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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Current management of patients with ST elevation myocardial infarction in Metropolitan Beijing, China
Shou-Yan Zhang1, Da-Yi Hu, Yi-Hong Sun
1Cardiovascular Center, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, PR China.
Insights
This study assessed ST-elevation myocardial infarction (STEMI) care in Beijing, finding guideline treatments are used, but reperfusion times lag. Improvements in timely reperfusion therapy are needed for better STEMI patient outcomes.
Area of Science:
- Cardiology
- Public Health
Background:
- ST-elevation myocardial infarction (STEMI) is a critical cardiovascular emergency.
- Effective management of STEMI relies on timely reperfusion therapy and guideline-adherent treatments.
Purpose of the Study:
- To evaluate clinical practices for STEMI management in Beijing.
- To assess in-hospital outcomes for STEMI patients in Beijing.
- To identify areas for improvement in STEMI care delivery.
Main Methods:
- A prospective, multicenter registry study was conducted in 19 hospitals across Metropolitan Beijing.
- Data collected included demographics, treatment delays, management strategies, and in-hospital outcomes for STEMI patients.
- 803 STEMI patients were enrolled for analysis.
Main Results:
- 80.9% of STEMI patients received reperfusion therapy (15.4% thrombolysis, 65.5% primary PCI).
- Median door-to-needle time for thrombolysis was 83 minutes; median door-to-balloon time for primary PCI was 132 minutes.
- Only 7% met guideline goals for door-to-needle time, and 22% for door-to-balloon time; in-hospital mortality was 5.4%.
Conclusions:
- STEMI treatment in Beijing largely follows recommended clinical guidelines.
- Significant delays in reperfusion therapy administration were observed, with many patients not meeting guideline timeframes.
- There is substantial potential to enhance STEMI care by improving the timeliness of reperfusion therapy.
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
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.
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