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. 2017 Jul 11;8(28):46540-46548.
doi: 10.18632/oncotarget.14890.

Clinical characteristics and improvement of the guideline-based management of acute myocardial infarction in China: a national retrospective analysis

Lechen Wang  1 , You Zhou  1 , Cheng Qian  1 , Yanggan Wang  1
Affiliations

Clinical characteristics and improvement of the guideline-based management of acute myocardial infarction in China: a national retrospective analysis

Lechen Wang et al. Oncotarget. .

Abstract

Objective: This study is to document the clinical characteristics and improvement in management of acute myocardial infarction (AMI) in Chinese population.

Results: This study included 64,654 patients (23,805 patients in 2011, 40,849 patients in 2013), of which STEMI and NSTEMI account for 85.09% and 14.91%, respectively. From 2011 to 2013, significant improvement has been achieved in the recanalization rate of PCI (96.01% vs. 98.63%, P < 0.001) and in-hospital deaths (4.52% vs. 3.55%, P = 0.038). Although the time of door-to-balloon and the duration of PCI were satisfactorily controlled within 90min and 60min, respectively, the onset-to-FMC time (≈3.5h) and door-to-thrombolysis time (≈1.1h) limited the efficiency of management. The total cost of medical care showed no increase from 2011 to 2013, but the patient's paid Portion decreased from 20.33% to 13.96%.

Materials and methods: The AMI patients admitted in the general hospitals in 2011 and 2013 were retrospectively analyzed according to the data reported to the Single Disease Quality Control Information Systemissued by Chinese Hospital Association.

Conclusion: Compared to the Western countries, STEMI accounted for a larger portion of AMI, and the AMI management in China basically meets the standards of the quality control of guidelines. With improvement of management, there was no increase in the total medical cost, while the patient's paid portion was actually reduced. In future, improvement of transportation strategy and the public medical education are recommended to shorten the onset-to-FMC time to further improve the outcome of AMI patients.

Keywords: China; acute myocardial infarction; epidemiology; quality of care.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have nothing to disclose.

Figures

Figure 1
Figure 1. Percentage of drug use during hospitalization
*: P < 0.05 compared with 2011. AA, ACEI/ARB; AS, aspirin; BB, β-blocker; CLO, clopidogrel; ST, statin.
Figure 2
Figure 2. Management efficacy for AMI
Figure 3
Figure 3. Completion rate of quality control indicators in year 2011 and 2013
*: the core indicators.
See this image and copyright information in PMC

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