A Cross-sectional Survey Of Treatment Status Of The Patients With Acute Myocardial Infarction In Partial Hospitals Of Liaoning Province

Objective To evaluate the current therapies status of hospitalized patients with acute ST segment elevation myocardial infarction (STEMI) in partial hospitals of Liaoning province and to investigate the current situation of following ACC/AHA guideline.Methods The data of hospitalized patients with STEMI discharged between December 2004 and December 2005 were retrospectively collected from medical records of 7 hospitals. All patients with a length of hospital stay more than 24 hours were included in the study. According to the degree of hospital, all the hospitals were divided by three-group. Group A: provincial hospital of Grade III A, Group B: municipal hospital of Grade III A, Group C: county hospital of Grade II A. We assessed both the use of western and traditional medicine.Results A total of 1239 patients were included 69.4 % of them were male, 33.1% of them were smoker, and the mean age was 64.6 year old. 42.3% of them underwent reperfusion therapy, 33.3% underwent emergency percutaneous coronary intervention (PCI): Group A (45.0%), Group B (44.7%). 9.0% underwent thrombolytic therapy: Group A(4.1%), Group B(3.8%), Group C(23.5%). Percentage of medications in 1239 patients: aspirin (95.9%), clopidogrel (64.3%), angiotensin-converting enzyme inhibitors/angiotensin-receptor blocker (88.4%), statins (94.9%), low-molecular-weight heparin (97.8%). The utilization rate of above-mentioned medication in the patients of Group C was lower than the other groups. The utilization rates ofβ–blockers achieved 75.0%. Up to51.8% of the patients received traditional medicine. The utilization days of traditional medicine in the patients of Group C was longer than the other group's .Of 1239 patients, the times from onset to getting into sickroom was nonnormal distribulation. The mean visit time was 19.2 hours. The mean time from onset to undergoing reperfusion therapy was 4.24 hours. The mean time from onset to undergoing emergency percutaneous coronary intervention was 7.16 hours. The days of patients stayed in hospital: Group A(9.43±5.05)days , Group B (9.96±5.04) days, Group C (10.67±6.48)days . The days of patients of Group C in hospital were longer than the other groups. The rates of major adverse cardiac event in the patients of Group C were higher than the other groups. The mortality of patients in Group C was highest among the three-group. The relationship of age, disease history, reperfusion therapy, congestive heart failure, cardiogenic shock and death were analyzed by multiple factor logistic analytical method. Reperfusion therapy was protecting factor. Age, diabetes history, congestive heart failure and cardiogenic shock happened in duration of hospital stay were dangerous factors of death.Conclusions The ACC/AHA guidelines were implemented in the treatment of STEMI in seven hospitals of Liaoning province. The rates of reperfusion therapy were lower than 50%. The rates of reperfusion therapy and medicine therapy will be improved. The hospitals of Grade III A were better than the hospitals of Grade II A. The traditional medicines were widely used, but still need to be proved by evidence-based medicine.