Patient routing and choice of reperfusion therapy for acute coronary disease (the experience of the Chelyabinsk region)

Aim: to improve the results of treatment in patients with acute coronary heart disease. We analyzed medical records of patients admitted to one of Chelyabinsk regional vascular centers. According to the analysis, 248 patients with acute myocardial infarction were treated in 2012, and 300 patients in 2013, respectively. We have discovered that mortality rate depends on the type of reperfusion treatment. In medical organization that had provided the basis of our research the mortality rate in patients with acute coronary disease was reduced from 16 % in 2007-2011 to 12 % in 2012-2013 with the help of emergency coronary stent placement. The lowest mortality rate was recorded in patients who had emergency coronary stent placement with/without thrombolytic therapy. The highest mortality rate was recorded in patients who did not receive reperfusion therapy: 19.6 % in 2012 and 21.6 % in 2013. Choice of reperfusion methods should be considered according to patient's condition, presence/absence of medical contraindications and regional health care system capability. Compliance with medical recommendations adapted for real practice will contribute to the rational usage and medical and economical effectiveness of reperfusion resources. When patient flow in the regional vascular center is intensive and diverse with various types of acute coronary pathology presented, all kinds of reperfusion therapy can find their application.