Rehabilitation and follow-up monitoring of patients who have experienced acute coronary syndrome in Perm krai

Objective. To analyze the organization of medical care for patients having experienced acute coronary syndrome (ACS) in terms of rehabilitation and long-term follow-up in Perm Krai (PK).

Materials and methods. Specialists from the Ministry of Health of Perm Krai and employees of Perm State Medical University (PSMU) conducted an audit of the organization of rehabilitation process and long-term follow-up of patients who have suffered from ACS using the regional data of 2024.

Results. In 2023, the total mortality rate per 100,000 population in Perm Krai was higher than the Russian average (1333.8 versus 1206.2). However, there was a decrease in the mortality rate by 4.1 % compared to 2022. The structure of mortality from diseases of the circulatory system: chronic forms of coronary heart disease (CHD) was 46.5 %, acute myocardial infarction (MI) accounted for 4.3 % of CVD. The number of patients with CHD was 76,870 in 2018 and 80,867 in 2023, but only 65,322 (68.0 %) of them were under a long-term follow-up in 2023. The number of patients with the history of ACS being under medical supervision decreased from 6,859 people in 2018 to 5,948 people in 2023. The proportion of patients with ACS who got the first stage cardiac rehabilitation became 3 times less. In 2023, the coverage of follow-up monitoring of patients with MI (84.3 % versus 91.6 % in the Russian Federation) and stroke (83.4 % versus 91.0 % in the Russian Federation), newly diagnosed patients with diseases of the circulatory system (67.8 % versus 73.1 %) and newly diagnosed patients with coronary heart disease (68.0 % versus 78.8 % in the Russian Federation) remains low. Detection rate of coronary heart disease (3.8 % versus 4.9 % in the Russian Federation) and cerebrovascular disease (3.5 % versus 5.0 % in the Russian Federation) among patients is poor.

Conclusions. To improve the long-term follow-up of patients with ACS in Perm Krai, we propose several key measures: organizing a monthly analysis of the effectiveness of long-term follow-ups, on-site counseling and training by specialists from the leading institutions of the region, ensuring continuity between inpatient and outpatient departments and informing the population. It is also necessary to intensify the rehabilitation process in general.