In Serbia, nearly 60 people per day experience a heart attack and, on average, 16 of them do not survive. According to official indicators of the Dr Milan Jovanović from the Batut Institute for the Public Health of Serbia, in 2014 some 53,993 people in Serbia died of heart and blood vessel diseases. That is more than half of all deaths. Not counting other cardiovascular diseases, myocardial infarctions alone are suffered by 16,000 to 18,000 residents of Serbia annually, and the impression is that the number of heart attacks is increasing constantly – warns Professor Aleksandar N. Nešković, chairman of the Clinic for Internal Medicine and Chief of the Interventional Cardiology at the Clinical Hospital Centre Zemun, speaking in this interview for CorD.
Professor Aleksandar Nešković says that in most cases myocardial infarction, or heart attack, is the result of atherosclerosis and rupture of the unstable atherosclerotic plaque. This results in the formation of clots in the coronary artery, which leads to the partial or complete blockage of blood flow. Acute myocardial infarction represents the death of the heart muscle, which occurs as a result of reduced blood flow through the coronary arteries.
How high is the risk of patients who have experienced a heart attack suffering a repeat occurrence?
– Compared to the general population, patients who have already suffered myocardial infarction are certainly at a greater risk of developing re-infarction and even death. About 20 per cent of those who have survived a heart attack experience repeats cardiovascular events, including new heart attacks and strokes, which are associated with a high risk of death. Today it is possible to significantly reduce these risks and improve quality of life through so-called secondary prevention measures, consisting of lifestyle changes and the use of modern medical treatment.
Do patients in Serbia have access to modern treatments and therapies, compared to the other countries of the region, or Europe, when it comes to acute care and secondary prevention of heart attacks?
– In Serbia over the last decade ate larger regional centres the most advanced therapeutic options have become available to patients suffering from acute myocardial infarction. These options include re-opening of coronary artery occluded by thrombus using percutaneous coronary intervention (PCI) in the cardiac catheterization laboratories with or without stent implantation.
Widespread use of this intervention in Serbia has resulted in a 50 per cent reduction of deaths after heart attacks. To achieve the maximal potential benefit of this lifesaving intervention, it is mandatory to plan and ensure additional employment of a significant number of doctors, nurses and x-ray technicians in the catheterisation laboratories, because currently employed staff is insufficient.
Also, financial issues related to running this programme, which is unresolved for more than two years, must be solved, and, finally, there a need for new age equipment at the majority of cardiac catheterisation laboratories. It is also necessary to introduce innovative drugs to cardiovascular medicine, which have long been widely used in the countries of Europe and the region and which significantly reduce damage to the heart and mortality risk after myocardial infarction and are very effective in secondary prevention. These medicines are currently available to our patients in limited amounts, due to the fact that they are not on the National Health Insurance Association’s positive list of medicines.
In Serbia over the last decade the most advanced methods have become available to patients in the treatment and care of acute myocardial infarction, which are conducted at larger regional centres
However, it often seems that innovative therapy is reserved only for oncology patients and sufferers of rare diseases.
– That is not true. Considering that most deaths in Serbia are a result of cardiovascular disease, if some of the key innovative medicines in this domain are made widely available to cardiac patients, they will suffer less and live longer, with better quality of life.