Current management of patients with ST elevation myocardial infarction in Metropolitan Beijing, China.
Current management of patients with ST elevation myocardial infarction in Metropolitan Beijing, China.
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DOI：
10.25011/cim.v31i4.4779
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发表时间：
2008-08
期刊：
影响因子：
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通讯作者：
Shou-yan Zhang;D. Hu;Yi-hong Sun;Jingang Yang
中科院分区：
文献类型：
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作者：
Shou-yan Zhang;D. Hu;Yi-hong Sun;Jingang Yang
目的评估中国北京地区ST段抬高心肌梗死（STEMI）患者的临床实践和住院结局。方法本研究是一项在中国北京大都市区进行的前瞻性多中心登记研究。收集了19家医院入选的STEMI患者的人口统计学资料、延迟时间、管理策略和院内结局数据。结果共纳入803例STEMI患者（平均年龄61 ± 13岁，22%为女性，42.1% ≥ 65岁）。超过一半的人有高血压史（50.4%）和目前吸烟（55.2%）。650例（80.9%）患者接受了再灌注治疗：124例（15.4%）接受了溶栓治疗，526例（65.5%）接受了直接经皮冠状动脉介入治疗（PCI）。溶栓的中位上门到针时间为83分钟，直接PCI的上门到球囊时间为132分钟。仅7%接受溶栓治疗的患者达到了上门到针时间≤ 30分钟的指南目标，22%的患者在≤ 90分钟内进行了PCI。97.8%的患者处方了阿司匹林，92%的患者处方了低分子量肝素，他汀类药物占91.0%，β受体阻滞剂占76.7%，ACE抑制剂占73.5%，氯吡格雷占89.7%，GP IIb/IIIa拮抗剂占19.3%。住院死亡率为5.4%。结论北京地区ST段抬高型心肌梗死患者普遍采用了临床指南推荐的治疗方法。然而，许多患者没有在推荐的时间内再灌注。在再灌注治疗的管理方面仍有重要的改进潜力。
PURPOSE To assess clinical practices and in-hospital outcomes of patients with ST elevation myocardial infarction (STEMI) in Beijing, China. METHODS This study was a prospective multicentre registry study in Metropolitan Beijing, China. Demographics, delay time, management strategy and in-hospital outcome data were collected from patients with STEMI enrolled in 19 hospitals. RESULTS A total of 803 patients (mean age 61+/-13 yr ,22% women and 42.1% >or= 65 yr) with STEMI were enrolled. More than half had a history of hypertension (50.4%) and current smoking (55.2%). Six hundred and fifty patients (80.9%) received reperfusion therapy: 124 (15.4% ) treated with thrombolysis and 526 (65.5% ) with primary percutaneous coronary intervention (PCI). The median door-to-needle time for thrombolysis was 83 min and door-to-balloon time for primary PCI was 132 min. Only 7% of patients treated with thrombolysis met the guidelines goal of the door-to-needle time <or= 30 min and 22% of patients had PCI performed in <or= 90 min. Aspirin was prescribed in 97.8% of patients, low molecular weigh heparin in 92%, statins in 91.0%, beta-blockers in 76.7%, ACE inhibitors in 73.5%, clopidogrel in 89.7% and GP IIb/IIIa antagonists in 19.3%. In-hospital mortality was 5.4%. CONCLUSION Recommended Clinical Guidelines treatments are largely implemented in patients with STEMI in Beijing. However, many patients were not reperfused within the recommended times. There remains important potential for improvement in the administration of reperfusion therapy.