Effects of primary PCI and facilitated PCI on myocardial viability and ventricular systolic synchrony in acute myocardial infarction patients

Objective To evaluate short time effects of primary percutaneous coronary intervention (pPCI) and rtPA thrombolysis+PCI (rtPA+PCI) on myocardial viability and ventricular systolic synchrony in AMI patients.Methods Eighty seven patients with first AMI were divided into two groups: group A ( n =42), pPCI group, the patients underwent PCI within 6h after onset of AMI; group B ( n =45), rtPA+PCI group, the patients underwent PCI after thrombolysis within 6h after onset of AMI; Myocardial viability was measured by 99m Tc MIBI SPECT. While, the parameters of cardiac function LVEF and ventricular systolic synchrony LVPS were measured by 99m Tc gated cardiac blood pool image on the first and the fourth weekend. Results (1) The peak CK MB was significantly lower in group A than that in group B( P <0.01 ). (2) Myocardial infarction area (MIA) was decreased and radioactivity counts in MIA was significantly increased in group A and B on the 4th weekend compared with that on the first weekend ( P <0.01 ), but there were no significant difference between group A and group B. (3) LVEF, LVPS were no significant difference between group A and group B.Conclusions (1)pPCI in acute myocardial infartion can limit infarct area, maintain ventricular systolic synchrony and improve ventricular function; (2) but, in those hospitals that there were no any condition for PCI, they should transfer the patients to central hospital for PCI after thrombolysis at the first time. It is beneficial to improve myocardial viability and ventricular systolic synchrony of AMI patients in short time.

A comparative study on transradial vs transfemoral artery access for primary percutaneous coronary intervention in patients with acute myocardial infarction

Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.

Clinical significance of diabetes on symptom and patient delay among patients with acute myocardial infarction——an analysis from China Acute Myocardial Infarction(CAMI) registry

Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI)patients.Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment.Few studies have reported detailed AMI symptoms in patients with diabetes.This study compared AMI symptoms and presentation characteristics between diabetics and non-diabetics.Methods We included patients from the China AMI registry diagnosed with AMI between January 2013 and September 2014.Baseline characteristics,symptomology,and delay in treatment were compared between diabetics and non-diabetics.Multivariable logistic regression analysis was used to explore independent predictors of atypical symptoms.Results A total of 4450(20.2%)patients had diabetes.They were older,more often women,higher in body mass index,and more likely to have non-ST segment elevation myocardial infarction.Fewer diabetic patients presented with persistent precordial chest pain(63.1%vs.68%,P<0.0001),diaphoresis(60.1%vs.65.6%,P<0.0001),fatigue(16.7%vs.18.3%,P=0.0123),and incontinence(0.4%vs.0.7%,P=0.0093).Time to hospital presentation was longer among patients with diabetes than those without.In multivariable analysis,diabetes was identified as an independent predictor of atypical symptoms(OR:1.112,95%CI:1.034?1.196).Conclusions Our study is the first large-scale study providing evidence that diabetics are less likely to present with typical chest pain and more likely to experience treatment delay when suffering from an AMI.Our results may increase clinician awareness of recognizing AMI patients rapidly to reduce diagnosis and treatment delay,particularly in the context of diabetes.

Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study

BACKGROUND Cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) complicates management of the condition, and often leads to poor prognosis. Prompt and accurate monitoring of cardiovascular and accompanying hemodynamic changes is crucial in achieving adequate management of the condition. Advances in technology has availed procedures such as pulse index continuous cardiac output (PiCCO), which can offer precise monitoring of cardiovascular functions and hemodynamic parameters. In this study, PiCCO is evaluated for its potential utility in improving management and clinical outcomes among elderly patients with AMI complicated by CS. AIM To assess whether use of the PiCCO system can improve clinical outcomes in elderly patients with AMI complicated by CS.METHODS Patients from emergency intensive care units (EICU) or coronary care units (CCU) were randomized to receive PiCCO monitoring or not. The APACHE II score, SOFA score, hs-TnI, NT-proBNP, PaO2/FiO2 ratio and lactate levels on day 1, 3 and 7 after treatment were compared. The infusion and urine volume at 0-24 h, 24-48 h and 48-72 h were recorded, as were the cardiac index (CI), extravascular lung water index (EVLWI), intrathoracic blood volume index (ITBVI) and global end diastolic volume index (GEDVI) at similar time intervals. RESULTS Sixty patients with AMI complicated by CS were included in the study. The PiCCO group had a significantly lower APACHE II score, SOFA score, hs-TnI and NT-proBNP levels on day 1, 3 and 7 after treatment. The infusion and urine volume during 0-24 h in the PiCCO group were significantly greater, and this group also showed significantly higher ADL scores. Furthermore, the PiCCO group spent lesser days on vasoactive agents, mechanical ventilation, and had a reduced length of stay in EICU/CCU. Additionally, the CI was significantly higher at 48 h and 72 h in the PiCCO group compared with that at 24 h, and the EVLWI, ITBVI and GEDVI were significantly decreased at 48 h and 72 h. CONCLUSION Applying the PiCCO system could improve the clinical outcomes of elderly patients with AMI complicated by CS.

Potassium variability during hospitalization and outcomes after discharge in patients with acute myocardial infarction

BACKGROUND The variability of metabolic biomarkers has been determined to provide incremental prognosis information,but the implications of electrolyte variability remained unclear.METHODS We investigate the relationships between electrolyte fluctuation and outcomes in survivors of acute myocardial infarction(n=4386).Ion variability was calculated as the coefficient of variation,standard deviation,variability independent of the mean(VIM)and range.Hazard ratios(HR)were estimated using the multivariable-adjusted Cox proportional regression method.RESULTS During a median follow-up of 12 months,161(3.7%)patients died,and heart failure occurred in 550(12.5%)participants after discharge,respectively.Compared with the bottom quartile,the highest quartile potassium VIM was associated with increased risks of all-cause mortality(HR=2.35,95%CI:1.36–4.06)and heart failure(HR=1.32,95%CI:1.01–1.72)independent of cardiac troponin I(c Tn I),N terminal pro B type natriuretic peptide(NT-pro BNP),infarction site,mean potassium and other traditional factors,while those associations across sodium VIM quartiles were insignificant.Similar trend remains across the strata of variability by other three indices.These associations were consistent after excluding patients with any extreme electrolyte value and diuretic use.CONCLUSIONS Higher potassium variability but not sodium variability was associated with adverse outcomes post-infarction.Our findings highlight that potassium variability remains a robust risk factor for mortality regardless of clinical dysnatraemia and dyskalaemia.

Effectiveness and safety of antithrombotic strategies in elderly patients with acute myocardial infarction

BACKGROUND Elderly patients represent a rapidly growing part of the population more susceptible to acute coronary syndromes and their complications.However,literature evidence is lacking in this clinical setting.AIM To describe the clinical features,in-hospital management and outcomes of“elderly”patients with myocardial infarction treated with antiplatelet and/or anticoagulation therapy.METHODS This study was a retrospective analysis of all consecutive patients older than 80 years admitted to the Division of Cardiology of St.Andrea Hospital of Vercelli from January 2018 to December 2018 due to ST-elevation myocardial infarction(STEMI)or non-ST elevation myocardial infarction(NSTEMI).Clinical and laboratory data were collected for each patient,as well as the prevalence of previous or in-hospital atrial fibrillation(AF).In-hospital management,consisting of an invasive or conservative strategy,and the anti-thrombotic therapy used are described.Outcomes evaluated at 1 year follow-up included an efficacy ischemic endpoint and a safety bleeding endpoint.RESULTS Of the 105 patients enrolled(mean age 83.9±3.6 years,52.3%males),68(64.8%)were admitted due to NSTEMI and 37(35.2%)due to STEMI.Among the STEMI patients,34(91.9%)underwent coronary angiography and all of them were treated with percutaneous coronary intervention(PCI);among the NSTEMI patients,42(61.8%)were assigned to an invasive strategy and 16(38.1%)of them underwent a PCI.No significant difference between the groups was found concerning the prevalence of previous or in-hospital de-novo AF.10.5%of the whole population received triple antithrombotic therapy and 9.5%single antiplatelet therapy plus oral anticoagulation(OAC),with no significant difference between the subgroups,although a higher number of STEMI patients received dual antiplatelet therapy without OAC as compared with NSTEMI patients.A low rate of in-hospital death(5.7%)and 1-year cardiovascular death(3.3%)was registered.Seven(7.8%)patients experienced major adverse cardiovascular events,while the rate of minor and major bleeding at 1-year follow-up was 10%and 2.2%,respectively,with no difference between NSTEMI and STEMI patients.CONCLUSION In this real-world study,a tailored evaluation of an invasive strategy and antithrombotic therapy resulted in a low rate of adverse events in elderly patients hospitalized with acute myocardial infarction.

Clinical study of recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicating congestive heart failure

Objectives To observe the efficacy and safety of recombinant human brain natriuretic peptide(rh-BNP) on patients with acute myocardial infarction complicating congestive heart failure.Methods 40 patients with acute myocardial infarction complicated by congestive heart failure were randomly divided into control group and treatment group of 20 cases.The control group,15 cases of acute anterior myocardial infarction,5 cases of acute inferior wall myocardial infarction, 15 males and 5 females,aged 55-70 years,mean age 58±12 years;treated 16 cases of acute anterior myocardial infarction,4 cases of acute myocardial infarction,16 males and 4 females,aged 56-70 years,mean age 59±11 years;two groups of age,gender,severity of disease and vascular lesions no significant difference and comparable(P】0.05).Conventional group were given aspirin,clopidogrel, statins,Inotropic,diuretic and vasodilator therapy.In the con- ventional treatment group based on the use of recombinant human brain natriuretic peptide(new bios,Tibet Pharmaceutical Co.,Ltd.Chengdu Nuodikang biopharmaceutical production, usage:1.5μg/Kg intravenous injection(impact), then 0.0075μg-0.01μg/(kg·min)infusion rate).Continuous medication 72 h.The clinical symptoms observed for 3 days in patients before treatment and after treatment,heart rate,blood pressure and left ventricular ejection fraction (LVEF) and tumor necrosis factor(TNF-α),brain natriuretic peptide(BNP) levels were measured.Results In control group,8 cases markedly effect,5 cases effect and 7 cases no effect,the total effective rate was 65%;In treatment group,13 cases markedly effect,6 cases effect and 1 cases no effect,the total effective rate was 95%,compared with two groups P New bios treatment group significantly increased cardiac index(CI) in patients with heart failure and left ventricular ejection fraction(LVEF) than the control group(all P【0.05),further reduce the levels of tumor necrosis (TNF-α) and brain natriuretic peptide(BNP).Conclusions rh-BNP can improve symptoms and heart function,reduced plasma tumor necrosis factor(TNF-α) and BNP levels of acute myocardial infarction patients with congestive heart failure,the treatment safe and reliable.As small sample size observed,larger sample to be accumulated to further evaluate its efficacy and safety.

Knowledge about Acute Myocardial Infarction (AMI) and attitudes to medical care seeking—A comparison between patients and the general public

Background: Patients with acute myocardial infarction often have long decision times before seeking medical care. The decision time is influenced by knowledge of AMI-symptoms, psychological factors and the response of people near the patient to the symptoms. Aim: To investigate and compare the knowledge of AMI, intended actions in response to AMI-symptoms and attitudes toward seeking medical care of patients and the general public. Method: This was a multicentre study with descriptive and comparative design, using questionnaires as an instrument. The population consisted of AMI-patients and representatives of the general public. Results: There was good knowledge about typical AMI-symptoms among the participants. The majority thought an AMI always starts suddenly. Patients did not know more about the time-dependency of treatment outcome than the general public. A greater proportion of the general public would contact an additional person before consulting medical professionals. Conclusions: Patients had no better knowledge about AMI than the general public, but would more commonly act appropriately in case of AMI-symptoms.

The safety of autologous peripheral blood stem cell transplantation by intracoronory infusionin in patients with acute myocardial infarction

Objective Bone-marrow stem-cell transplantation has been shown to improve cardiac function in patients with AMI, but the safety of intracoronory infusion of autologous peripheral blood stem-cell(PBSCs) in patients with AMI is unknown. For this reason, we observe the feasibility and safety of PBSCs transplantation by intracoronory infusion in such patients.Method Fourty one patients with AMI were allocated to receive Granulocyte Colony-Stimulating Factor (G-CSF:Filgrastim,300 μg) with the dose of 300 μg-600 μg/day to mobilize the stem cell, and the duration of applying G-CSF was 5 days . On the sixth day, PBSCs were separated by Baxter CS 3000 blood cell separator into suspend liquid 57 ml. Then the suspend liquid was infused into the infarct related artery (IRA)by occluding the over the wire balloon and infusing artery through balloon center lumen. In the process of the intracoronary infusion of PBSCs, the complications should be observed, which were arrhythmias including of bradycardia, sinus arrest or atrial ventricular block, premature ventricular beats ,ventricular tachycardia, ventricular fibrillation; and hypotention, etc. Results There were total 10 cases with complications during the intracoronary infusion of PBSCs. The incidence of complications was 24.4%(10/41), including bradycardia is 2.4 %(1/41), sinus arrest or atrial ventricular block is 4.9%(2/41), ventricular fibrillation is 2.4 %( 1/41), hypotention is14.6 % (6 /41).Conclusions In patients with AMI, intracoronary infusion of PBSCs is feasible and safe.

Efficacy and safety of single-bolus tenecteplase compared with front-loaded alteplase in Chinese patients with acute myocardial infarction

Following ST-segment elevation myocardial infarction(STEMI), early and complete epicardial reperfusion is associated with improved survival.……

The Safety of Autologous Peripheral Blood Stem Cell Transplantation by Intracoronory Infusion in Patients with Acute Myocardial Infarction

Objectives Bone-marrow stem-cell transplantation has been shown to improve cardiac function in patients with acute myocardial infarction (AMI) , but the safety of intracoronory infusion of autologous peripheral blood stem-cell (PBSCs) in patients with AMI is unknown. For this reason, we observe the feasibility and safety of PBSCs transplantation by intracoronory infusion in such patients. Methods 41 patients with AMI were allocated to receive granulocyte colony-stimulating factor (G- CSF: Filgrastim,300μg) with the dose of 300μg~ 600μg/day to mobilize the stem cell, and the duration of applying G-CSF was 5 days. On the sixth day, PBSCs were separated by Baxter CS 3000 blood cel 1 separator into suspend liquid 57 ml. Then the suspend liquid was infused into the infarct related artery (IRA) by occluding the over the wire balloon and infusing artery through balloon center lumen. In the process of the intracoronary infusion of PBSCs, the complications should be observed, which were arrhythmias including of bradycardia, sinus arrest or atrial ventricular block, premature ve. ntricular beats ,ven~icular tachycardia, ventricular fibrillation; and hypotention, etc. Results There were total 10 cases with complications during the intracoronary infusion of PBSCs. The incidence of complications was 24.4% (10/41), including bradyca- rdia was 2.4 % (1/41), sinus arrest or atrial ventri- cular block was 4.0% (2/41), ventricular fibrillation was 2.4 % (1/41), hypotention was 14.6 % (6/41). Conclusions In patients with AMI, intracoronary infusion of PBSCs is feasible and safe.

Patient Delay in Patients With ST-elevation Acute Myocardial Infarction

Objectives To examine patient delay (PD) in seeking treatment among patients with ST-elevation myocardial infarction (STEMI) and to identify factors influencing PD. Methods patients with STEMI were divided into two groups based on PD: Short PD group (PD ≤ 60 minutes after onset of symptoms) and long PD group ( > 60 minutes after symptom onset). A questionnaire developed to assess demographic characteristics, clinical factors and psychological factors. Patients were interviewed within 72 hours of admission to 2 hospitals. Results 329 consecutive confirmed STEMI patients (Mean age 61years; 72.5% men) with a median PD of 90 min and a pre-hospital delay time 170 min were studied, PD was less than 1 hours in 47.4% of patients, while more than 1 hours in 52.6%, In univariate analyses, patients with short PD were witness onset, progress course of symptom, severe pain, death anxiety, knowing AMI as a deadly disease and its presentation, taking the symptom seriously. Patients with longer PD were age ≥65 year, nocturnal onset, experienced their symptoms at home, gradual onset, ’waited to see whether symptoms disappeared’, ’worried about troubling others’, ’took pain medication’ and preinfarction angina. A stepwise multiple regression analysis further suggested that the following inde-pendent contributors to a late decision to seek medical help (relative risk, 95% confidence interval): taking pain medication (15.97; 1.70～149.8 ), wanting to wait and see (6.46; 1.92～21.74), not wanting to bother anybody (6.42; 2.87～14.34), preinfarct angina (2.73; 1.20～6.19), age ≥65 years (2.51; 1.15～5.48), gradual onset (2.40; 1.05～5.44), severe pain(0.38, 0.17～0.85), witness onset (0.27, 0.10～0.70), taking symptoms seriously (0.019; 0.08～0.46). Conclusions Age ≥65 years, gradual onset, witness onset, severe pain, preinfarct angina, emotional responses and coping strategies are the independent factors associated with patient delay or decision time in patients with AMI. Emotional responses and coping strategies are the major determinants of patient delay. Modification of these emotional factors might best be achieved by patients and public education.

Clinical disease registries in acute myocardial infarction

Disease registries,containing systematic records of cases,have for nearly 100 years been valuable in exploring and understanding various aspects of cardiology. This is particularly true for myocardial infarction,where such registries have provided both epidemiological and clinical information that was not readily available from randomised controlled trials in highlyselected populations. Registries,whether mandated or voluntary,prospective or retrospective in their analysis,have at their core a common study population and common data definitions. In this review we highlight how registries have diversified to offer information on epidemiology,risk modelling,quality assurance/improvement and original research-through data mining,transnational comparisons and the facilitation of enrolment in,and follow-up during registry-based randomised clinical trials.

Acute Myocardial Infarction in a 26-Year-Old Man with Normal ST-Segment

Acute myocardial infarction (AMI) is rare in young adults. The management of these patients is considered as a clinical challenge. We report the case of a 26-year-old man who was presented to the Emergency Room of Affiliated Hospital of Guilin Medical University with an acute onset of chest pain. Initially electrocardiogram (ECG) with no evidence of ST-segment abnormalities but QT prolongation a signal of sudden cardiac death, 20 minutes later, it revealed ST-segment elevation myocardial infarction (STEMI). Coronary angiography (CAG) demonstrated left main coronary artery occlusion. AMI was diagnosed based on clinical symptom, elevated cardiac biomarkers, electrocardiographic dynamic monitoring and CAG. The awareness of chest pain as possible underlying AMI symptom—especially in young patients presenting with QT prolongation—is crucial for clinical treatment, as a missed diagnosis can worsen the patient’s further prognosis. In addition, reperfusion arrhythmia is a challenge to short-term outcomes of young patients with AMI, so it is necessary to make preoperative risk stratification.

ALTERATIONS OF THE PERCENTAGE OF LYMPHOCYTES IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND CLINICAL EVALUATION

In order to investigate the human immunological response to acute myocardial infarction (AMI), lymphocyte cells of peripheral vein blood withdrawn from patients with AMI were continuously and quantitatively assayed by flow cytometry method (FCM). The correlation between the alterations of immunological function and clinical course was analyzed. MATERIAL AND METHODS Thirty-one samples were collected from peripheral vein blood of hospitalized patients with AMI in the author’s institution. The patients were aged from 39 to 81 years, ( 26 men and 5 women ). Samples withdrawn from 14 healthy adults served as normal control.

Effect of Puerarin on Plasma Endothelin, Renin Activity and Angiotensin Ⅱ in Patients with Acute Myocardial infarction

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THE EFFECT OF LOW DOSE ASPIRIN ON THE PLATELET FUNCTION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION (AMI)

To assess the optimal dose of aspirin （ASA） in the treatment of AMI, 60 cases of AMI: 1. admitted within 24 hours after onset of illness, 2. ASA not used within one week before, 3. any other drugs influencing the platelet function also not used during the course of study, were randomized into two groups, 30 cases each: one with conventional therapy as control, the other combined with daily oral ASA 100mg. They were matched in sex, age, infarct site and coexistent conditions （hypertension, diabetes mellitus, hyperlipemia, smoking etc.）. The second group was further divided into subgroup I with serum peak CK<1000 U/L and subgroup Ⅱ with serum peak CK>1000 U/L. The parameters of platelet function including plasma TXB/6-keto-PGF, platelet aggregation induced by 5-HT and epinephrine were studied on different days for 3 weeks. Twenty healthy persons were selected for normal value of platelet function.

Effect of acute kidney injury on short-and long-term mortality of patients with acute myocardial infarction

Objective To evaluate the role of acute kidney injury(AKI)in predicting early(30-day)and late(30-day to5-year)mortality of acute myocardial infarction(AMI)patients during hospitalization.Methods A total of 1371adult patients diagnosed with AMI in the First People’s Hospital of Changzhou from January 2008 to December2012 were analyzed retrospectively while their

China Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction： Study Design

Background： Despite the rapid growth in the incidence of acute myocardial infarction （AMI） in China, there is limited information about patients＇ experiences after AMI hospitalization, especially on long-tern1 adverse events and patient-reported outcomes （PROs）. Methods： The China Patient-centered Evaluative Assessment of Cardiac Events （PEACE）-Prospective AMI Study will enroll 4000 consecutive AM I patients from 53 diverse hospitals across China and follow them longitudinally for 12 months to docunlent their treatment, recovery, and outcomes. Details of patients＇ medical history, treatment, and in-hospital outcomes are abstracted from medical charts. Comprehensive baseline interviews are being conducted to characterize patient demographics, risk factors, presentation, and healthcare utilization. As part of these interviews, validated instruments are administered to measure PROs, including quality of life, symptoms, mood, cognition, and sexual activity. Follow-up interviews, measuring PROs, medication adherence, risk factor control, and collecting hospitalization events are conducted at 1, 6, and 12 months after discharge. Supporting documents for potential outcomes are collected for adjudication by clinicians at the National Coordinating Center. Blood and urine samples are also obtained at baseline, 1 - and 12-month follow-up. In addition, we are conducting a survey of participating hospitals to characterize their organizational characteristics. Conclusion： The China PEACE-Prospective AMI study will be uniquely positioned to generate new information regarding patient＇s experiences and outcomes alter AMI in China and seiwe as a foundation for quality improveinent activities.