Survey On The Early Reperfusion Therapy Status And Prognosis In Patients With Acute ST-segment Elevation Myocardial Infarction In Secondary And Tertiary Hospitals In Hebei Province

Objective: To observe the early reperfusion therapy status and prognosis for patients with acute ST-segment elevation myocardial infarction(STEMI)in secondary and tertiary hospitals in Hebei province.Methods:The investigation and study form(see appendix)was made,and 2961 patients with acute myocardial infarction who were admitted to 49 hospitals in Hebei province from January 2016 to December 2016 after emergency treatment were selected to analyze their baseline data,treatment status and prognosis.Results: 2010 patients within 12 h of onset were enrolled,of which 1747 patients were hospitalized in tertiary hospitals and 263 patients were hospitalized in secondary hospitals.69.1% of the patients received early reperfusion therapy,including 53.0% who received primary percutaneous coronary intervention(PCI)and 16.1% who received thrombolytic therapy.30.9% of patients received conservative treatment.Compared with tertiary hospitals,there was no statistical difference in the proportion of early reperfusion treatment in secondary hospitals(68.8% vs 69.1%,P > 0.05).Secondary hospitals were mainly treated with thrombolysis(62.0% vs 9.2%,P<0.001),and the proportion of primary PCI was lower(6.8% vs 60.0%,P<0.001).Among the reasons for not receiving reperfusion treatment,the proportion of thrombolytic contraindications and non-PCI ability in secondary hospitals was higher than that in tertiary hospitals(56.1% vs 10.2%,31.7% vs 2.2%,all P<0.001).There was no significant difference in in-hospital mortality(5.4% vs 7.6%,P>0.05)between the STEMI patients from the tertiary and secondary hospitals.There was no significant difference in one-year,two-year or three-year survival rates between secondary hospitals and tertiary hospitals(94.5% vs 93.1%,90.7% vs 90.6%,87.4% vs 88.5%,all P>0.05).The death rate of secondary hospitals caused by cardiogenic shock was higher than that of tertiary hospitals,and the difference was significant(5.3% vs 2.5%,P>0.05).Conclusion:There are still huge regional differences in the reperfusion treatment of STEMI inpatients in Hebei province.Compared with direct PCI,thrombolytic reperfusion had the same prognosis.A considerable proportion of patients did not receive any local reperfusion treatment in time.