RESUMO
Aim To study features of diagnosis and treatment of acute myocardial infarction (AMI) in Russian hospitals, results of the treatment, and early and late outcomes (6 and 12 months after AMI diagnosis); to evaluate the consistence of the treatment with clinical guidelines; and to evaluate patients' compliance with the treatment.Material and methods The program was designed for 3 years, including 24 months for recruitment of patients to the study. The study will include 10,â000 patients hospitalized with a confirmed diagnosis (I21 according to ICD-10) of ST segment elevation acute myocardial infarction (MI) (STEMI) or non-ST segment elevation MI (NSTEMI) based on criteria of the European Society of Cardiology Guidelines on Forth Universal Definition of Myocardial Infarction (2018). The follow-up period was divided into three stages: observation during the stay in the hospital and at 6 and 12 months following inclusion into the registry. The primary endpoint included cardiac death, nonfatal MI during the hospitalization and after one-year follow-up. Secondary endpoints were 6-months and one-year incidence of repeated MI, heart failure, ischemic stroke, clinically significant hemorrhage, unscheduled revascularization after discharge from the hospital, and the proportion of patients who continue on statins, antiplatelet drugs, and drugs of other groups for 6 months and 1 year.Results The inclusion of patients into the registry started in 2020 and will continue for 24 months. By the time of the article publication (June, 2021), more than 2,000 patients will be included.Conclusion REGION-MI (Russian rEGIstry Of acute myocardial iNfarction) is a multicenter, retrospective and prospective observational cohort study that excludes any interference with the clinical practice. Results of the registry will help to analyze a real picture of medical care provided to patients with myocardial infarction and to schedule ways to improve the situation.
Assuntos
Infarto do Miocárdio , Humanos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/terapia , Estudos Prospectivos , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Federação Russa/epidemiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
We conducted an anonymous survey among 382 physicians (58% internists, 42% cardiologists) in order to obtain information on their opinion on various aspects of antithrombotic therapy in atrial fibrillation. The survey revealed low level of awareness about algorithms of stratification of risks of stroke, systemic embolism, and bleeding. Reported rates of clinical use of recommended antithrombotic agents were: warfarin--30, aspirin monotherapy--19, dabigatran--10, rivaroxaban--8, and combination of aspirin and clopidogrel--8%. Rate of use of drugs without sufficient evidence base in AF was 25%. When asked to designate antithrombotic drug of choice 85% of physicians indicated warfarin and 12%--novel anticoagulants (NOAC). The following factors were considered as limiting wide application of NOAC: high cost (59%), lack of data on these drugs (14%), and impossibility to control safety of their administration (9%).