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Friday 18.08.2017 | Name days: Liene, Helēna, Elena, Ellena, Liena

Opinion: as elections draw closer, cardiologists get ready

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Baltic news, News from Latvia, BNN.LV, BNN-NEWS.COM, BNN-NEWS.RUA total of 2,606 people had died in Latvia from cardiovascular diseases in 2012. This is 1,100 persons fewer than there were in 2007. Latvian cardiologists managed to save lives of 4,370 people who would have otherwise died from cardiovascular diseases if death rates in Latvia remained on the level of 2007.

Mortality caused by cardiovascular diseases before the age of 65 in Latvia had reduced 14% over the course from 2000 to 2010. Estonia’s mortality rates from such diseases had reduced by 40%. Those of Lithuania had not changed. Positive results in Latvia were achieved in spite of the decline of funding for cardiology – 40% in 2008 and 25% in 2011. ‘Unfortunately, the level of quality in in decline as well, because we are no longer able to afford high-quality products. We have managed to more or less stabilize and improve the situation only recently,’ – says the head of Emergency Cardiology, Latvian Centre of Cardiology, Prof. Andrejs Erglis in his interview to BNN.

Cause of death Nr. 1

Cardiovascular diseases are the most often cause of death not only in Latvia, but in the rest of the world as well. For the past several years Latvian Centre of Cardiology has been working with advanced stages of cardiovascular diseases. Nevertheless, Latvian cardiologists manage to achieve results. For example, the number of myocardial infarction and pacemaker-dependent patients had reduced from 9,029 to 4,778 patients in 2005-2012. Mortality in hospitals caused by myocardial infarction had reduced from 22% in 2001 to 9.5% in 2012.

In terms of the number of surgeries performed to expand blood vessels and other manipulations per 100,000 residents, Latvia is among the leaders in Europe – second behind Germany. According to other statistical information, Latvia is third behind Cyprus and Germany. Cardiologist Erglis believes invasive procedures in Latvia are not performed often enough.

According to him, it is important to keep in mind not only the large number of cases of cardiovascular diseases, but also the fact that invasive cardiology in Latvia is a somewhat young field. The number of implant surgeries in Latvia had only exceeded 200 per 100,000 residents (average level in Europe) after 2007. In 2010, this number exceeded 300 per 100,000 residents – the highest level in Europe. Comments about the alleged excessive number of such procedures in Latvia have no justification also because each and every cardiologist has to perform a specific number of procedures annually in order to maintain qualifications. In addition to that, unlike other Baltic States, where there are multiple cardiology centres, Latvia has only one.

Patients return

‘Of course, it is annoying to see a person smoke three days after having a surgery! It is clear that he will return to us! It is a matter of time and intelligence. This has to change!’ – says the cardiologist, hoping society will become more informed and interested in a healthy life-style in time.

He believes the Saeima is to blame for this – funding for healthcare is reduced every year (current funding is at 2.9% of GDP). ‘Regular prevention measures are a long-term initiative. They are absolutely necessary. This is why we support all health campaigns organized by Healthcare Ministry and Disease Prevention and Control Centre. We also organize them ourselves. Organization costs are covered by donations of pharmacy companies. Information campaigns and events, publications, health guidelines, media events, conferences for cardiologists and family doctors – we would have achieved a lot less without information campaigns. Things are done the same way in the rest of the world. Ten years ago, we were happy about every article that mentioned cardio health. The media have been shown the ropes. Topics like blood pressure, salt, smoking, healthy eating, obesity, the need for movement, children’s heart health are often discussed. These topics are not related to surgeries or other kinds of invasive procedures. Theoretically, they may interest companies. This may even help us avoid any surgeries!’ – says Erglis.

A couple of rhetorical questions

While cardiologists in Latvia had an initial goal to introduce fast diagnostic and treatment methods in Latvia as quickly as possible, the current situation shows many advanced technologies are first introduced in Latvia and only then in the rest of the world. Foreign cardiologists praise the development of Latvia’s cardiology.

Commenting on the recently publicly voiced complaints about high prices, salaries and about him personally, Erglis told BNN in his interview that his objective as head of Cardiology Centre of Latvia is the development of cardiology in the country and increase funding for this field. This is why does all he can in order to provide Latvian patients the best doctors and equipment.

The procurement price of metal stents in Pauls Stradins University Hospital is EUR 498.01 (no VAT). The average price of metal stent with medicine in EUR 1,309.04 (no VAT). Demand for different metal stents from different manufacturers depends on individual needs of patients. According to the cardiologist, the calculation of the price of implanting a metal stent varies depending on materials and positioning. It is also important to keep in mind that the price of the procedure also includes costs of consultations, additional examinations and amortization of equipment. ‘While costs of such surgeries in Latvia vary between EUR 3,500 to 5,000, the price range in Estonia reaches EUR 7,500,’ – explains Erglis.

‘Why is there such a high degree of interest for Stradins Hospital if procurements in other hospitals are performed similarly? Why is there such a high degree of interest for stent prices and not the treatment process as a whole? Is it merely a coincidence that cardiology is regularly assaulted right before elections, as it was in 2006, 2010, 2011 and now in 2014?’ – he asks.


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