Key result
Endovascular-focused CV care algorithm linked to 100% two-year survival free of major events.
Why the study?
To develop an algorithm for primary specialized cardiovascular care prioritizing an endovascular strategy.
Does an organizational and technological algorithm for primary specialized cardiovascular care improve outcomes and survival in patients with cardiovascular diseases?
Observational (n=1,018)
Yes
Does an organizational and technological algorithm for primary specialized cardiovascular care improve outcomes and survival in patients with cardiovascular diseases?
Implementation of a specialized organizational algorithm for outpatient cardiovascular care with endovascular priority may ensure high availability of care and excellent short-term survival.
Should not yet change practice; leaves open whether endovascular-priority algorithms improve outcomes in broader populations.
Aim. To develop an algorithm for primary specialized cardiovascular care with a priority of endovascular strategy. Methods. The study was conducted in 20182019 based on the Central Clinical Hospital Russian Railways-Medicine and 14 polyclinics in the regions of the Russian Federation. The subject of the study is cardiovascular surgeons (n=2), possessing the skills of endovascular care. The object of the study was patients (n=1018) attended regional polyclinics of the Russian Federation. Patients were divided into two groups: group A consisting of 673 patients with clinically significant atherosclerosis of the coronary, brachiocephalic and peripheral arteries and abdominal aortic aneurysm; group B consisting of 345 patients with chronic lower limb ischemia that does not require surgical treatment. The average age of patients in group A was 696.1 years, in group B 637.2 years. There were 467 men in group A (69.4%), and 339 in group B (98.3%). An organizational and technological algorithm was developed to improve the primary specialized cardiovascular care. The results were assessed by the presence of outcomes (heart attack, stroke, bleeding, death), the availability of endovascular care and patient survival follow up 12 and 24 months. A content analysis of scientific publications on the issue under study has been performed. Results. An organizational and technological algorithm of primary specialized cardiovascular care has been developed, including the activities of the cardiovascular surgeon, who has the skills of endovascular care and a nurse in an outpatient clinic. The implementation of the algorithm ensured continuity, 100% availability, safety and quality of cardiovascular care using endovascular technology. Outcomes are not registered in both groups. Both patient groups showed 100% one and two-year survival. Conclusion. The developed algorithm of primary specialized cardiovascular care has provided high quality healthcare.
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Abramov et al. (2020) conducted an observational in Cardiovascular diseases (atherosclerosis, chronic lower limb ischemia, abdominal aortic aneurysm) (n=1,018). Organizational and technological algorithm of primary specialized cardiovascular care was evaluated on Composite of heart attack, stroke, bleeding, and death. Implementation of a primary specialized cardiovascular care algorithm with a priority on endovascular strategy achieved 100% one- and two-year survival with no registered heart attacks, strokes, bleeding, or deaths among 1,018 patients.
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