Management of patients with acute ST-segment elevation myocardial infarction in Russian hospitals adheres to international guidelines

Kontsevaya, A. V.; Bates, Katie; Schirmer, Henrik; Bobrova, Natalia; Leon, David A.; McKee, Martin

doi:10.1136/openhrt-2019-001134

Cited by 10 publications

(10 citation statements)

References 20 publications

(20 reference statements)

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“…One of the key factors that may contribute to CVD mortality differences is the effective treatment and medical prevention of CVD. There is evidence for example, that since 2010 there has been a reduction of in hospital mortality from myocardial infarction, most likely related to a very rapid expansion of percutaneous coronary intervention facilities across Russia 7 , 37 . Moreover, more effective and longer term control of blood pressure in the Norwegian population, and the irregular control of it in Russia 38 may also be a relevant factor that is not reflected in the mean blood pressures per se.…”

Section: Discussionmentioning

confidence: 99%

“…Several attempts have been made to explain the elevated mortality rate in Russia including socioeconomic level, standard of medical care, and lifestyle factors 4 – 7 . It is acknowledged that behaviours such as smoking 8 , 9 and alcohol intake 10 – 12 and contextual factors such as gross domestic product (GDP) per capita 13 are likely to contribute the elevated mortality rate in Russia.…”

Section: Introductionmentioning

confidence: 99%

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Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway

Trias‐Llimós

Pennells

Tverdal

et al. 2020

Sci Rep

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Surprisingly few attempts have been made to quantify the simultaneous contribution of well-established risk factors to CVD mortality differences between countries. We aimed to develop and critically appraise an approach to doing so, applying it to the substantial CVD mortality gap between Russia and Norway using survey data in three cities and mortality risks from the Emerging Risk Factor Collaboration. We estimated the absolute and relative differences in CVD mortality at ages 40–69 years between countries attributable to the risk factors, under the counterfactual that the age- and sex-specific risk factor profile in Russia was as in Norway, and vice-versa. Under the counterfactual that Russia had the Norwegian risk factor profile, the absolute age-standardized CVD mortality gap would decline by 33.3% (95% CI 25.1–40.1) among men and 22.1% (10.4–31.3) among women. In relative terms, the mortality rate ratio (Russia/Norway) would decline from 9–10 to 7–8. Under the counterfactual that Norway had the Russian risk factor profile, the mortality gap reduced less. Well-established CVD risk factors account for a third of the male and around a quarter of the female CVD mortality gap between Russia and Norway. However, these estimates are based on widely held epidemiological assumptions that deserve further scrutiny.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway

Trias‐Llimós

Pennells

Tverdal

et al. 2020

Sci Rep

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“…Despite advances in treatment, patients with acute myocardial infarction (MI) have a poor long-term prognosis. Hospitalized patients with ST-segment elevation MI (STEMI) have an increased mortality rate [ 2 , 3 ], and mitral regurgitation (MR) is a common complication of STEMI [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

In-Hospital Mortality in Patients With Acute ST-Elevation Myocardial Infarction With or Without Mitral Regurgitation

Ullah¹,

Shireen²,

Ahmad³

et al. 2022

Cureus

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Background Mitral regurgitation (MR) is a common complication in hospitalized cardiac patients with ST-segment elevation myocardial infarction (STEMI); however, the patient outcomes depend on various factors that vary across facilities and regions. There is an acute need to stratify STEMI patients by risk of in-hospital mortality. We conducted this study to compare the mortality of patients with acute STEMI with or without MR admitted to different units of the Cardiology Department at Lady Reading Hospital (LRH) in Peshawar. Methods In this prospective study, we compared the mortality rates of STEMI patients with and without MR from June 5 to October 30, 2021. All patients with different types of STEMI treated at LRH were enrolled in the study regardless of age and gender. ST-elevation was confirmed via electrocardiogram, and MR was confirmed via echocardiography. We excluded any patients with primary organic valve disease or congenital heart disease. We also collected patient demographic and clinical characteristics. We used IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY) for statistical analyses. Results Our study population included 228 patients with a mean age of 62.4 ± 12.3 years. Most of the patients were men (n=140; 61.4%), and only 78 (38.6%) were women. The prevalence of MR was 29.4%. Hypertension was the most common comorbidity (63.6%), and inferior wall myocardial infarction (MI) was the most common type of MI (49.1%). Hypertension, prehospital cardiopulmonary resuscitation (CPR), and Killip class ≥ 2 were significantly associated with MR (p<.001). In-hospital mortality was 29.8%, significantly associated with MR (p=.0001). Patients who needed CPR prior to hospitalization and those with Killip class ≥ 2 were less likely to survive (p=.0001). Conclusions MR is common following MI, especially in cases of inferior wall MI. Patients with MR have a poorer prognosis than those without MR following MI, more so when combined with other comorbidities. Regarding its relation to MI complications, an assessment of the MR is necessary to make an appropriate decision for treatment.

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Section: Introductionmentioning

confidence: 99%

“…Early primary percutaneous coronary intervention (PPCI) has now been set up as the rst-line treatment for subjects who has acute myocardial infarction (MI) [1] . A randomized trial of moderate size [2][3][4][5][6][7] showed there is a signi cant increase in major adverse cardio-cerebral events (MACCE) after undergoing the PPCI. Indeed, in high-risk patients and lesion subsets, including those older than 65 years old, with renal dysfunction, diabetes mellitus (DM), thrombotic target lesion and multi-vessel disease residual atherothrombotic risk remains substantial.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a prediction rule of major adverse cardiac and cerebrovascular event for high-risk STEMI patients after primary percutaneous coronary intervention

Zhao¹,

Liu²,

Zhou³

et al. 2021

Preprint

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Background and Aims We aimed to develop a clinical prediction tool to improve the prognostication of major adverse cardiac and cerebrovascular events (MACCE) among high-risk myocardial infarction (MI) patients undergoing primary PCI. Methods Among 4151 consecutive MI patients who underwent primary percutaneous coronary intervention (PPCI) from FuWai Hospital in BeiJing, China (January 2010 and June 2017), and a prediction rule was derived from derivation and internally validation cohort to predict MACCE after PPCI. Subject must have met at least one clinical criterion and at least one angiographic criterion to be eligible for treatment in the study. The predictive values of markers and clinical variables were assessed with least absolute shrinkage and selection operator (LASSO) regression. The most important variables were included in the score with weights proportional to the model coeﬃcients. Results The full model included 7 variables, and the risk score was total 160 points. The full model had similar discriminatory value across pre-specified subgroups and was well calibrated. Derivation cohort models predicting MACCE events had C statistics of 0.695 and 0.673, respectively. The areas under curve (AUC) of the survival receiver operator characteristic curve (ROC) were 0.991 and 0.883 in derivation and validation cohort among 3-year follow-up for predicting the MACCE events. The relative high risk group was observed to have significantly greater likelihood of occurrence of all-caused death, recurrence MI, heart failure, ischemic stroke, hemorrhagic stroke and revascularization compared with the low risk group (p<0.05 respectively). Conclusion The predicted model was internally validated and calibrated in large cohorts of patients with high risk MI receiving primary PCI therapy to predict the MACCE event and showed modest accuracy in derivation and validation cohorts.

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Management of patients with acute ST-segment elevation myocardial infarction in Russian hospitals adheres to international guidelines

Cited by 10 publications

References 20 publications

Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway

Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway

In-Hospital Mortality in Patients With Acute ST-Elevation Myocardial Infarction With or Without Mitral Regurgitation

Development and validation of a prediction rule of major adverse cardiac and cerebrovascular event for high-risk STEMI patients after primary percutaneous coronary intervention

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