俄罗斯联邦急性冠状动脉综合征的治疗发生了什么变化?

IF 0.3 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
S. Boytsov, B. Alekyan, R. Shakhnovich, V. Ganyukov
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引用次数: 0

摘要

俄罗斯联邦国家血管中心网络根据俄罗斯心脏病学会的临床建议和向心血管疾病患者提供医疗服务的程序开展工作,在该国治疗急性冠状动脉综合征(ACS)患者方面取得了显著的积极成果,尽管一些目标尚未实现。该出版物的目的是展示2020-2022年ACS患者治疗方法的趋势。并对其有效性进行分析。本文分析的ACS患者治疗的定量和定性指标是根据俄罗斯卫生部2018-2021年的监测数据获得的。介绍:监测降低冠心病死亡率的措施,俄罗斯卫生部2015年3月13日第17-6 / 10 / 1-177号和2015年7月24日第17-9 / 10 / 2-4128号信函,其中每月进行数据收集;在俄罗斯卫生部联邦国家预算机构“TsNIIOIZ”的门户网站上-监测医疗统计的自动化系统和登记区域- im(俄罗斯急性心肌梗死登记)-由联邦国家预算机构“以俄罗斯卫生部院士命名的国家心脏病医学研究中心”组织的2020-2022年多中心前瞻性观察队列研究。在俄罗斯,2020年和2021年诊断为ACS的患者分别为403,931例和397,930例。俄罗斯医院诊断为ACS的患者人数减少了22.32%,主要是由于诊断为非st段抬高ACS (non-STE-ACS)的患者入院人数显著减少(29.03%)。与此同时,ST段抬高型心肌梗死(STEMI)患者入院率仅下降6.02%。与2018-2019年相比,2020-2022年。原发性经皮冠状动脉介入治疗(PCI)组(9.6%)和一般STEMI组(12.3%)死亡率增加;NSTE-ACS普通组(48%)和非ste - acs患者PCI期间(28.6%)的死亡率均显著增加;平均每年首次PCI次数增加(12.6%);非ste - acs患者PCI次数的绝对和相对增加(分别增加2.7%和37.1%)。在该国的医院,到出院时,95%的患者接受他汀类药物,-受体阻滞剂- 87%,ACE抑制剂- 80%,乙酰水杨酸- 82%,P2Y12抑制剂- 98%的患者,无论ACS类型如何。在俄罗斯,2020-2022年对ACS患者提供护理的不利趋势包括:初级PCI和一般STEMI组死亡率增加;非ste - acs普通组和非ste - acs患者PCI期间的死亡率均增加。国家血管中心网络工作的积极成果包括:原发性PCI数量的绝对、相对和估计增加;非ste - acs患者PCI次数的绝对和相对增加;高水平的处方药物,证明对预后有积极作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
What is changing in the treatment of acute coronary syndrome in the Russian Federation?
The work of the national network of vascular centers of the Russian Federation (RF), based on the Clinical recommendations of the Russian Society of Cardiology and the procedure for providing medical care to patients with cardiovascular diseases, has led to significant positive results in the treatment of patients with acute coronary syndrome (ACS) in the country, although a number of targets have not yet been reached. The purpose of the publication is to demonstrate the trend in therapeutic approaches to the management of patients with ACS in 2020-2022. in Russia and analysis of their effectiveness. Quantitative and qualitative indicators of the treatment of patients with ACS for the presented analysis were obtained on the basis of monitoring data from the Russian Ministry of Health for 2018-2021. presented: Monitoring of measures to reduce mortality from coronary heart disease, letters of the Ministry of Health of Russia dated March 13, 2015 No. 17-6 / 10 / 1-177 and dated July 24, 2015 No. 17-9 / 10 / 2-4128, within which data collection carried out monthly, on the portal of the Federal State Budgetary Institution "TsNIIOIZ" of the Ministry of Health of Russia - Automated system for monitoring medical statistics and the register REGION-IM (Russian Register of Acute Myocardial Infarction) - a multicenter prospective observational cohort study for 2020-2022, organized by the Federal State Budgetary Institution "National Medical Research Center of Cardiology named after Academician E.I. Chazov" of the Ministry of Health of Russia. In Russia with a diagnosis of ACS in 2020 and 2021 403,931 and 397,930 patients were hospitalized, respectively. The decrease in the number of patients diagnosed with ACS admitted to Russian hospitals by 22.32% was mainly due to a significant decrease in hospital admissions of patients diagnosed with non-ST elevation ACS (non-STE-ACS) (by 29.03%). At the same time, the admission of patients with ST elevation myocardial infarction (STEMI) decreased only by 6.02%. Compared to 2018-2019, in 2020-2022. increased mortality in primary percutaneous coronary intervention (PCI) (by 9.6%) and in the general STEMI group (by 12.3%); significantly increased mortality both in the general group of NSTE-ACS (by 48%) and during PCI for patients with non-STE-ACS (by 28.6%); there was an increase in the average annual number of primary PCI (by 12.6%); an absolute and relative increase in the number of PCI in non-STE-ACS was revealed (by 2.7 and 37.1%, respectively). In the country's hospitals, by the time of discharge, 95% of patients receive statins, beta-blockers – 87%, ACE inhibitors – 80%, acetylsalicylic acid – 82%, P2Y12 inhibitors – 98% of patients, regardless of the type of ACS. In Russia in 2020-2022 unfavorable tendencies in the provision of care to patients with ACS include: increased mortality in primary PCI and in the general STEMI group; increased mortality both in the general group of non-STE-ACS and during PCI for patients with non-STE-ACS. The positive results of the work of the national network of vascular centers include: absolute, relative and estimated increase in the number of primary PCI; absolute and relative increase in the number of PCI in non-STE-ACS; a high level of prescribing drugs with a proven positive effect on the prognosis.
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来源期刊
Rational Pharmacotherapy in Cardiology
Rational Pharmacotherapy in Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.00
自引率
50.00%
发文量
79
审稿时长
6 weeks
期刊介绍: The primary goals of the Journal are consolidation of information on scientific and practical achievements in pharmacotherapy and prevention of cardiovascular diseases and continuing education of cardiologists and internists. The scientific concept of the edition suggests the publication of information on current achievements in cardiology, the results of national and international clinical trials. The Journal publishes original articles on the results of clinical trials designed to study the effectiveness and safety of drugs, analysis of clinical practice and its compliance with national and international recommendations, expert s’ opinions on a wide range of cardiology issues, associated conditions and clinical pharmacology. There is a heading “Preventive cardiology and public health” in the Journal to stimulate research interest in this highly demanded area. Memories of the outstanding people in medicine including cardiology, which are of great interest to historians of medicine, are published in "Our Mentors” heading.
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