Trends of ST-segment Elevation Myocardial Infarction in Western Rural China From 2001 to 2011 -China PEACE Retrospective Acute Myocardial Infarction Study / 中国循环杂志

ABSTRACT

Objective: To assess the trends in clinical characteristics and treatments for in-hospital patients with ST-segment elevation myocardial infarction (STEMI) in western rural China from 2001 to 2011. Methods: A two-stage random sampling procedure was used in our study. In 1st stage, stratiifed random sampling was applied to identify the participating hospitals and in 2nd stage, random sampling was applied to determine the patients to be studied. Taking 2001, 2006 and 2011 as 3 time points to study the in-hospital records for STEMI treatments. The results in each year were analyzed by weighted calculation in order to adjust the proportional impact by different sampling and therefore, to relfect the entire condition in western rural area. Results: A total of 32/35 hospitals with 1028 STEMI records were enrolled. From 2001 to 2011, the admitted STEMI patients from 64 (54-70) years of age increased to 67 (56-75) years,Ptrend<0.05, while gender composition was similar, the risk factors for cardiovascular disease such as hypertension, dyslipidemia and smoking substantially increased. Among patients without contraindications, the ues of following medications increased from 2001 to 2011 aspirin from 73.6% to 89.9%, clopidogrel from 0% to 66.5%, β-blockers from 25.4% to 64.3% and statins from 7.5% to 89.8%, allPtrend<0.01. From 2001 to 2011, the rates of primary PCI application were from 0% to 0.3%,Ptrend=0.51, the rates of thrombolytic therapy increased from 33.4% to 55.4%,Ptrend<0.01. At the year of 2001, 2006 and 2011, the reperfusion rates were 33.4%, 50.7% and 55.4%, Ptrend<0.01; the mortality within 7 days of admission were 3.0%, 10.1% and 6.7%, the rates of death or treatment withdrawal because of terminal status were 5.3%, 12.3% and 10.9%, there was no signiifcant trend in the above 2 rates after adjustments. Conclusion: The quality of medical care for STEMI was signiifcantly improved in western rural China from 2001 to 2011, while there are still gaps between western rural area and other regions.