ENDOVASCULAR TREATMENT OF ISCHEMIC HEART DISEASE IN THE SUBJECTS OF THE CENTRAL, VOLGA AND NORTH CAUCASIAN FEDERAL DISTRICTS OF RUSSIA FOR THE PERIOD 2019–2023

Highlights

• The number of therapeutic endovascular interventions on coronary arteries in Russia has increased significantly over the observed period of 2019–2023.
• There is an uneven distribution and use of angiographic units, which may be the reason for insufficient performance of X-ray endovascular interventions and/or ineffective use of expensive equipment.
• Despite the increasing number of percutaneous coronary interventions in the Russian Federation, clinical and economic difficulties remain in the treatment of various forms of coronary heart disease. Analysis of the dynamics of myocardial revascularization indicators allows monitoring the implementation of treatment measures in the regions of Russia and identifying ways to further improve their effectiveness.

Abstract

Aim. To study the dynamics of the number of therapeutic percutaneous coronary interventions (PCI) performed in the subjects of the Central, Volga and North Caucasian Federal Districts of Russia for the period 2019–2023.

Methods. The sources of information were data provided at the request of the A.N. Bakulev National Medical Research Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation, official statistics (statistical observation forms No. 14; 30); materials obtained during field events in the supervised regions; statistics of the Organization for Economic Cooperation and Development, literature data.

Results. During the observed period, the number of regional vascular centers in the supervised subjects of the Russian Federation increased by 54.2%. However, the distribution of angiographic equipment in the subjects remains uneven, which led to different efficiency of its use: from 0.7 interventions (excluding planned coronary angiographic studies and interventions on other vessels) per one angiographic unit in the Republic of North Ossetia-Alania and the Karachay-Cherkess Republic to 3.4 in the Kostroma Region. In the studied federal districts the total number of therapeutic PCI increased by an average of 1.5 times: from 89 863 to 135 009 operations. Compared with 2019 the number of PCI per 100 thousand population in 2023 increased by 54.1% (from 137.15 ± 45.04 to 211.41 ± 61.51 operations): in the Central Federal District the number of PCIs was 184.0; in the Volga Federal District – 225.0; in the North Caucasus Federal District – 149,8 per 100 thousand population. Compared to 2019 hospital mortality after PCI increased by 6.7% (from 2.85% in 2019 to 3.05 in 2023): in the Central Federal District mortality increased from 3.69% to 4.10%, in the Volga Federal District – from 2.67% to 3.44%; in the North Caucasus Federal District – decreased from 1.98% to 1.70%

Conclusions. In the studied federal districts in 2019–2023 the number of PCI increased by 1.5 times. At the same time mortality increased by 6.7%, which requires measures to eliminate it. There is an uneven territorial distribution of angiographic equipment, which may be the reason for its ineffective use.

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