[Regional experience of conducting registry of acute coronary syndrome].

Since 2008 Cardiological Dispensary of Khanty-Mansi Autonomous Okrug "Center of Diagnostics and Cardiovascular Surgery" has been participating in Rossiysky Registry of Acute Coronary Syndrome. In this paper we present some of the results on the use of percutaneous coronary interventions, time intervals, characterizing urgent medical aid to patients with acute coronary syndrome, rate of complications, and mortality.

[ST-segment elevation acute coronary syndrome (according to the data of the District Cardiac Dispensary Register of Surgut)].

AIM: To analyze the individual indicators of emergency medical care in ST-segment elevation (STSE) acute coronary syndrome (ACS) according to the data of the ACS Register of the District Cardiology Dispensary, Center for Diagnosis and Cardiovascular Surgery, Khanty-Mansi Autonomic District-Yugra, Surgut, over time from 2008-2010 and 2011 versus the data of health care facilities taking part in the ACS Register. MATERIALS AND METHODS: The quality of medical care for patients with STSE ACS was considered and analyzed in accordance with "The information analytical system user's guide for the integrated rapid assessment of the quality and level of organization of medical care for patients with acute coronary syndrome to "The Federal Register of Patients with ACS". RESULTS: The data of the ACS Register of the Surgut District Cardiology Dispensary indicate that the majority of patients with STSE ACS are males (86.9%); the patients' median age is 56.0 (range 51.0-61.0) years. The scope of performed drug therapy is comparable with the data of the European Registers: aspirin (97.6%), clopidogrel (93.7%), anticoagulants (98.5%), angiotensin-converting enzyme inhibitors (96.6%), beta-blockers (96.1%), and statins (87.4%). In STSE ACS, percutaneous coronary intervention is performed in 93.7% of cases; thrombolytic therapy in 14.6%; emergency coronary bypass surgery in more than 3%. CONCLUSION: The individual indicators characterizing the level of medical care for STSE ACS were analyzed using the ACS Register.

[Acute coronary syndrome: regional experience of rendering urgent aid at prehospital stage in Khanty-Mansi Autonomous Okrug--Yugra].

Aim of the study was assessment of efficacy of rendering urgent aid to patients with acute coronary syndrome (ACS) at prehospital stage on the territory of Khanty-Mansi Autonomous Okrug (KhMAO). The analysis showed that yearly about 5000 inhabitants of KhMAO-Yugra received prehospital medical care (30% because of acute myocardial infarction, 70% because of unstable angina). Over 3 years portion of persons requesting medical aid during first 3 hours after onset of pain attack increased 6.1%. Rate of prehospital fibrinolysis did not exceed 6.5%. Alteplase was used most often (79.7%). Late patient's appeal was among causes of rare application of thrombolytic therapy (41.8%). Most physicians responsible for prehospital care considered it necessary to refer patients with ACS directly to centers of interventional cardiology. The data obtained would promote improvement of quality of medical aid to ACS patients at prehospital stage.

[Prognostication of results of coronary artery bypass surgery in men living in the North].

We analyzed immediate and remote results of coronary artery bypass surgery and prognostication of outcome of the intervention in dependence on various risk factors in 576 men aged 29 - 71 years living in the North. We formed a model with strong prognostic effect on lethal outcome during in-hospital postoperative period which included the following parameters: perioperative myocardial infarction, complex character of surgery, left ventricular ejection fraction less than 40%, number of distal anastomoses 5 and more, functional class III chronic heart failure. Method of regression analysis revealed factors also related to lethal outcome in period of hospitalization: functional class IV of angina, duration of operation more than 5 hours, mitral insufficiency of 2nd degree and above, myocardial infarction of left ventricular anterior wall, history of 2 or more infarctions. Model with strong prognostic effect on mortality in remote period (3 years after surgery) included the following parameters: left ventricular ejection fraction less than 40%, functional class III chronic heart failure, repeat character of operation, left ventricular aneurysm, lack of use of internal mammary artery. Most significant factors additionally affecting long term mortality were the following: involvement of left coronary artery trunk, duration of surgery more than 5 hours, atherosclerosis of magistral arteries, mitral insufficiency of 2nd degree and above, cardiac rhythm disturbances.