DOI: 10.25881/BPNMSC.2020.42.93.013

Authors

Gricanchuk A.M.1, 2, Yarockaya I.A.2, Nikushkina I.N.2, Fomin V.V.1, Emelyanenko M.V.2, 3

1 I.M. Sechenov First Moscow State Medical University, Moscow

2 City Clinical Hospital named after M.P. Konchalovsky, Moscow

3 Military medical academy of S.M. Kirov (Moscow subsidiary), Moscow

Abstract

The article presents the principle of a multidisciplinary approach in the treatment of older age patients with myocardial infarction in a city hospital in a Regional vascular center. A medical and social portrait of a typical elderly and senile MI patient was compiled. The concept of a multidisciplinary heart team (MHT) with a list of medical specialists included in it is defined. An algorithm of actions of MHT specialists in the inpatient treatment of an age-related patient with myocardial infarction has been developed. A comparative assessment of the medical and economic efficiency of treatment of patients with MI before and after the introduction of an organizational and staff structure in the form of MHT in the RSC was carried out. The medical and economic efficiency of MHT in the treatment of patients with MI is shown based on the analysis of the four-year follow-up period.

Keywords: myocardial infarction, multidisciplinary approach, multidisciplinary heart team, medical efficiency of the heart team, economic efficiency of the heart team.

References

1. Babunashvili AM, Kartashov DS, Babokin VE, Ozashvili IG, Judin IE. Jeffektivnost’ primenenija stentov, pokrytyh sirolimusom, pri lechenii diffuznyh (dlinnyh i ochen’ dlinnyh) ateroskleroticheskih porazhenij koronarnyh arterij. Rossijskij kardiologicheskij zhurnal. 2017; (8): 42–50 (In Russ). doi: 10.15829/1560-4071-2017-8-42-50.

2. Bokerija LA., Gudkova RG. Serdechno-sosudistaja hirurgija – 2015. Bolezni i vrozhdennye anomalii sistemy krovoobrashhenija. Moscow: NCSSH im. A.N. Bakuleva RAMN; 2016: pp. 5–8 (In Russ).

3. Oshhepkova EV. Smertnost’ naselenija ot serdechno-sosudistyh zabolevanij v Rossijskoj Federacii v 2001–2006 gg. i puti k ee snizheniju. Kardiologija. 2009; (2): 63–70. (In Russ).

4. Petrosian KV. Multidisciplinary approach in a Heart Team concept — direct strategy in optimization of treatment for coronary lesions. Russian Journal of Thoracic and Cardiovascular Surgery. 2018; 60(4): 287–93 (In Russ). doi: 10.24022/0236-2791-2018-60-4-287-293.

5. Rekomendacii EOK po vedeniju pacientov s ostrym infarktom miokarda s pod’emom segmenta ST 2017. Rossijskij kardiologicheskij zhurnal. 2018; (5): 103–158. (In Russ).

6. 2018 ESC/EACTS guidelines on myocardial revascularization. Russian Journal of Cardiology. 2019; 24(8): 151–226. (In Russ). doi: 10.15829/1560-4071-2019-8-151-226.

7. Rozhdaemost’ i smertnost’ v Rossii. Rosstat; 2020. (In Russ).

8. Shpektor AV. Ostryj infarkt miokarda: sovremennye podhody k diagnostike i lecheniju / III Moskovskij gorodskoj s’ezd anesteziologov i reanimatologov; 2018; Moscow. (In Russ). URL. Accessed 08.11.2020.

9. Choi AR, Jeong MH, Hong YJ, Sohn SJ, Kook HY, Sim DS, Ahn YK, Lee KH, Cho JY, Kim YJ, Cho MC, Kim CJ, other Korea Acute Myocardial Infarction Registry Investigators. Clinical characteristics and outcomes in acute myocardial infarction patients with versus without any cardiovascular risk factors. The Korean Journal of Internal Medicine. 2019; 34(5): 1040–1049. doi: 10.3904/kjim.2018.056.

10. Lopes RD, de Barros E Silva PGM, de Andrade Jesuino I, et al. Timing of Loading Dose of Atorvastatin in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes: Insights From the SECURE-PCI Randomized Clinical Trial. JAMA Cardiol. 2018; 3(11): 1113–1118.

11. Mechanic OJ., Grossman SA. Acute Myocardial Infarction. 2020 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. PMID: 29083808.

12. Stone GW, Ellis SG, Gori T, Metzger DC, Stein B, Erickson M, Torzewski J, Williams JJr, Lawson W, Broderick TM, Kabour A, Piegari G, Cavendish J, Bertolet B, Choi JW, Marx SO, Genereux P, Kereiakes DJ. ABSORB IV Investigators. Blinded outcomes and angina assessment of coronary bioresorbable scaffolds: 30-day and 1-year results from the ABSORB IV randomised trial. Lancet. 2018 Oct 27; 392(10157): 1530–1540. doi: 10.1016/S0140-6736(18)32283-9.

13. Sabate M, Cequier A, Iniguez A, Serra A, Hernandez-Antolin R, Mainar V, Valgimigli M, Tespili M, den Heijer P, Bethencourt A, Vazquez N, Gomez-Hospital JA, Baz JA, Martin-Yuste V, van Geuns RJ, Alfonso F, Bordes P, Tebaldi M, Masotti M, Silvestro A, Backx B, Brugaletta S, van Es GA, Serruys PW. Everolimus-eluting stent versus bare-metal stent in ST-segment elevation myocardial infarction (EXAMINATION): 1 year results of a randomised controlled trial. Lancet. 2012 Oct 27; 380(9852): 1482–90. doi: 10.1016/S0140-6736(12)61223-9.

For citation

Gricanchuk A.M., Yarockaya I.A., Nikushkina I.N., Fomin V.V., Emelyanenko M.V. Optimization of the hospital stage of treatment of patients with myocardial infarction in the format of a multidisciplinary heart team. Bulletin of Pirogov National Medical & Surgical Center. 2020;4(15):63-68. (In Russ.) https://doi.org/10.25881/BPNMSC.2020.42.93.013