Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction （STEMI）. Methods All patients with STEMI...Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction （STEMI）. Methods All patients with STEMI who were admitted to the emergency depart- ment and underwent primary percutaneous coronary intervention at Peking University People＇s Hospital between April 2012 and March 2015 were included. We examined differences in clinical characteristics, total ischemic time, and in-hospital death between patients admitted during off-hours and those admitted during regular hours. Multivariate logistic regression was used to estimate the relationship between off-hours admission and clinical outcome. Results The sample comprised 184 and 105 patients with STEMI admitted to hospital during off-hours and regular hours, respectively. Total ischemic and onset-to-door times were significantly shorter in patients admitted during off-hours than among those admitted during regular hours （all P 〈 0.05）. Door-to-balloon （DTB） time, the rate of DTB time 〈 90 min, and in-hospital death were comparable between groups. Multivariate logistic regression showed that age and creatinine level, but not off-hours admission, were associated independently with increased in-hospital death. Conclusions Off-hours admission did not result in delayed reperfusion therapy or increased in-hospital mortality in patients with STEMI. Further efforts should focus on identifying pivotal factors associated with the pre-hospital and in-hospital delay of reperfusion therapy, and implementing quality improvement initiatives for reperfusion programs.展开更多
Reperfusion is the key strategy in acute ST-segment elevation myocardial infarction (STEMI) care,and it is time-dependent.Shortening the time from symptom to reperfusion and choosing the optimal reperfusion strategy f...Reperfusion is the key strategy in acute ST-segment elevation myocardial infarction (STEMI) care,and it is time-dependent.Shortening the time from symptom to reperfusion and choosing the optimal reperfusion strategy for STEMI patients are great challenges in practice.We need to improve upon the problems of low reperfusion rate,non-standardized treatment,and economic burden in STEMI care.This article briefly reviews the current status of reperfusion strategy in STEMI care,and also introduces what we will do to bridge the gap between the guidelines and implementation in the clinical setting through the upcoming China STEMI early reperfusion program.展开更多
Objective： To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infamtion （ASTEMI）, who were treated with emergency percutaneous cor...Objective： To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infamtion （ASTEMI）, who were treated with emergency percutaneous coronary intervention （PCI）. Methods： 420 patients hospitalized in Peking University First Hospital, diagnosed with ASTEMI treated with emergency （PCI） from January 2001 to June 2011 were enrolled in this study. Estimated glomerular filtration rate （eGFR） was used as a measure of renal function. We compared the clinical parameters and outcomes between ASTEMI patients combined renal insufficiency and the patients with normal renal function. Results： There was a significant increase in the concentrations of fibrinogen and D-Dimer （P〈0.05） and a much higher morbidity of diabetes mellitus in the group of patients with chronic kidney disease （CKD; eGFR〈60 ml/（min-1.73 m^2）） （P〈0.01）. CKD （eGFR〈60 ml/（min.1.73 m^2）） was an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI receiving PCI therapy rapidly （P=0.032, odds ratio （OR） 4.159, 95% confidence interval （CI） 1.127-15.346）. Conclusions： Renal insufficiency is an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI treated with primary PCI.展开更多
文摘Objective To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction （STEMI）. Methods All patients with STEMI who were admitted to the emergency depart- ment and underwent primary percutaneous coronary intervention at Peking University People＇s Hospital between April 2012 and March 2015 were included. We examined differences in clinical characteristics, total ischemic time, and in-hospital death between patients admitted during off-hours and those admitted during regular hours. Multivariate logistic regression was used to estimate the relationship between off-hours admission and clinical outcome. Results The sample comprised 184 and 105 patients with STEMI admitted to hospital during off-hours and regular hours, respectively. Total ischemic and onset-to-door times were significantly shorter in patients admitted during off-hours than among those admitted during regular hours （all P 〈 0.05）. Door-to-balloon （DTB） time, the rate of DTB time 〈 90 min, and in-hospital death were comparable between groups. Multivariate logistic regression showed that age and creatinine level, but not off-hours admission, were associated independently with increased in-hospital death. Conclusions Off-hours admission did not result in delayed reperfusion therapy or increased in-hospital mortality in patients with STEMI. Further efforts should focus on identifying pivotal factors associated with the pre-hospital and in-hospital delay of reperfusion therapy, and implementing quality improvement initiatives for reperfusion programs.
文摘Reperfusion is the key strategy in acute ST-segment elevation myocardial infarction (STEMI) care,and it is time-dependent.Shortening the time from symptom to reperfusion and choosing the optimal reperfusion strategy for STEMI patients are great challenges in practice.We need to improve upon the problems of low reperfusion rate,non-standardized treatment,and economic burden in STEMI care.This article briefly reviews the current status of reperfusion strategy in STEMI care,and also introduces what we will do to bridge the gap between the guidelines and implementation in the clinical setting through the upcoming China STEMI early reperfusion program.
文摘Objective： To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infamtion （ASTEMI）, who were treated with emergency percutaneous coronary intervention （PCI）. Methods： 420 patients hospitalized in Peking University First Hospital, diagnosed with ASTEMI treated with emergency （PCI） from January 2001 to June 2011 were enrolled in this study. Estimated glomerular filtration rate （eGFR） was used as a measure of renal function. We compared the clinical parameters and outcomes between ASTEMI patients combined renal insufficiency and the patients with normal renal function. Results： There was a significant increase in the concentrations of fibrinogen and D-Dimer （P〈0.05） and a much higher morbidity of diabetes mellitus in the group of patients with chronic kidney disease （CKD; eGFR〈60 ml/（min-1.73 m^2）） （P〈0.01）. CKD （eGFR〈60 ml/（min.1.73 m^2）） was an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI receiving PCI therapy rapidly （P=0.032, odds ratio （OR） 4.159, 95% confidence interval （CI） 1.127-15.346）. Conclusions： Renal insufficiency is an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI treated with primary PCI.
