Dynamics of clinical and demographic characteristics and immediate outcomes over a 4-year period in patients with primary transmural myocardial infarction (according to RIMIS register data)


DOI: https://dx.doi.org/10.18565/therapy.2024.9.15-22

Afonina O.S., Zagrebelny A.V., Kuzmina I.M., Gvindzhiliya T.R., Muradyan N.A., Martsevich S.Yu., Drapkina O.M.

1) National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia, Moscow; 2) N.V. Sklifosovsky Research Institute for Emergency Medicine of the Department of Healthcare of Moscow
Abstract. Myocardial infarction (MI) continues to be a serious health problem, despite the fact that modern treatment based on clinical guidelines can improve the prognosis of patients.
The aim: to compare the “portrait” of patient with primary acute transmural MI and hospital mortality rates in patients from 2017 and 2021 years.
Material and methods. The study was performed basing on the retrospective hospital register RIMIS. Patients with primary transmural MI admitted to the emergency cardiology department of Moscow vascular center from January 1 to December 31, 2017 and from January 1 to December 31, 2021 were included in the study. Permanent residence in Moscow or Moscow region was also an inclusion criterion. During 2017, 329 patients were admitted to the department with a diagnosis of acute MI, 153 of them met the inclusion criteria. During 2021, there were 219 and 42 such kind of patients, respectively.
Results. The average age of patients with transmural MI did not change. The proportion of males has increased in 2021. The patient groups were comparable in terms of risk factors such as smoking and obesity. There were also no statistically significant differences between them in terms of most points in their medical histories: arterial hypertension, coronary heart disease, exertional angina, anemia, and cancer. In 2021, the proportion of patients with a history of diabetes mellitus, stroke, and chronic kidney disease increased. Probably, it caused an increase in the number of patients with complications such as acute heart failure and cardiogenic shock. However, this did not significantly affect in-hospital mortality rates. About 30% of patients received regular drug therapy before admission to hospital in 2017 and 2021. The groups did not differ in terms of the time of admission to hospital. Most patients were admitted within the first 6 hours from the onset of the disease. There were also no differences in the number of endovascular interventions performed for most patients in both 2017 and 2021.
Conclusion. Over 4 years, an increase in the proportion of patients with comorbidities was noted, in particular diabetes mellitus, chronic kidney disease, and brain stroke. Apparently, due to this, they got more complications in the form of acute heart failure and cardiogenic shock.
Keywords: risk factors for coronary heart disease, acute coronary syndrome register, myocardial infarction register, hospital mortality, myocardial infarction
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About the Autors

Olga S. Afonina, MD, postgraduate student of the Department of preventive pharmacotherapy, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia, physician of functional diagnostics of the Department of functional diagnostics, N.V. Sklifosovsky Research Institute for Emergency Medicine of the Department of Healthcare of Moscow. Address: 129090, Moscow, 3 Bolshaya Sukharevskaya Sq.
E-mail: afonina-os@yandex.ru
ORCID: https://orcid.org/0000-0002-6635-9628
Alexander V. Zagrebelny, MD, PhD (Medicine), senior researcher at the Department of preventive pharmacotherapy, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia, cardiologist of the Department of emergency cardiology, N.V. Sklifosovsky Research Institute for Emergency Medicine of the Department of Healthcare of Moscow. Address: 129090, Moscow, 3 Bolshaya Sukharevskaya Sq.
E-mail: azagrebelny@mail.ru
ORCID: https://orcid.org/0000-0003-1493-4544
Irina M. Kuzmina, MD, PhD (Medicine), head of the Scientific Department of emergency cardiology for patients with myocardial infarction, N.V. Sklifosovsky Research Institute for Emergency Medicine of the Department of Healthcare of Moscow. Address: 129090, Moscow, 3 Bolshaya Sukharevskaya Sq.
E-mail: KuzminaIM@sklif.mos.ru
ORCID: https://orcid.org/0000-0001-9458-7305
Tamara R. Gvindzhiliya, MD, junior researcher at the Department of emergency cardiology for patients with myocardial infarction, N.V. Sklifosovsky Research Institute for Emergency Medicine of the Department of Healthcare of Moscow. Address: 129090, Moscow, 3 Bolshaya Sukharevskaya Sq.
E-mail: GvindzhiliaTR@sklif.mos.ru
ORCID: https://orcid.org/0000-0003-3362-3557
Nina A. Muradyan, MD, research scientist, cardiologist of the Department of emergency cardiology, N.V. Sklifosovsky Research Institute for Emergency Medicine of the Department of Healthcare of Moscow. Address: 129090, Moscow, 3 Bolshaya Sukharevskaya Sq.
E-mail: MuradyanNA@sklif.mos.ru
ORCID: https://orcid.org/0000-0003-1002-6629
Sergey Yu. Martsevich, MD, Dr. Sci. (Medicine), professor, chief researcher, head of the Department of preventive pharmacotherapy, National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101990, Moscow, 10/3 Petroverigsky Lane.
E-mail: sergeymartsevich@mail.ru
ORCID: https://orcid.org/0000-0002-7717-4362
Oksana M. Drapkina, MD, Dr. Sci. (Medicine), professor, academician of RAS, director of National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101990, Moscow, 10/3 Petroverigsky Lane.
E-mail: ODrapkina@gnicpm.ru
ORCID: https://orcid.org/0000-0002-4453-8430


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