What we have to change in the treatment of ST-segment elevation myocardial infarction?

Objective. To describe treatment outcomes in patients with ST segment elevation myocardial infarction (STEMI), to identify the problems and to propose potential solutions. Material and methods. A retrospective observational study included data of patients treated between March 1, 2018 and November 15, 2023. Results. There were 4732 patients including 3266 (69%) men (mean age 64±12 years). Diabetes mellitus was found in 683 (14%) patients, previous stroke — in 281 (3%) patients, aortic stenosis — in 54 (0.6%) patients, anemia — in 214 (2%) patients. Mechanical complications of STEMI were observed in 41 (0.9%) patients. Cardiogenic shock among patients with STEMI was recorded in 499 (10.5%) cases. Overall mortality was 10.5% (404 patients). Intra-aortic balloon pump was used in 83 (2%) patients with survival rates ranging from 50% to 77%. Veno-arterial extracorporeal membrane oxygenation was used in 32 patients with survival rate 50—54%. Conclusion. To reduce mortality from STEMI, it is necessary to create a system of care for patients with cardiogenic shock (availability of instrumental and laboratory diagnostics at the early stages of disease, mechanical circulatory support for endovascular interventions and early treatment of shock). It is necessary to develop clearer recommendations for the management of patients with concomitant diseases (anemia, aortic stenosis).