Trends in mortality rates from chronic forms of coronary heart disease in the regions of the Russian Federation in 2017–2021

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To assess the trend and variability of standardized mortality ratios (SMRs) from chronic forms of coronary heart disease (CHD) in the regions of the Russian Federation (RF) in 2017–2021.

Material and methods. The investigation used the 2017–21 Russian Federal State Statistics Service (RFSS) data on the average annual population and the number of deaths in the one-year age groups in 82 RF regions on the basis of the RFSS “Brief Death Cause Nomenclature” (BDCN). The SMRs were calculated on the basis of the European standard per 100,000 population for each region; then the average regional SMRs related to the chronic forms of CHD were determined using 4 BDCN accounting lines.

Results. For the period from 2017 to 2019, a decrease was noted in the average regional SMRs from all forms of CHD (from 183.9±68.5 to 176.8±65.3 cases per 100,000 population), but in 2020 and 2021, an increase was recorded in SMRs from CHD (204.3±75.4 and 207.4±76.9 cases per 100,000 population, respectively) as the proportion of these causes decreased in the structure of all-cause mortality in the COVID-19 pandemic period (18.4±7.1% in 2017 and 15.8±5.4% in 2021). there was a decrease in the average regional SMRs from all forms of chronic heart diseases (CHD) (from 183.9±68.5 to 176.8±65.3 cases per 100,000 population), but in 2020 and 2021, an increase in the SMRs from CCHD (204.3±75.4 and 207.4±76.9 cases per 100,000 population, respectively) hand in hand with a reduction in the proportion of these causes in the COVID-19 pandemic period (18.4±7.1% in 2017 and 15.8±5.4% in 2021).

Results. For the period from 2017 to 2019, over a 5-year period, an annual consistent decrease was recorded in the SMR from CHD in none Russia’s regions; their annual rise was seen in 4 regions; whereas an unstable trend was noted with a decrease and a rise in SMRs in the others. There was a considerable interregional variability of SMRs from all forms of CHD (in 2017, the maximal SMR differed from the minimal one by 60 times) and from individual forms of CHD (in 2020, the regional minimum and maximum SMRs from I25.1 differed by 500 times).

The paper presents hypotheses about the causes of the revealed differences and proposals to modify the accounting of deaths from CHD.

Conclusion. There were substantial regional differences with an unstable 5-year trend in SMRs from CHD in the entire and individual accounting forms included in this group in accordance with the ICD. The fact that there are no unified criteria for and approaches to identifying the individual forms of CHD as the main cause of death, including that in the presence of multimorbid pathology complicates understanding the causes of death.

Full Text

Restricted Access

About the authors

I. V. Samorodskaya

National Medical Research Center for Therapy and Preventive Medicine, Ministry of Health of Russia

Author for correspondence.
Email: samor2000@yandex.ru
ORCID iD: 0000-0001-9320-1503

Doctor of Medical Sciences, Professor

Russian Federation, Moscow

I. V. Klyuchnikov

A.N. Bakulev National Medical Research Center of Cardiovascular Surgery, Ministry of Health of Russia; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

Email: samor2000@yandex.ru
ORCID iD: 0000-0002-8652-9639

Doctor of Medical Sciences, Professor

Russian Federation, Moscow; Moscow

References

  1. Стабильная ишемическая болезнь сердца. Клинические рекомендации 2020. Российский кардиологический журнал. 2020; 25 (11): 4076 [Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2020; 25 (11): 4076 (in Russ.)]. doi: 10.15829/1560-4071-2020-4076
  2. Зайратьянц О.В., Васильева Е.Ю., Михалева Л.М. и др. Правила формулировки диагноза, выбора и кодирования по МКБ-10 причин смерти. Методические рекомендации №45-56. Департамент здравоохранения города Москвы. М., 2019; 515 с. [Zayratyants O.V., Vasilyeva E.Yu., Mikhaleva L.M. et al. Rules of the formulation of the diagnosis, the choice and coding on MKB-10 of causes of death. Methodical recommendations No.45-56. Moscow Department of Healthcare. Moscow, 2019; 515 p. (in Russ.)]. URL: https://mosgorzdrav.ru/ru-RU/science/default/search.html?phrase=&year=2019&group_id=33&type=0
  3. Драпкина О.М., Самородская И.В., Ларина В.Н. Рекомендации Европейского общества кардиологов по диагностике и лечению хронических коронарных синдромов – вопрос приемлемости для первичного звена здравоохранения в Российской Федерации. Кардиология. 2020; 60 (4): 130–6 [Drapkina O.M., Samorodskaya I.V., Larina V.N. Recommendations of the European Society of Cardiology for the Diagnosis and Treatment of Chronic Coronary Syndromes – а Question of Acceptability for Primary Health Care in the Russian Federation. Cardiology. 2020; 60 (4): 130–6 (in Russ.)]. doi: 10.18087/cardio.2020.4.n1000
  4. Knuuti J., Wijns W., Saraste A. et al. ESC Scientific Document Group, 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J. 2019; 41 (3): 407–77. doi: 10.1093/eurheartj/ehz425
  5. Краткая номенклатура причин смерти 2010 г., основанная на Международной статистической классификации болезней и проблем, связанных со здоровьем, 10-го пересмотра [2010 Concise nomenclature of causes of death based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision (in Russ.)]. URL: https://www.rosstat.gov.ru›storage/mediabank/prich-smert.docx
  6. Дедов Д.В., Мазаев В.П., Рязанова С.В. и др. Исследование качества жизни при интервенционном и консервативном лечении больных стабильной стенокардией на отдаленных сроках наблюдения. Кардиоваскулярная терапия и профилактика. 2014; 13 (5): 31–5 [Dedov D.V., Mazaev V.P., Ryazanova S.V. et al. The study of life quality in interventional and conservative treatments of the patients with stable angina at delayed observations. Cardiovascular Therapy and Prevention. 2014; 13 (5): 31–5 (in Russ.)]. doi: 10.15829/1728-8800-2014-5-31-35
  7. Grey C., Jackson R., Schmidt M. et al. One in four major ischaemic heart disease events are fatal and 60% are pre-hospital deaths: a national data-linkage study (ANZACS-QI 8). Eur Heart J. 2015; 38 (3): 172–80. doi: 10.1093/eurheartj/ehv524
  8. Holmström L., Juntunen S., Vähätalo J. et al. Plaque histology and myocardial disease in sudden coronary death: the Fingesture study. Eur Heart J. 2022; 43 (47): 4923–30. doi: 10.1093/eurheartj/ehac533
  9. Flagg L.A., Anderson R.N. National Center for Health Statistics (U.S.), Division of Vital Statistics. Unsuitable underlying causes of death for assessing the quality of cause-of-death reporting. Nat Vital Stat Rep. 2021; 69 (14): 1–25. URL: https://stacks.cdc.gov/view/cdc/100414
  10. Бойцов С.А., Самородская И.В., Галявич А.С. и др. Статистическая, клиническая и морфологическая классификация ишемической болезни сердца – есть ли возможность объединения? Российский кардиологический журнал. 2017; 3 (143): 63–71 [Bojcov S.A., Samorodskaya I.V., Galyavich A.S. et al. Statistical, clinical and morphological classification of coronary heart disease – is there a possibility of association? Russian Journal of Cardiology. 2017; 3 (143): 63–71 (in Russ.)]. doi: 10.15829/1560-4071-2017-3-63-71
  11. Шматова Е.Н., Гринштейн Ю.И. Микроваскулярная стенокардия: патогенез, клиника, диагностика и принципы терапии. РМЖ. Медицинское обозрение. 2020; 4 (7): 425–30 [Shmatova E.N., Grinshtein Yu.I. Microvascular angina: pathogenesis, clinical picture, diagnosis and therapy tactics. Russian Medical Inquiry. 2020; 4 (7): 425–30 (in Russ.)]. doi: 10.32364/2587-6821-2020-4-7-425-430.
  12. Cannon R.O. Microvascular angina and the continuing dilemma of chest pain with normal coronary angiograms. J Am Coll Cardiol. 2009; 54 (10): 877–85. doi: 10.1016/j.jacc.2009.03.080
  13. Алексеева И.А., Тюрина А.В., Ежов М.В. Вазоспастическая стенокардия у пациента с перенесенным инфарктом миокарда без обструктивного поражения коронарных артерий, «MINOCA». Кардиологический вестник. 2019; 14 (1): 67 74 [Alekseeva I.A., Tyurina A.V., Ezhov M.V. Vasospastic angina in a patient with prior myocardial infarction without obstructive coronary artery disease, "MINOCA". Cardiology Bulletin. 2019; 14 (1):67–74 (in Russ.)]. doi: 10.17116/Cardiobulletin20191401167
  14. Хабибулина М.М. Выявление безболевой ишемии миокарда на амбулаторном этапе у женщин с артериальной гипертензией и кардиалгией в период пременопаузы. Российский кардиологический журнал. 2011; 16 (6): 14–8 [Khabibulina M.M. Ambulatory diagnostics of painless myocardial ischemia in premenopausal women with arterial hypertension and cardialgia. Russian Journal of Cardiology. 2011; 16 (6): 14–8 (in Russ.)].
  15. Shimokawa H., Suda A., Takahashi J. et al. Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group. Eur Heart J. 2021; 42 (44): 4592–600. doi: 10.1093/eurheartj/ehab282
  16. Kunadian V., Chieffo A., Camici P.G. et al. An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group. Eur Heart J. 2020; 41 (37): 3504–20. doi: 10.1093/eurheartj/ehaa503
  17. Леонова И.А., Захарова О.В., Болдуева С.А. Нарушения эндотелий-зависимой вазодилатации у больных с микрососудистой стенокардией. РМЖ. Медицинское обозрение. 2022; 6 (8): 427–32 [Leonova I.A., Zaharova O.V., Boldueva S.A. Violations of endothelium-dependent vasodilation in patients with microvascular angina pectoris. breast cancer. Russian Medical Inquiry. 2022; 6 (8): 427–32 (in Russ.)]. doi: 10.32364/2587-6821-2022-6-8-427-432
  18. Драпкина О.М., Самородская И.В., Семенов В.Ю. и др. Сравнительный анализ вариабельности показателей смертности от различных причин в субъектах Российской Федерации. Архив патологии. 2020; 82 (3): 31–7 [Drapkina O.M., Samorodskaya I.V., Semenov V.Y. et al. Сomparative analysis of variability of mortality rates from various causes in the subjects of Russian Federation. Arkhiv patologii. 2020; 82 (3): 31–7 (in Russ.)]. doi: 10.17116/patol20208203131
  19. Драпкина О.М., Самородская И.В., Старинская М.А. и др. Сравнение российских регионов по уровню стандартизованных коэффициентов смертности от всех причин и болезней системы кровообращения в 2006–2016 гг. Профилактическая медицина. 2018; 21 (4): 4–12 [Drapkina O.M., Samorodskaia I.V., Starinskaya M.A. et al. Comparison of Russian regions by standardized mortality rates from all causes and circulatory system diseases in 2006—2016. Profilakticheskaya Meditsina. 2018; 21 (4): 4–12 (in Russ.)]. doi: 10.17116/profmed20182144

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies