The annual incidence of hospital admission for acute coronary syndrome (ACS) was 581 182 patients in Russian Federation in 2011. There are 195 592 with an acute myocardial infarction (AMI) and 385 590 – with unstable angina. Percutaneous coronary intervention (PCI) were performed for only 4,3 % ACS and 8,8 % AMI patients. There were 62 329 PCIs in the Russian Federation in 2011, and only 24 931 (40 %) were performed for ACS. The Russian Federation goals for ACS treatment were defi ned as follow: existing PCI centres should offer a 24/7 service; short «fi rst medical contact – balloon time» for myocardial infarction with elevation ST STEMI patients; the number of primary PCI should be more than 70 % of all STEMI cases; each STEMI patient after thrombolytic therapy should be transferred to a PCI center during 24 hours.

The article highlights the history and development of the «Stent for Life Initiative», launched in 2008 as a result of the joint work of the European Society of Cardiology (ESC), the European Association for Percutaneous Cardiovascular Interventions (EAPCI) and Eucomed, the European medical technology organization. It is aimed to promote life-saving indications for percutaneous coronary intervention, especially in all myocardial infarctions.

Primary PCI is the preferred and most effective reperfusion therapy of patients with acute myocardial infarction with ST elevations (STEMI). By developing the healthcare system for primary PCI (STEMI patients) the highly signifi cant decrease of mortality can be observed. There is a large variation among the STEMI patients´ treatment in Europe and beyond. The European «Stent for Life» Initiative can serve as the best nation- or even worldwide model of highly effective interdisciplinary healthcare collaboration.

Primary percutaneous coronary intervention (PPCI) provides the best treatment results for ST elevation myocardial infarction (STEMI). Minimizing PPCI delay is associated with higher survival rates of STEMI patients. Thrombolytic therapy may provide more effective reperfusion than delayed PPCI. The acceptable time of PPCI delay, which allows for the advantage of endovascular approach, is mostly within 60–120 minutes. This is feasible in most cases. If the estimated time from the fi rst medical contact to balloon infl ation is over 90–120 minutes it is necessary to optimize the logistics of the patient transfer to PPCI centers and increase the number of centers providing 24/7 service.

The article describes the main historical and current aspects, perspectives and tendencies of acute myocardial care system in Siberia in the context of the «Stent for Life» initiative and modern clinical guidelines.

The article describes the possible strategy of acute myocardial care modernization, according to the principles of the European «Stent for Life» initiative. The main purpose is to increase the proportion of primary percutaneous coronary interventions in order to provide a wider access to this technology to as many patients as possible.

«Symptom – balloon» time is the cornerstone quality indicator of the national (regional) primary percutaneous coronary intervention (PPCI) network. Many reasons for PPCI delay require huge efforts of health professionals and the governing authorities to achieve the target result. The target «symptom – balloon» time can be less than 3 hours.

«Kemerovo model» or closed circle is developed using the systemic approach. A key role in cardiac care is given to one specialized municipal institution – Kemerovo Cardiology Dispensary, which refl ects a management pattern characterized by a close cooperation at all levels of (emergency care, in-hospital setting, outpatient setting, rehabilitation), cardiological and cardiac surgery care in patients with acute coronary syndrome. «Kemerovo model» of care for ST-segment elevation MI patients develops a strategy to deliver specialized medical care and especially primary PCI, a prior method of reperfusion therapy, expeditiously. The implementation of the systemic approach of medical care to cardiovascular diseases has allowed to change a negative population rate by 2005 in Kemerovo.

The development of primary invasive strategy in acute myocardial infarction treatment in Kemerovo Cardiology Centre led to a signifi cant reduction in mortality from cardiovascular diseases in Kemerovo and made it possible to approach the European targets of the «Stent for Life» initiative. In Kemerovo region there are objective prerequisites for experience sharing and further development of the invasive strategy of acute myocardial infarction treatment at a regional level. The article highlights the perspectives and ways to further improve emergency care for acute myocardial infarction.

The article describes the main historical and current aspects, perspectives and tendencies of acute myocardial care system in Krasnoyarsk region in the context of the «Stent for Life» initiative and modern clinical guidelines.

The article describes the main current aspects, perspectives and tendencies of acute myocardial infarction care system in Kemerovo region regarding European program «Stent for Life» initiative and advanced clinical guidelines.