TEN-YEAR DYNAMICS OF SURGICAL AND ENDOVASCULAR TREATMENT OF ISCHEMIC HEART DISEASE IN THE RUSSIAN FEDERATION (2014–2023). PART 1.

Highlights

• Over the period from 2014 to 2023, the number of coronary artery angioplasties (with and without stenting) in the Russian Federation increased by 153%, and mortality increased from 2.1 to 4.3%. The number of coronary artery bypass grafting surgeries increased by 6.4%, without changing mortality (1.8 and 1.9%).

Absract

Aim. To assess the dynamics of the number of operations for coronary heart disease (CHD) and mortality in the Russian Federation in 2014–2023; possibilities for modifying the accounting and analysis of data.

Methods. The data obtained from Rosstat upon request from table 2000 of the federal statistical observation form (FSOS) No. 14 were used. The data contained information on the number of operations for CHD performed in hospitals of the Russian Federation and the number of deaths after operations for the year from 2014 to 2023.

Results. The number of operations for CHD in 2023 increased by 46.7% compared to 2014, with a period of decline during the COVID-19 pandemic (in 2020 compared to 2019 by 14.1% and recovery in 2022). In 2023, the absolute number of coronary artery angioplasties increased by 153% compared to 2014 (from 112,574 or 108 per 100,000 population in 2014; to 309,063 or 276 per 100,000 in 2023, or from 7 to 22.5 per 100 hospitalizations for coronary artery disease). The number of angioplasty operations without stenting decreased by 5%, and with stenting increased by 2.7 times. The number of coronary artery bypass grafting (CABG) surgeries increased by 6.4% (from 30,128 to 32,056; from 25 to 27.7 per 100 thousand population or from 1.7 to 2.2 per 100 hospitalizations for coronary artery disease; their share of the total number of operations for coronary artery disease decreased from 17.8% to 8.8%). The ratio between the number of angioplasties and CABG in 2014 was 4:1; in 2023, 10:1. The proportion of deaths from the number of CABG surgeries performed has not changed significantly over the past 10 years; the maximum was registered in 2021 (2.1%), the minimum in 2017 (1.6%). The proportion of deaths from the number of endovascular surgeries increased (in 2014 – 2.1%; in 2023 – 4.3%; p < 0.001).

Conclusions. A trend towards a significant increase in the number of coronary artery stenting (and mortality after them) against the background of stagnation in CABG surgeries was revealed. The lack of personalized databases does not allow for a correct assessment of the causes of the identified changes; it is necessary to change approaches to organizing accounting.

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