Major Trends in Hospitalization Rates, Mortality Rates, and the Frequency of Cardiac Interventions for Acute Myocardial Infarction in the Zakarpattia Region

Abstract

Purpose. This study aimed to analyze epidemiological trends of acute myocardial infarction (AMI) and features of medical care provided to the population of the Zakarpattia region, as a component of a model for improving the quality of medical care for patients with AMI. Materials and methods. A retrospective analysis of hospitalization rates, mortality rates, and interventional care for AMI among the population of the Zakarpattia region for the period from 2016 to 2025 was conducted. Primary statistical data on the total number of hospitalized patients and in-hospital deaths in Ukraine and the Zakarpattia region (for the period 2016–2024) were extracted from the reports of the Ministry of Health of Ukraine, Form No. 20. The statistical analysis involved the calculation of relative values (intensive, extensive, and ratio indicators) and dynamic indicators (absolute growth and growth rate) using established statistical analysis methods. Results. The study found an increase in the total number of cardiovascular disease cases in the Zakarpattia region from 2021 to 2024, and particularly in acute myocardial infarction during 2022–2023. The results of the analysis of primary disability rates due to cardiovascular diseases in the Zakarpattia region indicate a significant increase during the first years of the full-scale Russian invasion, with a growth rate of +89.60 % in 2022 and +30.48 % in 2023. An increase in mortality rates due to AMI in hospitals of the Zakarpattia region from 2019 to 2024 was established, with values exceeding the national mortality rates due to AMI in 2022 and 2024. The epidemiological analysis of hospitalization trends of patients with AMI in the Zakarpattia region for 2020–2025 showed an increase in the number of hospitalized patients, particularly in healthcare facilities capable of performing cardiological interventional procedures (the “Zakarpattia Regional Clinical Center of Cardiology and Cardiac Surgery”, “St. Martin’s Hospital”, and “Khust Central Hospital named after O. P. Vitsynskyi”). Conversely, the number of hospitalized patients decreased in healthcare facilities that lacked the capacity to perform these procedures. The study established a clear trend toward increased availability of interventional treatment methods, namely an increase in the frequency of stenting for AMI in the Zakarpattia region from 27.23 stenting procedures per 100 AMI patients in 2016 to 71.00 cases of stenting per 100 hospitalized AMI patients in the Zakarpattia region in 2024. In healthcare facilities with interventional cardiac surgery, no clear decrease in AMI mortality rates was observed despite an increase in the frequency of interventional procedures (stenting). Mortality rates fluctuated independently of the frequency of cardiological interventions across all three facilities. The increase in mortality levels in these facilities may be due to a rise in the proportion of hospitalized patients with clinically complex AMI, from 45.54 % in 2016 to 91.10 % in 2025. However, the mortality rate due to AMI in healthcare facilities capable of performing interventional procedures during the analyzed period was approximately half of the overall mortality rate due to AMI in all inpatient healthcare facilities in the Zakarpattia region, which suggests high effectiveness of cardiological interventional techniques in reducing mortality and improving the quality of medical care for AMI. Conclusions. The increasing trend in AMI mortality rates and primary disability due to cardiovascular diseases in the Zakarpattia region supports the need to develop modern approaches to improve the quality, accessibility, and effectiveness of AMI care in the regional population.