WHO Program "Register of Acute Myocardial Infarction ": Effectiveness of Health Care for the 39-Year Period Patients with Myocardial Infarction (1977-2015) in Russia / Siberia

Objective: To identify the prodromal period, trends of diagnostic combinations, uptake and effectiveness of health care for the 39-year period patients with myocardial infarction (1977-2015), Siberia (Novosibirsk).
Methods: The program of WHO "Register of myocardial infarction", working in three areas of the city with a population of 600,000 inhabitants. During the 39 years of age (1977-2016 years.) 27 835 cases of myocardial infarction have been reported, of which 9,022 died.
Results: The prodromal period in surviving for 28 days after the onset of MI patients were significantly more than that of the dead, there was a worsening of angina, chest tightness and heaviness in their hands. In patients who died on the contrary prevailed shortness of breath, unusual fatigue in the group suddenly died, and the dead band is not all of a sudden. From the beginning of the study and until 1992 remained at the level of 1977: within an hour the doctor was paid 40%; from 1 hour to 5 hours and 59 minutes - 28%; from 6 hours to days - 21%; over days - 11%. In subsequent years, the situation has worsened: the number who applied after a day or more with the onset of the disease has increased in 2 times, and applied for the first hour and 2-fold decreased, partially moved in the interval from 1 hour to 5 hours and 59 minutes. The leading causes of late uptake MI patients for medical care are: a review of the patient that the attack stopped by on their own (58%), no knowledge of the symptoms (43%) and lack of communication (34 %).
Conclusion: we established the existence of differences in the prodromal period in surviving and deceased patients with MI; poor knowledge of the clinic infarction sick and the deterioration of knowledge over the last 23 years.