Reperfusion therapy for ST-elevation acute myocardial infarction in Eastern Europe: the ISACS-TC registry

Abstract

A substantial number of patients are still not offered any reperfusion therapy in many Eastern European countries with economy in transition, and this was associated with increased 30-day mortality. Time from symptoms onset to admission >12 h was the highest ranking among factors related to lack of reperfusion therapy. Quality improvement efforts should focus on minimizing delay to hospital admission among STEMI patients.

Delayed Care and Mortality Among Women and Men With Myocardial Infarction

“…is a large observational registry initiated in 2010. The protocol was described previously . Briefly, ISACS‐TC is an investigator‐driven initiative designed to include information on risk factors, clinical presentation, and complications of acute coronary syndromes.…”

Contemporary roles of registries in clinical cardiology: Insights from Western and Eastern European countries

“…Beyond the quality of care provided in hospitals, differences in pre-hospital logistics, management and time delays strongly influence patients' outcome. This is particularly true for the Central and Eastern European countries [12,14,15].…”

“…To date this international clinical registry has revealed substantial opportunities for healthcare improvement among patients with acute STEMI (as reflected in long times to reperfusion and high 30 day mortality rates), and reported the efficiency of early blockade following acute coronary syndrome (associated with improved left ventricular systolic function and higher in-hospital survival rates) [14,17]. A recent study from the ISACS-TC registry reviewed current practice in antithrombotic therapy and reported that STEMI patients who fail to receive any reperfusion therapy benefit in terms of survival from unfractioned heparin -clopidogrel combination therapy without significant increases in risk of bleeding as compared to combined enoxaparin and clopidogrel therapy [18].…”

“…Whilst there are several reports of between country comparisons of acute myocardial infarction care and outcomes, typically these have either compared high performing countries with each other, [19][20][21] eastern countries with each other, [14,16] or used aggregated data [11,22,23] to compare many countries. There are limited contemporary comparisons of care for acute myocardial infarction between eastern and western European countries which have used patient-level data derived from a range of clinical registries [10].…”

Comparative Results of Recombinant Non-Immunogenic Staphylokinase and Tenecteplase Use in St-Segment Elevation Myocardial Infarction in Real Clinical Practice

“…Однако, в ряде регионов Восточной Европы и России, в силу вполне понятных причин, такое вмешательство не может быть проведено в приемлемые сроки всем больным ИМпST, и даже большинству из них [3,4]. По-этому в нашей стране на сегодняшний день основным методом восстановления кровотока по инфаркт-свя-занной артерии остается тромболитическая терапия (ТЛТ), которая может быть изолированной, либо со-провождаться последующей рутинной ангиографией, то есть, проводиться в рамках фармакоинвазивного подхода [5].…”