Ways of improvement of specialized medical care for acute coronary syndrome in the regional vascular center

Objective: to improve the results of treatment of patients with acute coronary pathology. We performed retrospective analysis of medical activities of the regional vascular centres of the Chelyabinsk region and the specific health organization which work within the framework of the Regional program of specialized medical care in acute coronary syndrome. In 2013, 4373 patients with acute coronary syndrome applied to the regional vascular centres of the Chelyabinsk region; in 2014 - 5553 patients (+27 %). The rate of patients, who were treated in these medical institutions and had the final diagnosis of acute myocardial infarction (AMI), among the total number of AMI in 2013 and 2014, was 38.2 % and 47.3%, respectively. In 2014 the number of emergency coronarography in patients with AMI, which was performed by regional vascular centres, was higher than in 2013 - 2677 against 1589, +68 %. The number of emergency stenting in 2014 was 1529 operations, in comparison with 2013 - 884 (+73 %). In 2014, the participation rate of Road Clinical Hospital at Chelyabinsk station, JSC “Russian Railways” in the diagnostic and therapeutic work among the regional vascular centres of the Chelyabinsk region was 19.6 % and 26.2 % respectively. In the dynamics of 2013-2014 at the level of the hospital, the number of coronary interventions was increased: diagnostic - from 231 to 525 (+127 %); medical - from 208 to 400 (+92 %). The regional vascular centres are the most important organizational elements of the treatment of AMI, because the majority of emergency percutaneous coronary interventions are performed there. The improved results of the treatment are connected with the complex of measures aimed at formation of favorable conditions for coronary stenting practice which has the significant impact on reducing the hospital mortality.