Management of patients with acute myocardial infarction without ST-segment elevation in the Republic of Moldova

Abstract

Purpose: To evaluate the quality of NSTEMI care in AMI centers and to identify potential gaps in the management of patients with this diagnosis. Material and methods: 550 patients with NSTEMI, hospitalized in 3 coronary angioplasty centers were enrolled in the study. The information was collected using a questionnaire composed of 179 questions, developed according to the standards of the EORP NSTEMI Registry. The research took place in two stages: retrospective observational study during 2019 and prospective - in the period 01.2020-09.2022. Results. The NSTEMI rate from the total number of patients hospitalized with AMI in the Institute of Cardiology and SP Novamed, in the period 2019-2022 was 21,6%. The results of the evaluation of NSTEMI management in the studied AMI centers are close to those reported by equivalent international registries (EORP NSTEMI, FAST-MI, PLACS, MINAP), excepting some differences in certain chapters: the diagnostic strategy of NSTE-ACS, risk stratification, diagnosis and treatment of hypercholesterolemia and the antiplatelet treatment indicated at discharge. The mortality rate in the hospital was 4,2%, at 30 days m8k– 6,0%, at 6 months after hospitalization – 10,2%, and at 12 months – 12,8%. Conclusions. The rate of NSTEMI in the Republic of Moldova is lower than that reported by the international registers of IMA, while the mortality indicators are higher. These discrepancies are largely explained by gaps in NSTEMI management identified within the studied AMI centers.