OBJECTIVETo observe the early reperfusion therapy status for patients with ST elevation acute myocardial infarction (STEMI) hospitalized in tertiary and secondary hospitals in Henan province.

METHODSBaseline data, early reperfusion treatment and in-hospital mortality of STEMI patients hospitalized in 17 hospitals in Henan province (8 tertiary hospitals, 9 secondary hospitals) from June 2011 to June 2012 were obtained using a uniformed questionnaire.

RESULTSOne thousand six hundred and eighty six patients were enrolled, of which 886 patients were hospitalized in tertiary hospitals and 880 patients were early hospitalized in secondary hospitals. Six hundred and fifty four patients (38.8%, 654/1 686) underwent early reperfusion therapy (543 with thrombolysis and 111 with primary percutaneous coronary intervention (PCI)). There was no difference in the proportion of early reperfusion therapy between tertiary and secondary hospitals (40.1% (355/886) vs. 37.4% (299/800), P = 0.257). The median time from symptom onset to first medical contact, door-to-needle and door-to-balloon was 132 min, 18 min and 60 min, respectively. The median time from symptom onset to first medical contact (150 min vs. 120 min, P = 0.001), door-to-needle (30 min vs. 18 min, P = 0.003) and symptom onset-to-thrombolysis (3.5 h vs. 2.7 h, P = 0.001) were significantly longer in tertiary hospitals than in secondary hospitals. No difference was found in median time of door-to-balloon, symptom onset-to-primary PCI or symptom onset-to-elected PCI between tertiary and secondary hospitals (all P > 0.05). The proportion of door-to-needle ≤ 30 min was lower in tertiary hospitals than in secondary hospitals (46.4% (84/181) vs. 62.2% (153/246), P = 0.001). However, there was no difference in the proportion of door-to-balloon ≤ 90 min between tertiary and secondary hospitals (58.8% (60/102) vs. 57.1% (4/7), P = 1.000). In-hospital mortality was also similar between tertiary and secondary hospitals (5.8% (51/886) vs. 5.5% (44/800), P = 0.820).

CONCLUSIONSEarly reperfusion rate is low, and thrombolysis is the main early reperfusion therapy in both tertiary and secondary hospitals in Henan province. Tertiary hospitals did not take advantage of their primary PCI capability. There is great room for improvement in early reperfusion therapy in tertiary and secondary hospitals.

Hospital Mortality ; Hospitals ; Humans ; Myocardial Infarction ; Myocardial Reperfusion ; Percutaneous Coronary Intervention ; Secondary Prevention ; Surveys and Questionnaires

Objective:To observe the changes in bone mineral density and microstructure parameters in sclerostin (SOST) gene knockout (SOST -/-) mice after ovariectomy. Methods:Twelve 4-week-old SOST knockout mice were randomly divided into two groups ( n=6): ovariectomized group (SOV), sham operated group (SSO). Twelve wild-type mice were randomly divided into two groups ( n=6): wild-type ovariectomized group (WTO), wild-type sham operated group (WTS). Twelve weeks later, mice were sacrificed and one lumbar vertebra of each mouse was selected for micro-CT analysis. The bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness were observed and compared in the 4 groups. Results:There was no difference in bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness between SOV and SSO groups. Bone mineral density, trabecular volume fraction, trabecular number and trabecular thickness in SOV and SSO groups were significantly higher than those in WTO and WTS groups ( P<0.001). Bone mineral density, trabecular volume fraction and trabecular number in WTO group were significantly lower than those in WTS group ( P=0.017, 0.039, 0.021, respectively). There was no difference in trabecular thickness between WTO and WTS groups. Conclusions:Sclerostin knockout mice showed high bone mass, and ovariectomy did not lead to bone loss and bone microstructure degeneration, which indicates that slerostin is a potential therapeutic target for postmenopausal osteoporosis.

Objective: To observe the changes in bone mineral density and microstructure parameters in sclerostin (SOST) gene knockout mice treated with glucocorticoid. Methods: 12 4-week-old SOST knockout mice were randomly divided into two groups (n=6): methylprednisolone intervention group [SOM group, methylprednisolone 3 mg/(kg·d), subcutaneous injection], placebo group (SOS group, isovolumetric saline subcutaneous injection). 12 wild-type mice were randomly divided into two groups (n=6): wild-type placebo group (WTS group, isovolumetric saline subcutaneous injection), wild methylprednisolone intervention group [WTM group, methylprednisolone 3 mg/(kg·d), subcutaneous injection]. 12 weeks later, mice were sacrificed and one lumbar vertebra of each mouse was selected for micro-CT analysis. Results: There was no difference in bone mineral density (BMD), trabecular volume fraction, trabecular number and trabecular thickness between SOM and SOS groups (P>0.05). BMD, trabecular volume fraction, trabecular number and trabecular thickness in SOM and SOS groups were significantly higher than those in WTS and WTM groups (P<0.05). BMD, trabecular volume fraction, trabecular number and trabecular thickness in WTM group were significantly lower than those in WTS group (P<0.05). Conclusions Sclerotin gene knockout mice can resist glucocorticoid-induced bone loss and bone microarchitectural deterioeration. The treatment of osteoporosis with SOST/sclerotin as a target will be an effective method in the future.