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. 2017 Dec;121(12):1274-1279.
doi: 10.1016/j.healthpol.2017.09.018. Epub 2017 Oct 5.

How Has the Management of Acute Coronary Syndrome Changed in the Russian Federation During the Last 10 Years?

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Free PMC article

How Has the Management of Acute Coronary Syndrome Changed in the Russian Federation During the Last 10 Years?

Anna Kontsevaya et al. Health Policy. .
Free PMC article

Abstract

Methods: We report trends and patterns of percutaneous cardiovascular interventions (PCI) by region for 2005-2009, with more detailed data on management of myocardial infarctions in 2009-2103, relating them to regional economic development and changes in mortality from myocardial infarction.

Results: PCIs per 100,000 population increased from 8.7 in 2005-71.3 in 2013, with considerable regional variation. In 2013 the highest rates were in the wealthiest regions, although not in some remote regions dependent on oil and mineral extraction. Between 2009 and 2013 rates of thrombolysis in those with acute myocardial infarctions potentially eligible for treatment remained broadly similar at about 28% but rates of primary revascularisation with stenting rose rapidly, from 6.5% to 23.7%. In-hospital mortality from myocardial infarction since 2009 has declined most in regions achieving highest rates of primary revascularisation.

Conclusions: The sustained investment in advanced cardiovascular technology has been associated with substantial increases in revascularisation in some but not all regions. However, rates overall remain far behind those in Western Europe. Further research is in progress to understand the reasons for these variations and the barriers to further expansion of services.

Keywords: Access to medical care; Acute coronary syndrome; Percutaneous cardiovascular interventions; Russian Federation.

Figures

Fig. 1
Fig. 1
Trends in PCI/100,000 population by Russian federal district 2005–2013.
Fig. 2
Fig. 2
Rate of angioplasty/100,000 population in Russian regions in 2013 (top) and the absolute change between 2005 and 2013 (bottom).
Fig. 3
Fig. 3
Association between annual increase in PCI/100,000 population (2005–2013) and gross regional product in Russian regions.
Fig. 4
Fig. 4
Trends in-hospital mortality following acute myocardial infarction in Russian federal districts.

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