In-hospital Reperfusion and Secondary Preventive Drug Therapy for ST-segment Elevation Myocardial Infarction Patients in Provincial, City and County Hospitals of China
10.3969/j.issn.1000-3614.2017.01.004
- VernacularTitle:中国省、市和县级医院急性ST段抬高型心肌梗死住院患者再灌注治疗和二级预防用药分析
- Author:
Jingang YANG
;
Haiyan XU
;
Xiaojin GAO
;
Wei LI
;
Yang WANG
;
Weimin LI
;
Shuqing WANG
;
Yanyan ZHAO
;
Wenxiu LENG
;
Yuejin YANG
- Keywords:
Myocardial infarction;
Myocardial Reperfusion;
Thrombolytic therapy;
Angioplasty,transluminal,percutaneous coronary
- From:
Chinese Circulation Journal
2017;32(1):12-16
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate reperfusion and secondary preventive drug therapy for ST-segment elevation myocardial infarction (STEMI) patients in provincial, city and county levels hospitals of China.
Methods:A total of 18,967 STEMI patients within 7 days of symptom onset from 2013-01-01 to 2014-09-30 were enrolled by China acute myocardial infarction (CAMI) registry study group from 107 hospitals covering 31 provinces/autonomous regions, cities and counties in China;223 patients were excluded for key information missing. Demographic data, reperfusion as primary percutaneous coronary intervention (pPCI), thrombolytic therapy (TT) and secondary preventive drug therapy as aspirin, P2Y12 inhibitors, statins,β-blockers, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor antagonist (ARB) were analyzed and compared among 3 levels of hospitals.
Results:There were 9,885/18,744 (52.7%) patients received reperfusion including 8,038 (42.9%) pPCI and 1,847 (9.9%) TT. Reperfusion rate in provincial hospital (61.8%, 4041/6537) was higher than city hospital (49.1%, 4728/9625) and county hospital (43.2%, 1116/2582), P<0.001;reperfusion type was distinctive among 3 levels of hospitals, for provincial hospital:pPCI was performed in 3,840 (58.7%), TT in 201(3.07%) patients;for city hospital:pPCI in 3,753 (39.0%), TT in 975 (10.1%) patients;for county hospital:pPCI in 445 (17.2%), TT in 671 (26.0%) patients. 12,502 patients arrived hospital within 12 h of symptom onset and 8,835 (70.8%) of them received reperfusion including 7089 (56.7%) patients with pPCI and 1,746 (14.1%) with TT. 3537 (80%) patients received reperfusion in provincial hospital, 4272 (67.5%) in city hospital and 1045 (59.8%) in county hospital, P<0.001.The in-hospital application of statins was in 16,575 (90.9%) patients, aspirin was 17,963 (96.8%), P2Y12 inhibitors was 17,922 (96.5%),β-blockers was 12,657 (68.2%) and ACEI/ARB was 10,541 (56.8%) respectively;the therapeutic condition was similar among 3 levels of hospitals.
Conclusion:In CAMI Registry, 70.8%arrived hospital within12 h of symptom onset had been treated by reperfusion therapy in China; the reperfusion rate in county hospital was obviously lower. The secondary preventive drug therapy condition was similar among 3 levels of hospitals.
