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

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.