Comorbidities and Percutaneous Coronary Intervention in Elderly Patients with Acute Coronary Syndrome

Aim. To assess comorbidities in elderly patients with acute coronary syndrome (ACS) and to analyze patient subgroups with different treatment strategies in the Regional Vascular Center (RVC).Material and methods. The prospective study included 205 patients with confirmed ACS 75 years and older, the mean age was 81±4.9 years, and 68% were women. ST segment elevation myocardial infarction (STEMI) was diagnosed in 46 (22.4 %) patients, non-ST segment elevation myocardial infarction (NSTEMI) was diagnosed in 159 (77,6 %) patients. The Charlson Comorbidity Index (CCI) was calculated in every patient. Early outcomes were defined as those assessed during hospital stay. Late outcomes were assessed at 6 months after the discharge using phone calls and/or clinic visits. All patients provided written informed consent.Results. Percutaneous coronary intervention (PCI) was performed in 42% of patients. In patients with STEMI and NSTEMI PCI was performed in 73% and 32%, respectively. Mean CCI score was 7.9 points: 7.6 points in men and 8.04 in women. Patients with STEMI had higher CCI score than NSTEMI patients (p<0.01): 8.1 points and 7.1 points, respectively. Patients who underwent PCI had lower CCI score (7.2 points) than patients in non-PCI group (8.2 points; p<0.05). Patients with STEMI in PCI and non-PCI groups had significant difference in CCI score (p<0.05): 7.4 and 8.4 points, respectively. Mean CCI score in patients who died in hospital was 8.5 while discharged patients had 7.6 points (p<0.01). In 6 months 13 patients (6.3%) died, their mean age was 84.9 years, mean CCI was 9 points, PCI was performed in 3 (23%) patients.Conclusions. Elderly patients with ACS had high comorbidity level assessed by CCI score. Higher CCI score was associated with PCI non-performance in elderly patients. Elderly patients with STEMI had higher CCI score than patients with NSTEMI which was significantly associated with PCI non-performance. Patients who died in hospital or in 6 months after the ACS onset had higher CCI score than other elderly patients with ACS

Epidemiological Assessment of the First Results of the National Program of Immunization of Young Children against Pneumococcal Infection in Russia

Pneumococcal infections are among the most common infections are an important cause of morbidity and mortality worldwide, including Russia. At the end of 2014 in the national immunization schedule countries introduced vaccination against pneumococcal infection The aim of study. To assess the epidemiological effectiveness of vaccination against pneumococcal infection in young children selectively in different territories of the Russian Federation 2 years later from its beginning Materials and methods. In the course of epidemiological observational analytical research of type «case-control» data were obtained on the incidence in vaccinated and unvaccinated against pneumococcal infection in children from 2 months to 2 years We analyzed 1422 outpatients and 356 case histories of children in several cities (Moscow, Smolensk, Sevastopol, Perm, Tyumen, Barnaul). The results are subjected to statistical processing The results and discussion Established that there is a reliable causal connection between the lack of vaccination of children against pneumococcal infection and incidence of diseases. Shows high prophylactic efficacy of vaccination of children up to 2 years. Received in outpatient and inpatient facilities, evidence suggests that the incidence of invasive and non-invasive forms of pneumococcal infection was significantly lower in the vaccinated children It was revealed that the vaccination coverage against pneumococcal infection in children from 2 months to one year and the second year of life was 51 and 40% respectively. Vaccination in the first six months of life in 2016 received only 25% of children. A high proportion of the parent's refusal of vaccination of children (54.2%), and high frequency medical taps (9.7%) from vaccination