Reperfusion strategy and in-hospital outcomes for ST elevation myocardial infarction in secondary and tertiary hospitals in predominantly rural central China: a multicentre, prospective and observational study

Reperfusion strategy and in-hospital outcomes for ST elevation myocardial infarction in secondary and tertiary hospitals in predominantly rural central China: a multicentre, prospective and observational study

Objectives To assess differences in reperfusion treatment and outcomes between secondary and tertiary hospitals in predominantly rural central China.Design Multicentre, prospective and observational study.Setting Sixty-six (50 secondary and 16 tertiary) hospitals in Henan province, central China.Par...

Full description

Saved in:
Bibliographic Details
Main Authors: Shan Wang, Zheng Liu, Ling Zhang, Peng Liu, Wei Wei, Dongsheng Wang, Yi Yang, Chuanyu Gao, Na Sun, Haiyan Sun, Haitao Wang, Lianjie Li, Shengli Li, Xinyuan Yang, You Zhang, Xiaowen Ma, Pingshuan Dong, Yanhui Gao, Junhui Zhang, Hongxia Zhang, Dayi Hu, Xiaoli Ji, Shuhong Su, Qianqian Cheng, Datun Qi, Xianpei Wang, Zhongyu Zhu, Muwei Li, Zhifang Wang, Xuming Yang, Hualing Xia, Wuxing Li, Shuiyin Ding, Baoqiang Bai, Changming Tian, Jinbo Li, Chuntong Wang, Jixia Yan, Heping Li, Wanke Li, Zhenfu Zhao, Huading Zhou, Chuanqian Zhang, Hengliang Wang, Dequan Jing, Suxia Chen, Haijun Zheng, Fengxian Lin, Guiye Zhao, Yanggui Liu, Xiangyang Cheng, Chengwen Zhang, Liangping Wang, Changgang Tong, Huihui Lang, Haojie Xu, Hengshan Wei, Ruilu Xue, Hongxu Geng, Yonghong Shi, Qiwei Tang, Yuchun Li, Yonggang Liu, Jianbo Jia, Xianzhang Li, Xinling Deng, Qinghua Xu, Linming Zhao, Lipeng Li, Suqin Chen, Keqi Liang, Linwu Zhang, Jiandang Jiang, Weitian Xiao, Hongwen Zhang, Shengke Zhu, Baofu Liu, Chengxuan Pan, Fengyun Lu, Yaoze Li, Qingchun Zhang, Yintao Qiao
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e053510.full
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objectives To assess differences in reperfusion treatment and outcomes between secondary and tertiary hospitals in predominantly rural central China.Design Multicentre, prospective and observational study.Setting Sixty-six (50 secondary and 16 tertiary) hospitals in Henan province, central China.Participants Patients with ST elevation myocardial infarction (STEMI) within 30 days of symptom onset during 2016–2018.Primary outcome measures In-hospital mortality, and in-hospital death or treatment withdrawal.Results Among 5063 patients of STEMI, 2553 were treated at secondary hospitals. Reperfusion (82.0% vs 73.0%, p<0.001) including fibrinolytic therapy (70.3% vs 4.4%, p<0.001) were more preformed, whereas primary percutaneous coronary intervention (11.7% vs 68.6%, p<0.001) were less frequent at secondary hospitals. In secondary hospitals, 53% received fibrinolytic therapy 3 hours after onset, and 5.8% underwent coronary angiography 2–24 hours after fibrinolysis. Secondary hospitals had a shorter onset-to-first-medical-contact time (176 min vs 270 min, p<0.001). Adjusted in-hospital mortality (adjusted OR 1.23, 95% CI 0.89 to 1.70, p=0.210) and in-hospital death or treatment withdrawal (adjusted OR 1.18, 95% CI 0.82 to 1.70, p=0.361) were similar between secondary and tertiary hospitals.Conclusions With fibrinolytic therapy as the main reperfusion strategy, the reperfusion rate was higher in secondary hospitals, whereas in-hospital outcomes were similar compared with tertiary hospitals. Public awareness, capacity of primary and secondary care institutes to treat STEMI, and establishment of deeper cooperation among different-level healthcare institutes need to further improve.Trial registration number NCT02641262.
ISSN:2044-6055

Similar Items