women, 78,4±12,5; p<0,0001). The proportion of women who died under the age of 70 was <20%, men — >50%. Half of the deaths were registered at home, a third in a hospital, and the rest elsewhere. Taking into account age and sex, inhospital death from myocardial infarction (MI) is recorded 12 times more often than in “other forms of acute IHD”. Chronic forms of IHD were registered in 76,9% of cases; in 47,3%, such IHD form as “Atherosclerotic heart disease” was noted. The proportion of deaths from acute MI and deaths after MI was 37,3%. In 92,1% of MCCDs of “other forms of acute IHD”, “acute coronary insufficiency” is indicated. Differences in the prevalence of various IHD forms between men and women were significant (p<0,0001). In female mortality pattern, there are 3 times less deaths from other (non-MI) acute forms of IHD and almost 2 times less deaths from old myocardial infarction and cardiac aneurysm. As the immediate cause of death, heart failure was indicated in 78,9%, while among those with prior MI — in 91%. In other acute forms of IHD, acute coronary insufficiency was indicated in 89%.Conclusion. A high proportion of deaths with unspecified acute and chronic forms of IHD as the cause of death, especially in young men, requires a comprehensive study and development by the Russian Society of Cardiology of criteria for death from various IHD forms.