ST-segment Elevation Myocardial Infarction in Eastern Rural China From 2001 to 2011-China PEACE Retrospective Acute Myocardial Infarction Study
10.3969/j.issn.1000-3614.2016.01.002
- VernacularTitle:2001年~2011年中国东部农村ST段抬高型心肌梗死诊疗变化趋势--China PEACE回顾性急性心肌梗死研究
- Author:
Jing LI
;
Xi LI
;
Yuan YU
;
Shuang HU
;
Xiaofang YAN
;
Lixin JIANG
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Therapeutics;
Mortality
- From:
Chinese Circulation Journal
2016;31(1):4-9
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To assess the trends of clinical characteristics, diagnostic and treatment conditions and outcomes for in-hospital patients with ST-segment elevation myocardial infarction (STEMI) in eastern rural China from 2001 to 2011.
Methods: Through a two-stage random sampling, a representative in-hospital STEMI patient group in eastern rural China of 2001, 2006 and 2011 were enrolled. In 1st step, a simple random-sampling procedure was conducted to identify the collaborating hospitals and in 2nd step, a systematic sampling procedure was performed to select representative patients from those admitted to each collaborating hospital for STEMI during the study period. Then we obtained patients’ clinical information from their medical records. Finally, we weighted the ifndings for each year to represent the overall situation.
Results: A total of 2820 STEMI medical records from 32 collaborating hospitals were enrolled. From 2001 to 2011, the median age of STEMI patients increased from 66 to 68 years, P<0.01, the percentage of female patients elevated from 31.4%to 35.8%, P<0.05. The ratios of cardiovascular risk factors were gradually increased. Among the patients without documented contraindications, application of percutaneous coronary intervention (PCI) increased from 0%to 27.5%, P<0.01, reperfusion increased from 49.7%to 58.8%, P<0.01. Administration of aspirin elevated form 80%to 87.8%, Clopidogrel from 0%to 72.6%, statins from 16.7%to 89.6%;administration ofβ-blockers within 24 h of admission elevated from 41.5%to 55.5%, P<0.05 and ACEI/ARB from 58.3%to 69%, P<0.01. In 2001, 2006 and 2011, the in-hospital mortality within 7 days were 6.8%, 8.3%and 5.7%respectively;mortality plus treatment withdrawal because of terminal status at discharge were 10.2%, 12.4%and 9.5%respectively. After adjustment, the above ratios did not change signiifcantly.
Conclusion: From 2001 to 2011, application of PCI grew from nothing and effective medication was improved for in-hospital STEMI patients in eastern rural China. However, there were still obvious gaps for diagnosis and treatment from the guideline requirement;the patient outcomes have not been improved.
