Key result
Acute CAD and SCD mortality in Russia remains stable during 2019-2021 despite high regional variability.
Why the study?
The regional variability of standardized mortality rates from acute types of coronary artery disease and sudden cardiac death across the Russian Federation needed assessment for the 2019-2021 period.
Observational
Yes
Mortality from acute CAD and SCD in Russia remained stable from 2019-2021, though recurrent MI mortality decreased, highlighting high regional variability and challenges in cause-of-death classification.
Acute CAD/SCD mortality remained stable while recurrent MI declined in Russia; observational data leave open classification accuracy and regional care gaps.
Aim. To compare standardized mortality rates (SMR) from acute types of coronary artery disease (CAD) and sudden cardiac death (SCD) with an assessment of their regional variability in the Russian Federation in 2019-2021. Material and methods. Rosstat data on the average annual population and the number of deaths in one-year age groups for 2019-2021 in 82 Russian subjects from acute types of CAD and SCD were analyzed using following ICD-10 codes: I21.0-9 (acute primary) myocardial infarction (MI), I22.0-9 (recurrent MI), I20, I24.1-9 (other forms of acute coronary artery disease), I46.1 (SCD). SMR was calculated based on the European standard per 100,000 population. Average regional SMR values (M±SD), coefficients of variation (СV), nonparametric Wilcoxon T-test with Bonferroni adjustment were calculated (differences were considered significant at р<0,05). Results. The average regional values of SMR from the sum of causes (acute types of CAD and SCD for 2019, 2020 and 2021) did not change significantly and amounted to 52,3±33,72; 53,84±36,17; 53,58±34,55, respectively. The annual increase in the average regional SMR for this period was noted from acute MI — 23,59±11,01; 24,85±10,92; 25,73±11,38, and other OF CAD — 19,47±26,17, 19,78±27,45; 20,54±26,79, respectively, in 2019, 2020 and 2021. A significant decrease in SMR occurred only from recurrent MI: from 7,19±5,38 to 6,97±5,97 in 2019-2020 (p=0,048) and to 4,99±4,25 in 2021 (p=0,023 to 2020). In 18 constituent entities of the Russian Federation, an annual decrease in SMR was noted, and in the rest — multidirectional changes. The increase in SMR from acute MI took place in 23 subjects of the Russian Federation with a minimum CV in 2020 and 2021 (44%). The maximum CV for SMD was recorded in 2021 (169%). Conclusion. Mortality from acute types of CAD and SMD for 2019-2021 in the Russian Federation was characterized by a stable level and high regional variability. The problem of improving the criteria for establishing acute types of CAD and SMD as the initial cause of death remains relevant in the absence or insufficiency of data for universal criteria for MI.
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Samorodskaya et al. (2023) conducted an observational in Acute types of coronary artery disease and sudden cardiac death. Time period (2019-2021) was evaluated on Standardized mortality rates (SMR) from acute types of CAD and SCD per 100,000 population. Standardized mortality rates from acute coronary artery disease and sudden cardiac death in Russia remained stable between 2019 and 2021 (52.3 to 53.58 per 100,000), with high regional variability.
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