Roles of the chest pain rapid response system in treatment of patients with acute ST-elevated myocardial infarction / 重庆医学

ABSTRACT

Objective To investigate the effects of rapid response system of chest pain on the short-term and long-term prognosis of patients with acute ST segment elevation myocardial infarction (STEMI).Methods Referring to the international association of chest pain centers,the chest pain center was established in this hospital,and the corresponding management system and treatment process were worked out.A total of 374 acute STEMI patients who were recruited as the observation group were admitted to this hospital after the establishment of the chest pain center (December 2014 to June 2016),and 250 STEMI patients admitted before the establishment of the chest pain center (January 2012 to December 2012) were recruited as control group.Patients in observation group were treated in the chest pain center,and those in control groupreceived conventional treatment.The general situation,basic diseases,the finishing time of the first electrocardiogram(ECG),the time of door-to balloon expansion(D2B),the time of hospital stay,the average hospitalization expenses,in-hospital cardiac events and in-6-month cardiac events were compared between the two groups.All patients were followed up for 1 years,left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter (LVEDD),left ventricular aneurysm,B type natriuretic peptide (pro-BNP),serum creatinine (Scr),C-reactive protein (CRP) levels and adverse cardiac events (heart failure,death,readmission rate etc.)were compared between two groups.Results Compared with the control group,the average completion time of the first electrocardiogram in the observation group was shortened (P=0.001),the time of entry balloon dilatation,the time of hospital stay,the average hospitalization expenses were less than that of the control group (P＜0.05),the adverse cardiac events (hospital death and heart failure) were lower in the observation group than in the control group (P＜0.05).After 6 months of follow-up,LVEF was significantly higher in the observation group than in the control group (P＜0.05).the levels of LVEDD,pro-BNP,CRP and adverse cardiac events in the observation group were significantly lower than those in the control group (P＜0.05),there was no significant difference in the formation rate of ventricular aneurysm and Scr between the observation group and the control group (P＞0.05).After 1 year of follow-up,LVEF was still higher in the observation group than in the control group (P＜0.05).The incidence of LVEDD,pro-BNP,CREA,CRP,left ventricular aneurysm formation rate,the incidence of adverse cardiac events were lower in the observation group than in the control group (P＜0.05).Conclusion The establishment of rapid response system of chest pain treatment not only effectively shortenthe treatment time of STEMI patients,improve the treatment efficiency,shorten the hospital stay,reduce the cost of hospitalization,but also improve the quality of life and disease prognosis.