A comparison of the treatment of acute myocardial infarction between St. Petersburg, Russia and Seattle, Washington

This study compared the baseline demographics, time to treatment and types of treatment of patients presenting with acute myocardial infarction in St. Petersburg, Russia and Seattle, WA. The study included 63 consecutive patients admitted to City Hospital #1 in St. Petersburg in July 1993. Comparative data for Seattle patients was obtained from the multi-year Myocardial Infarction Triage and Intervention project, a registry of all acute myocardial infarction patients hospitalized in the Seattle area. The results show a significantly prolonged time from symptom onset to presentation in Russia (51.8 h vs. 8.0 h; P < 0.001). Aspirin was used slightly more often in Seattle (78.9% vs. 74.6%; P = 0.40) while thrombolysis was used much more often in Seattle (22.5% vs. 6.3%; P = 0.002). There was also much less use of percutaneous transluminal coronary angioplasty (0% vs. 26.9%; P < 0.001), heparin (12.7% vs. 79.1%; P < 0.001), or cardiac catheterization (4.8% vs. 64.3%; P < 0.001). Also, the length of hospitalization was longer in St. Petersburg (23.8 ± 10.8 vs. 7.5 ± 5.1 days; P < 0.001). The findings in this study are an impetus for us all in understanding the magnitude of differences currently existing and the challenges for improving health care delivery in Russia.