Clinical, Anamnestic, and Demographic Characteristics of Patients with Myocardial Infarction in Russian Federation According to the Russian Registry of Acute Myocardial Infarction – REGION–IM

Aim. Based on data from the Russian REGION-MI registry, to characterize patients with myocardial infarction (MI) hospitalized in Russian hospitals, describe their historical, demographic, and clinical characteristics, and compare the results with the data of previous Russian and international registries of acute coronary syndrome.
Material and methods. REGION-MI is a multicenter prospective observational study. The follow-up period was divided into three stages: during the hospital stay, at 6 and 12 months after the inclusion in the registry. Demographic and historic data and information about the present case of MI were entered into the patient’s individual record card.
Results. The median age of all patients was 63 years; 68% of patients were men. The mean age of women was older than that of men. Among all MI cases, 70% were ST-segment elevation myocardial infarction (STEMI). Patients with non-ST-segment elevation myocardial infarction (NSTEMI) were older and had more comorbidities than patients with STEMI. The median time from the first symptoms to ECG recording was two hours, and from the first symptoms to CAG 7 hours. CAG was performed in 91% of patients with STEMI and 84% of patients with NSTEMI. Stenting was performed in 69% of patients. Although many patients had a complicated cardiovascular history, at the time of admission only 31.5% of patients were taking at least one drug from the groups of antiplatelets, oral anticoagulants, statins, and beta-blockers.
Conclusion. Patients with MI in the Russian Federation are younger than patients with MI in European countries. Among the clinical and historical characteristics, conspicuous is the presence of modifiable risk factors in many patients, as well as the presence of a previous diagnosis of ischemic heart disease. Furthermore, a small proportion of patients took statins, antiplatelet agents or anticoagulants at the outpatient stage, which indicates a great reserve of both primary and secondary prevention of cardiovascular diseases in the Russian Federation. The delayed seeking medical help is also noticeable, which indicates the need for increasing the public awareness of the symptoms of MI and the importance of timely hospitalization.

1. Federal State Statistics Service. The Demographic Yearbook of Russia. Statistical Handbook. -M.: Rosstat;2021. - 256p. Доступно на: https://rosstat.gov.ru/storage/mediabank/dem21.pdf

2. Boytsov S.A., Shakhnovich R.M., Erlikh A.D., Tereschenko S.N., Kukava N.G., Rytova Yu.K. et al. Registry of Acute Myocardial Infarction. REGION-MI – Russian Registry of Acute Myocardial Infarction. Kardiologiia. 2021;61(6):41–51. DOI: 10.18087/cardio.2021.6.n1595

3. Kovalchuk E.Yu., Soroka V.V. Current clinical and epidemiological portrait of a patient with acute myocardial infarction (by the data of the regional vascular center). The Scientific Notes of the I. P. Pavlov St. Petersburg State Medical University. 2015;22(2):56–60. DOI: 10.24884/1607-4181-2015-22-2-56-60

4. Belle L, Cayla G, Cottin Y, Coste P, Khalife K, Labèque J-N et al. French Registryon Acute ST-elevation and non−ST-elevation Myocardial Infarction 2015 (FAST-MI 2015). Design and baseline data. Archives of Cardiovascular Diseases. 2017;110(6–7):366–78. DOI: 10.1016/j.acvd.2017.05.001

5. Schwaab B, Zeymer U, Jannowitz C, Pittrow D, Gitt A. Improvement of low-density lipoprotein cholesterol target achievement rates through cardiac rehabilitation for patients after ST elevation myocardial infarction or non-ST elevation myocardial infarction in Germany: Results of the P ATIENT CARE registry. European Journal of Preventive Cardiology. 2019;26(3):249–58. DOI: 10.1177/2047487318817082

6. Gandhi S, Garratt KN, Li S, Wang TY, Bhatt DL, Davis LL et al. Ten-Year Trends in Patient Characteristics, Treatments, and Outcomes in Myocardial Infarction From National Cardiovascular Data Registry Chest Pain–MI Registry. Circulation: Cardiovascular Quality and Outcomes. 2022;15(1):e008112. DOI: 10.1161/CIRCOUTCOMES.121.008112

7. SWEDEHEART. Annual report 2022. 2023. [Internet] Av. at: https://www.ucr.uu.se/swedeheart/dokument-sh/arsrapporter-sh/01-swedeheart-annual-report-2022-english-2/viewdocument/3479.

8. European Society of Cardiology. 30-day mortality after acute myocardial infarction drops with improved treatment. 2012. [Internet] Av. at: https://www.sciencedaily.com/releases/2012/08/120828073308.htm

9. Yeh RW, Sidney S, Chandra M, Sorel M, Selby JV, Go AS. Population Trends in the Incidence and Outcomes of Acute Myocardial Infarction. New England Journal of Medicine. 2010;362(23):2155–65. DOI: 10.1056/NEJ-Moa0908610

10. Erlikh A.D., Gratsiansky N.A. Registry of Acute Coronary Syndromes ‘RECORD-3’. Characteristics of Patients and Treatment During Initial Hos pitalization. Kardiologiia. 2016;56(4):16–24. DOI: 10.18565/cardio.2016.4.16-24

11. Erol MK, Kayıkçıoğlu M, Kılıçkap M, Arin CB, Kurt IH, Aktas I et al. Baseline clinical characteristics and Patient profile of the TURKMI: First results of nation-wide acute myocardial infarction registry in Turkey. The Anatolian Journal of Cardiology. 2020;24(1):43–53. DOI: 10.14744/AnatolJCardiol.2020.69696

12. Kalla K, Christ G, Karnik R, Malzer R, Norman G, Prachar H et al. Implementation of Guidelines Improves the Standard of Care: The Viennese Registry on Reperfusion Strategies in ST-Elevation Myocardial Infarction (Vienna STEMI Registry). Circulation. 2006;113(20):2398–405. DOI: 10.1161/CIRCULATIONAHA.105.586198

13. Thosar SS, Butler MP, Shea SA. Role of the circadian system in cardiovascular disease. Journal of Clinical Investigation. 2018;128(6):2157–67. DOI: 10.1172/JCI80590

14. McLoughlin SC, Haines P, FitzGerald GA. Clocks and Cardiovascular Function. Methods in Enzymology. 2015;552:211–28. DOI: 10.1016/bs.mie.2014.11.029

15. Takeda N, Maemura K. Circadian clock and vascular disease. Hypertension Research. 2010;33(7):645–51. DOI: 10.1038/hr.2010.68

16. Atkinson G, Jones H, Ainslie PN. Circadian variation in the circulatory responses to exercise: relevance to the morning peaks in strokes and cardiac events. European Journal of Applied Physiology. 2010;108(1):15–29. DOI: 10.1007/s00421-009-1243-y

17. Boytsov S.A., Shakhnovich R.M., Tereschenko S.N., Erlikh A.D., Kukava N.G., Pevsner D.V. et al. The prevalence of hyperlipidemia and features of lipid-lowering therapy in patients with myocardial infarction according to the Russian register of acute myocardial infarction REGION-MI. Kardiologiia. 2022;62(7):12–22. DOI: 10.18087/cardio.2022.7.n2051