Changes in process and outcome for ST elevation myocardial infarction in central China from 2011 to 2018

作     者：You Zhang Shan Wang Datun Qi Xianpei Wang Muwei Li Zhongyu Zhu Qianqian Cheng Dayi Hu Chuanyu Gao 

作者机构：Department of CardiologyCentral China Fuwai Hospital of Zhengzhou UniversityHenan Provincial People’s Hospital Heart CenterZhengzhouHenan 451464China Henan Institute of Cardiovascular EpidemiologyZhengzhouHenan 451464China Henan Key Laboratory for Prevention and Control of Coronary Heart DiseaseCentral China Fuwai HospitalZhengzhouHenan 451464China Institute of Cardiovascular DiseasePeking University People’s HospitalBeijing 100044China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2023年第136卷第18期

页      面：2203-2209页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported by the grant from Project of Scientific and Technological Support Plan of Health and Family Planning Commission of Henan Province in 2016[No.201602210] 

主　　题：ST elevation myocardial infarction Management Healthcare Mortality 

摘      要：Background:Limited data are available on the changes in the quality of care for ST elevation myocardial infarction(STEMI)during China’s health system reform from 2009 to *** study aimed to assess the changes in care processes and outcome for STEMI patients in Henan province of central China between 2011 and ***:We compared the data from the Henan STEMI survey conducted in 2011-2012(n=1548,a cross-sectional study)and the Henan STEMI registry in 2016-2018(n=4748,a multicenter,prospective observational study).Changes in care processes and in-hospital mortality were *** of care measures included reperfusion therapies,aspirin,P2Y12 antagonists,β-blockers,angiotensin-converting enzyme inhibitors or angiotensin receptor blockers,and *** use was analyzed among patients who were considered ideal candidates for ***:STEMI patients in 2016-2018 were younger(median age:63.1 vs.63.8 years)with a lower proportion of women(24.4%[1156/4748]vs.28.2%[437/1548])than in *** composite use rate for guideline-recommended treatments increased significantly from 2011 to 2018(60.9%[5424/8901]vs.82.7%[22,439/27,129],P0.001).The proportion of patients treated by reperfusion within 12 h increased from 44.1%(546/1237)to 78.4%(2698/3440)(P0.001)with a prolonged median onset-to-first medical contact time(from 144 min to 210 min,P0.001).The use of antiplatelet agents,statins,andβ-blockers increased *** risk of in-hospital mortality significantly decreased over time(6.1%[95/1548]vs.4.2%[198/4748],odds ratio[OR]:0.67,95%confidence interval[CI]:0.50-0.88,P=0.005)after ***:Gradual implementation of the guideline-recommended treatments in STEMI patients from 2011 to 2018 has been associated with decreased in-hospital ***,gaps persist between clinical practice and guideline *** awareness,reperfusion strategies,and construction of chest pain centers need to be further unders