Treatment delay and reperfusion management of acute ST-segment elevation myocardial infarction: analysis of the China STEMI Care Project Phase 1

作者：Y Zhang, Ye Tian, Pingshuan Dong, Yan Xu, Bo Yu, H Li, J Li, Junbo Ge, Yi Sun, J Wang, Luyao Wang, Julong Chen, Hongbing Yan, Y Chen, Yong Han, Yong Huo, the CSCAP-1 Investigators · 发表于：QJM · 年份：2020 · DOI：10.1093/qjmed/hcaa186 · 被引用次数：11 · 研究领域：Acute Myocardial Infarction Research、Mechanical Circulatory Support Devices、Sepsis Diagnosis and Treatment

BACKGROUND: The China ST-segment elevation myocardial infarction (STEMI) Care Project (CSCAP) was launched in 2011 to address the problems of insufficient reperfusion and long treatment delay in STEMI care in China. AIM: To describe the baseline status of STEMI emergency care in Tertiary PCI Hospitals using Phase 1 (CSCAP-1) data. DESIGN: CSCAP-1 is a prospective multi-center STEMI registry. METHODS AND RESULTS: A total of 4191 patients with symptom onset within 12 or 12-36 h requiring primary percutaneous coronary intervention (PCI), were enrolled from 53 tertiary PCI hospitals in 14 provinces, municipalities, and autonomous regions of China in CSCAP-1. Among them, 49.0% were self-transported to the hospital, 26.5% were transferred to the hospital by calling the emergency medical services directly, and 24.5% were transferred from other hospitals. In patients with symptom onset within 12 h, 83.2% received primary PCI, 5.9% received thrombolysis and 10.9% received conservative medications. The median door-to-balloon time was 115 (85-170) min and the median door-to-needle time for in-hospital thrombolysis was 80 (50-135) min. The overall in-hospital all-cause mortality was 2.4%, while it was 5.3% in the non-reperfusion group and 2.1% in the reperfusion group (P < 0.001). CONCLUSION: Although a long treatment delay and a high proportion of patients transporting themselves to the hospital were observed, trends were positive with greater adoption of primary PCI and lower in-hospit...