cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2013-5-40-44cardiovascular-233Research ArticleОСТРЫЙ КОРОНАРНЫЙ СИНДРОМACUTE CORONARY SYNDROMEОЦЕНКА МЕРОПРИЯТИЙ ПО РЕПЕРФУЗИИ МИОКАРДА У БОЛЬНЫХ С ОСТРЫМ КОРОНАРНЫМ СИНДРОМОМ С ПОДЪЕМОМ СЕГМЕНТА ST НА ОСНОВЕ КРИТЕРИЕВ АМЕРИКАНСКОГО КОЛЛЕДЖА КАРДИОЛОГИИ/ АМЕРИКАНСКОЙ АССОЦИАЦИИ СЕРДЦАASSESSMENT OF MYOCARDIAL REPERFUSION QUALITY IN PATIENTS WITH ACUTE CORONARY SYNDROME AND ST SEGMENT ELEVATION, BASED ON THE CRITERIA BY THE AMERICAN COLLEGE OF CARDIOLOGY/AMERICAN HEART ASSOCIATIONПосненковаО. М.PosnenkovaO. M.

к. м.н., с. н.с. Центра продвижения новых кардиологических информационных технологий

arthyplab@list.ruКиселевА. Р.KiselevA. R.

д. м.н., в. н.с. Центра

ГридневВ. И.GridnevV. I.

д. м.н., руководитель Центра

ПоповаЮ. В.PopovaYu. V.

аспирант

ДовгалевскийП. Я.DovgalevskyiP. Ya.

д. м.н., проф., директор

ОщепковаЕ. В.OshchepkovaE. V.

д. м.н., проф., руководитель лаборатории профилактики артериальной гипертонии

ФГБУ “Саратовский научно-исследовательский институт кардиологии” Минздрава России, Саратов, РоссияРоссияSaratov Research Institute of Cardiology, SaratovRussian FederationФГБУ “Российский кардиологический научно-производственный комплекс” Минздрава России, МоскваРоссияRussian Cardiology Scientific and Clinical Complex, MoscowRussian Federation2013201020131254044Copyright © Посненкова О.М., Киселев А.Р., Гриднев В.И., Попова Ю.В., Довгалевский П.Я., Ощепкова Е.В., 20132013Посненкова О.М., Киселев А.Р., Гриднев В.И., Попова Ю.В., Довгалевский П.Я., Ощепкова Е.В.Posnenkova O.M., Kiselev A.R., Gridnev V.I., Popova Y.V., Dovgalevskyi P.Y., Oshchepkova E.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/233Цель

Цель. Применить критерии, предложенные Американским колледжем кардиологии и Американской ассоциацией сердца (АСС/АНА), для оценки качества выполнения рекомендованных мероприятий по реперфузии миокарда у больных с острым коронарным синдромом (ОКС) с подъемом сегмента ST (ОКС↑ST) в России.

Материал и методы

Материал и методы. Изучались клинические данные 25682 больных с ОКС↑ST, которым в 2010–2011 гг. оказывалась медицинская помощь в стационарах РФ, входящих в российский регистр ОКС. Использовались индикаторы АСС/АНА 2008г: “Время до тромболитической терапии (ТЛТ)” – определяет долю больных с ОКС↑ST, кому начат тромболизис в течение 30 мин с момента поступления в стационар”; “Время до первичного чрескожного коронарного вмешательства (ЧКВ)” – определяет долю больных с ОКС↑ST, кому начато первичное ЧКВ в течение 90 мин с момента поступления в стационар; “Реперфузионная терапия” – определяет долю боль- ных с ОКС↑ST, кому выполнено любое реперфузионное вмешатель- ство в течение 12 ч с момента начала болевого синдрома.

Результаты

Результаты. Среди 25682 больных с ОКС↑ST, включенных в исследование, какие-либо реперфузионные вмешательства (ЧКВ и/или ТЛТ, без учета их очередности) выполнили 12043 (46,9%) пациентам. Индикатор “Время до ТЛТ показал, что из 7437 больных с ОКС↑ST, кому выполнили ТЛТ, 5119 (69%) больных удовлетворяли критериям включения. Среди них индикатор выполнен у 3342 (65,3%) больных. Индикатор “Время до первичного ЧКВ” показал, что из 5405 больных с ОКС↑ST, кому выполнялось ЧКВ, критериям включения удовлетворяли 3993 (73,9%) больных. Среди них индикатор был выполнен у 2797 (70%) больных. Индикатор “Реперфузионная терапия” показал, что среди 25135 (97,9%) больных с ОКС↑ST, включенных в анализ, индикатор выполнен у 9800 (38,9%) пациентов.

Заключение

Заключение. Главная проблема медицинской помощи больным с ОКС↑ST в России – охват реперфузионными методами. При этом отмечается относительно удовлетворительное качество их выполнения. 

Aim

Aim. To use the criteria by the American College of Cardiology/American Heart Association (ACC/AHA), in order to assess the quality of myocar-dial reperfusion in Russian patients with acute coronary syndrome (ACS) and ST segment elevation (STE-ACS).

Material and methods

Material and methods. We analysed the clinical data of 25682 patients with STE-ACS, who were treated (2010–2011) in Russian hospitals participating in the Russian ACS Registry. The following ACC/AHA indicators (2008) were used: “time to thrombolysis” — the percentage of STE-ACS patients who received thrombolysis within 30 minutes after admission; “time to primary percutaneous coronary intervention (PCI)” — the per-centage of STE-ACS patients in whom primary PCI started within 90 minutes after admission; and “reperfusion” — the percentage of STE-ACS patients who underwent any reperfusion intervention within 12 hours after the chest pain onset.

Results

Results. Among 25682 STE-ACS patients, any reperfusion intervention (PCI and/or thrombolysis, in any order) were performed in 12043 (46,9%). Among 7437 STE-ACS patients who underwent thrombolysis, 5119 (69%) met the inclusion criteria. In this group, the indicator “time to thrombolysis” was met in 3342 patients (65,3%). Among 5405 STEACS patients who underwent PCI, 3993 (73,9%) met the inclusion criteria. In these patients, the indicator “time to primary PCI” was met in 2797 (70%). Finally, among 25135 (97,9%) patients with STE-ACS who were included in the analyses, the indicator “reperfusion” was met in 9800 (38,9%).

Conclusion

Conclusion. The main problem of the health care for Russian patients with STE-ACS is the limited reperfusion coverage. However, the reperfusion quality could be regarded as satisfactory. 

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The authors declare that there are no conflicts of interest present.