[CAUSES OF DEATH IN PATIENTS WITH ACUTE MYOCARDIAL INFECTION IN NON-SPECIALIZED SETTINGS].

The aim of the study was to analyse the causes of death in patients with acute myocardial infection (AMI) treated in non-specialized settings of the city of Tomsk based on the WHO registry of AIM. A total of 156 deaths from AIM that occurred in 2013 were studied. The diagnoses were verified using results of autopsies. The study group included 42.3% of men and 57.7% of women. 91.7% of the deceased patients aged above 50 years including 30.4% of those above 80 years. All patients were referred to the clinics by the emergency aid services. Most of them presented with the atypical onset and clinical picture of AIM, had an aggravated medical history, and died soon after hospitalization. Results of primary medical examination suggested AIM only in 58.3% of the cases. The remaining patients showed ECG signs of possible AIM. Positive results of serum enzyme tests (creatine phosphokinase, its MB fraction, troponin) were obtained in 72.4% of the cases. It is concluded that the above death cases were very complicated diagnostically, clinically, and prognostically. To prevent lethal outcomes, all patients with unstable angina should be hospitalized only in specialized clinics providing regular ECG monitoring and control of biochemical markers of myocardial necrosis for diagnostics of suspected AIM.