Mortality from acute types of coronary artery disease in men and women in Russia in 2015 and 2019

Aim. To comparison standardized mortality rates (SMRs) among men and women from acute types of coronary artery disease (CAD) and their regional variability in Russia in 2015 and 2019.

Material and methods. The Federal State Statistics Service (Rosstat) data on the population and the number of deaths from CAD based on the brief nomenclature of death causes using the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) in 2015 and 2019 in 82 Russian subjects are presented. For each sex, SMR was calculated for acute (primary) and recurrent myocardial infarction (MI) (I21-I22), for other types of acute CAD (I20, I24.1-9), as well as average regional SMRs, coefficient of variation (CV).

Results. The average regional SMR for each of the acute CAD types among men was significantly higher than among women both in 2015 (p<0,0001) and in 2019 (p<0,0001). For the period of 2015-2019 in men, SMR from all acute CAD types decreased by 22,5%, from acute MI — by 7,4%, from recurrent MI — by 22,2% and from other acute CAD types — by 25,8%, while in women, these figures were 11,8, 8,8, 19,0 and 29,7%, respectively. The men-to-women SMR ratio in 2015 and 2019 were 2,79/2,72 for all acute CAD types, 2,58/2,55 for all MI cases, and 3,36/4,18 for other acute CAD types. The minimum CV values (41,9% among men in 2019 and 44,7% among women in 2015) were recorded for acute MI, while the maximum CV values (129,3% among men and 158,6% among women in 2019) for other acute CAD types.

Conclusion. Over the period of 2015-2019, the average regional SMR from acute CAD types in men and women decreased in Russia, with a more noticeable decrease for men. Greater regional variability in mortality, especially for other acute CAD types, poses the problem of finding organizational, methodological and strategic solutions to clarify the criteria for coding and refine the logistics schemes for providing healthcare for doubtful or uncertain diagnostic signs of acute CAD.