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Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015

OBJECTIVE: Access to acute cardiovascular care has improved and health services capacity has increased over the past decades. We assessed national changes in (1) patient characteristics, (2) in-hospital management and (3) patient outcomes among patients presenting with ST segment elevation myocardia...

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Autores principales: Zhou, Tianna, Li, Xi, Lu, Yuan, Murugiah, Karthik, Bai, Xueke, Hu, Shuang, Gao, Yan, Masoudi, Frederick A, Krumholz, Harlan M, Li, Jing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488733/
https://www.ncbi.nlm.nih.gov/pubmed/34599073
http://dx.doi.org/10.1136/openhrt-2021-001666
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author Zhou, Tianna
Li, Xi
Lu, Yuan
Murugiah, Karthik
Bai, Xueke
Hu, Shuang
Gao, Yan
Masoudi, Frederick A
Krumholz, Harlan M
Li, Jing
author_facet Zhou, Tianna
Li, Xi
Lu, Yuan
Murugiah, Karthik
Bai, Xueke
Hu, Shuang
Gao, Yan
Masoudi, Frederick A
Krumholz, Harlan M
Li, Jing
author_sort Zhou, Tianna
collection PubMed
description OBJECTIVE: Access to acute cardiovascular care has improved and health services capacity has increased over the past decades. We assessed national changes in (1) patient characteristics, (2) in-hospital management and (3) patient outcomes among patients presenting with ST segment elevation myocardial infarction (STEMI) in 2011–2015 in China. METHODS: In a nationally representative sample of hospitals in China, we created two random cohorts of patients in 2011 and 2015 separately. We weighted our findings to estimate nationally representative numbers and assessed changes from 2011 to 2015. Data were abstracted from medical charts centrally using standardised definitions. RESULTS: While the proportion of patients with STEMI among all patients with acute myocardial infarction decreased over time from 82.5% (95% CI 81.7 to 83.3) in 2011 to 68.5% (95% CI 67.7 to 69.3) in 2015 (p<0.0001), the weighted national estimate of patients with STEMI increased from 210 000 to 380 000. The rate of reperfusion eligibility among patients with STEMI decreased from 49.3% (95% CI 48.1 to 50.5) to 42.2% (95% CI 41.1 to 43.4) in 2015 (p<0.0001); ineligibility was principally driven by larger proportions with prehospital delay exceeding 12 hours (67.4%–76.7%, p<0.0001). Among eligible patients, the proportion receiving reperfusion therapies increased from 54% (95% CI 52.3 to 55.7) to 59.7% (95% CI 57.9 to 61.4) (p<0.0001). Crude and risk-adjusted rates of in-hospital death did not differ significantly between 2011 and 2015. CONCLUSIONS: In this most recent nationally representative study of STEMI in China, the use of acute reperfusion increased, but no significant improvement occurred in outcomes. There is a need to continue efforts to prevent cardiovascular diseases, to monitor changes in in-hospital treatments and outcomes, and to reduce prehospital delay.
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spelling pubmed-84887332021-10-14 Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015 Zhou, Tianna Li, Xi Lu, Yuan Murugiah, Karthik Bai, Xueke Hu, Shuang Gao, Yan Masoudi, Frederick A Krumholz, Harlan M Li, Jing Open Heart Coronary Artery Disease OBJECTIVE: Access to acute cardiovascular care has improved and health services capacity has increased over the past decades. We assessed national changes in (1) patient characteristics, (2) in-hospital management and (3) patient outcomes among patients presenting with ST segment elevation myocardial infarction (STEMI) in 2011–2015 in China. METHODS: In a nationally representative sample of hospitals in China, we created two random cohorts of patients in 2011 and 2015 separately. We weighted our findings to estimate nationally representative numbers and assessed changes from 2011 to 2015. Data were abstracted from medical charts centrally using standardised definitions. RESULTS: While the proportion of patients with STEMI among all patients with acute myocardial infarction decreased over time from 82.5% (95% CI 81.7 to 83.3) in 2011 to 68.5% (95% CI 67.7 to 69.3) in 2015 (p<0.0001), the weighted national estimate of patients with STEMI increased from 210 000 to 380 000. The rate of reperfusion eligibility among patients with STEMI decreased from 49.3% (95% CI 48.1 to 50.5) to 42.2% (95% CI 41.1 to 43.4) in 2015 (p<0.0001); ineligibility was principally driven by larger proportions with prehospital delay exceeding 12 hours (67.4%–76.7%, p<0.0001). Among eligible patients, the proportion receiving reperfusion therapies increased from 54% (95% CI 52.3 to 55.7) to 59.7% (95% CI 57.9 to 61.4) (p<0.0001). Crude and risk-adjusted rates of in-hospital death did not differ significantly between 2011 and 2015. CONCLUSIONS: In this most recent nationally representative study of STEMI in China, the use of acute reperfusion increased, but no significant improvement occurred in outcomes. There is a need to continue efforts to prevent cardiovascular diseases, to monitor changes in in-hospital treatments and outcomes, and to reduce prehospital delay. BMJ Publishing Group 2021-10-01 /pmc/articles/PMC8488733/ /pubmed/34599073 http://dx.doi.org/10.1136/openhrt-2021-001666 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Coronary Artery Disease
Zhou, Tianna
Li, Xi
Lu, Yuan
Murugiah, Karthik
Bai, Xueke
Hu, Shuang
Gao, Yan
Masoudi, Frederick A
Krumholz, Harlan M
Li, Jing
Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
title Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
title_full Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
title_fullStr Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
title_full_unstemmed Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
title_short Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015
title_sort changes in st segment elevation myocardial infarction hospitalisations in china from 2011 to 2015
topic Coronary Artery Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488733/
https://www.ncbi.nlm.nih.gov/pubmed/34599073
http://dx.doi.org/10.1136/openhrt-2021-001666
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