[Autopsy study in the analysis of cardiovascular mortality].

The frequency of using autopsy to verify the cardiovascular causes of death was studied in typical regions of Russia. One thousand and sixty deaths from circulatory system diseases were analyzed among a representative sample of 285,736 subjects. Death occurred outside health care facilities in 88% of the analyzed cases; nevertheless, autopsy was made only in 28.3%. Moreover, autopsy was carried out in all cases of less than 40-year-old males and less than 50-year-old females who had died from suspected cardiovascular diseases. The proportion of notified cardiovascular mortality increased in the structure of overall mortality and the rate of autopsy-verified diagnosis decreased with advanced age. To obtain valid information on cardiovascular mortality rates is limited due to low autopsy rates primarily in cases of death outside health care facilities, particularly among elderly and senile persons, despite the fact that it is these fatal cases that constitute the bulk of registered cardiovascular mortality.

[Detectability of acute forms of coronary heart disease in real clinical practice].

The study was designed to evaluate the frequency of inapparent and/or unrecorded cases of acute coronary heart disease (CHD) and its influence on overall estimates of CHD mortality and morbidity. A specially developed algorithm was used to identify unrecorded cases in official medical documentation concerning 285,736 subjects. Their fraction was found to be 20.78 and 24.48% among men and women respectively. 89.43% of them died from acute CHD. Addition of the newly identified cases to official statistics increased overall CHD morbidity rates by 26.24 and 32.41% for men and women and mortality rates by 2.13 and 2.28 times respectively. These data indicate that acute CHD is poorly diagnosed in routine clinical practice and the real CHD mortality rate is grossly underestimated.