Department of Non-communicable Disease Epidemiology, National Research Center for Preventive Medicine, Moscow, Russian Federation. Electronic address: AKontsevaya@gnicpm.ru.
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.
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.
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.
Notes
Cites: PLoS One. 2014 Aug 20;9(8):e103280 PMID 25141122
Cites: Surg Res Pract. 2014;2014:726158 PMID 25374960
Cites: Eur Heart J. 2014 Aug 1;35(29):1957-70 PMID 24419804