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ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data.

BACKGROUNDDespite the importance of ST-segment elevation myocardial infarction (STEMI) in China, no nationally representative studies have characterised the clinical profiles, management, and outcomes of this cardiac event during the past decade. We aimed to assess trends in characteristics, treatme... Full description

Journal Title: Lancet (London England), January 31, 2015, Vol.385(9966), pp.441-451
Main Author: Li, Jing
Other Authors: Li, Xi , Wang, Qing , Hu, Shuang , Wang, Yongfei , Masoudi, Frederick A , Spertus, John A , Krumholz, Harlan M , Jiang, Lixin , Li, Jing
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1474-547X ; DOI: 1474-547X ; DOI: 10.1016/S0140-6736(14)60921-1
Link: http://search.proquest.com/docview/1658421559/?pq-origsite=primo
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title: ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data.
format: Article
creator:
  • Li, Jing
  • Li, Xi
  • Wang, Qing
  • Hu, Shuang
  • Wang, Yongfei
  • Masoudi, Frederick A
  • Spertus, John A
  • Krumholz, Harlan M
  • Jiang, Lixin
  • Li, Jing
subjects:
  • Aged–Administration & Dosage
  • Aspirin–Epidemiology
  • China–Administration & Dosage
  • Clopidogrel–Trends
  • Female–Statistics & Numerical Data
  • Fibrinolytic Agents–Statistics & Numerical Data
  • Healthcare Disparities–Epidemiology
  • Hospital Mortality–Therapy
  • Hospitals, Rural–Trends
  • Hospitals, Urban–Statistics & Numerical Data
  • Humans–Administration & Dosage
  • Male–Analogs & Derivatives
  • Middle Aged–Analogs & Derivatives
  • Myocardial Infarction–Analogs & Derivatives
  • Myocardial Reperfusion–Analogs & Derivatives
  • Patient Admission–Analogs & Derivatives
  • Percutaneous Coronary Intervention–Analogs & Derivatives
  • Quality of Health Care–Analogs & Derivatives
  • Retrospective Studies–Analogs & Derivatives
  • Ticlopidine–Analogs & Derivatives
  • Treatment Outcome–Analogs & Derivatives
  • Fibrinolytic Agents
  • Clopidogrel
  • Ticlopidine
  • Aspirin
ispartof: Lancet (London, England), January 31, 2015, Vol.385(9966), pp.441-451
description: BACKGROUNDDespite the importance of ST-segment elevation myocardial infarction (STEMI) in China, no nationally representative studies have characterised the clinical profiles, management, and outcomes of this cardiac event during the past decade. We aimed to assess trends in characteristics, treatment, and outcomes for patients with STEMI in China between 2001 and 2011. METHODSIn a retrospective analysis of hospital records, we used a two-stage random sampling design to create a nationally representative sample of patients in China admitted to hospital for STEMI in 3 years (2001, 2006, and 2011). In the first stage, we used a simple random-sampling procedure stratified by economic-geographical region to generate a list of participating hospitals. In the second stage we obtained case data for rates of STEMI, treatments, and baseline characteristics from patients attending each sampled hospital with a systematic sampling approach. We weighted our findings to estimate nationally representative rates and assess changes from 2001 to 2011. This study is registered with ClinicalTrials.gov, number NCT01624883. FINDINGSWe sampled 175 hospitals (162 participated in the study) and 18,631 acute myocardial infarction admissions, of which 13,815 were STEMI admissions. 12,264 patients were included in analysis of treatments, procedures, and tests, and 11,986 were included in analysis of in-hospital outcomes. Between 2001 and 2011, estimated national rates of hospital admission for STEMI per 100,000 people increased (from 3·5 in 2001, to 7·9 in 2006, to 15·4 in 2011; ptrend
language: eng
source:
identifier: E-ISSN: 1474-547X ; DOI: 1474-547X ; DOI: 10.1016/S0140-6736(14)60921-1
fulltext: fulltext
issn:
  • 1474547X
  • 1474-547X
url: Link


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titleST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data.
creatorLi, Jing ; Li, Xi ; Wang, Qing ; Hu, Shuang ; Wang, Yongfei ; Masoudi, Frederick A ; Spertus, John A ; Krumholz, Harlan M ; Jiang, Lixin ; Li, Jing
contributorWeng, Shiping (correspondence author) ; Xie, Shuying (record owner) ; Wu, Lirong ; Chen, Jiulin ; Li, Tianfa ; Wang, Jun ; Yu, Qin ; Li, Xiaofei ; Li, Zhong ; Hao, Shiguo ; Zhang, Yuzhen ; Wu, Xuemei ; Zhang, Yachen ; Liu, Zhifeng ; Wang, Zhongxin ; Jia, Hao ; Bate, Bayin ; Qiqige, Badeng ; Jin, Xiang ; Cai, Ting ; Liu, Fengqin ; Xu, Dayong ; He, Xuejin ; Yang, Shui ; Yuan, Chun ; Wang, Jiping ; Gu, Lihua ; Li, Lin ; Chen, Shijiao ; Zhi, Yongchao ; Sun, Lili ; Zhou, Shengcheng ; Jin, Lingjiao ; Leng, Yong ; Zhang, Liangchuan ; Deng, Tianyun ; Wang, Yuanjin ; Zhang, Wenhua ; Ma, Xinmin ; Li, Weimin ; Lu, Liang ; Ge, Xuan ; Wu, Xiaoping ; He, Yanming ; Meng, Fanju ; Li, Jia ; Liao, Dexi ; Liu, Guangyong ; Long, Wen ; Chen, Xiangwen ; Zhang, Baohong ; Yin, Yonghou ; Tian, Bin ; Yi, Yong ; Wu, Chaoyong ; Liu, Baoqi ; Zhao, Zhihui ; Li, Haiming ; Guo, Yansong ; Chen, Xinjing ; Xiang, Liquan ; Ning, Lin ; Chen, Mei ; Jin, Xin ; Li, Guiling ; Li, Xiuqi ; Wu, Xing'an ; Tan, Congjun ; Feng, Mingfang ; Wang, Meili ; Wen, Liangfa ; Fu, Xiang ; Xie, Qunxing ; Zhang, Wei ; Zhuang, Yanni ; Lu, Hua ; Lu, Jiaqian ; Huang, Yu ; Zhou, Yin ; Hu, Qiuling ; Xiao, Chunhui ; Hu, Xiaoli ; Wu, Yongshuan ; Wang, Qiuli ; Xu, Youlin ; Yu, Xuefei ; Gao, Chuanyu ; Zhang, Jianhong ; Zhang, You ; Niu, Wentang ; Ma, Xiaolei ; Wang, Yong ; Pan, Xiaowen ; Liu, Yanlong ; Miao, Lifu ; Yin, Yanping ; Zhang, Zhiying ; Feng, Shutang ; Wang, Aiping ; Zhang, Jiangli ; Li, Feipeng ; Wang, Hong ; Yu, Lijun ; Zhao, Xinxin ; Shen, Yuansheng ; Li, Zhiming ; He, Lizhen ; Rong, Zhiyi ; Luo, Wei ; Wang, Xueqiao ; Yao, Jianghua ; Wan, Rongjun ; Tang, Jianglin ; Wu, Guanghan ; Wu, Jie ; Xu, Bin ; Huang, Qing ; Wu, Xiaohe ; Ge, Sang ; Pu, Pian ; Duoji, Pingcuo ; Dai, Hui ; Du, Yuming ; Guo, Wei ; Shi, Jianping ; Zhao, Peihua ; Sun, Jingsheng ; Li, Hongxiang ; Liang, Wen ; Qin, Wen ; Dong, Zhiwen ; Zhao, Zhenhai ; Li, Xin ; Xu, Qin ; Yuan, Yaofeng ; Li, Zhirong ; Gao, Jinbo ; Guo, Qiu'E ; Zhao, Ruiqing ; Song, Guangjun ; Wang, Lize ; Song, Haiyun ; Bai, Lanping ; He, Jinwen ; He, Jinming ; Shang, Keyong ; Liu, Changjiang ; Xi, Kuituan ; Liu, Rihui ; Guo, Peng ; Guo, Chaoyang ; Liu, Xiangjun ; Zhao, Rujun ; Yu, Zeyong ; Li, Wenzhou ; Jing, Xudong ; Wang, Huanling ; Zhao, Xiyuan ; Zhang, Chao ; Chen, Long ; Wei, Meifa ; Liu, Yan ; Chen, Shengde ; Chen, Kaihong ; Fang, Yong ; Liao, Ying ; Wang, Junli ; Liu, Tianyu ; Cheng, Suzhe ; Zhou, Yunke ; Niu, Xiaoxia ; Cao, Huifang ; Feng, Zebin ; Feng, Min ; Duan, Feilong ; Yi, Haiming ; Xu, Yuanxun ; Guo, Anran ; Zhou, Xianshun ; Cai, Hongzhuan ; Zheng, Peng ; Guo, Gaofeng ; Li, Xiang ; Bao, Minwu ; Liu, Yuhong ; Chen, Shaoliang ; Jia, Haibo ; Peng, Hongjuan ; Dai, Duanping ; Hong, Shaoxiong ; Chen, Song ; Zhang, Dongya ; Wang, Ying ; Li, Yudong ; Gao, Jianbu ; Yang, Shouzhong ; An, Junhu ; Shen, Chenyang ; Liu, Yunfeng ; Wu, Chun ; Qu, Huan ; Chen, Saiyong ; Lin, Yuhui ; Jiao, Dehai ; Wang, Manhong ; Wang, Qiu ; Xue, Yingliang ; Zhang, Ruijun ; Yuan, Cheng ; Wu, Lei ; Zhang, Jianqing ; Wei, Chunmei ; Shen, Yanmei ; Zhang, Hehua ; Pan, Hongmei ; Gao, Yong ; Ma, Xiaowen ; Liang, Yanli ; Wang, Tianbiao ; Zhao, Daguo ; Tu, Xiaoming ; Gao, Zhenyan ; Wang, Fangning ; Yang, Qiang ; Kang, Xiaoping ; Fang, Jianbin ; Liu, Dongmei ; Shen, Chengning ; Li, Mengfei ; Guan, Yingmin ; Wang, Wenfeng ; Xiao, Ting ; Wang, Qian ; Jiang, Fengyun ; Wu, Kaiyou ; Wang, Songguo ; Fu, Xujie ; Zhang, Shu ; Gao, Lifang ; Zhang, Min
ispartofLancet (London, England), January 31, 2015, Vol.385(9966), pp.441-451
identifier
subject
descriptionBACKGROUNDDespite the importance of ST-segment elevation myocardial infarction (STEMI) in China, no nationally representative studies have characterised the clinical profiles, management, and outcomes of this cardiac event during the past decade. We aimed to assess trends in characteristics, treatment, and outcomes for patients with STEMI in China between 2001 and 2011. METHODSIn a retrospective analysis of hospital records, we used a two-stage random sampling design to create a nationally representative sample of patients in China admitted to hospital for STEMI in 3 years (2001, 2006, and 2011). In the first stage, we used a simple random-sampling procedure stratified by economic-geographical region to generate a list of participating hospitals. In the second stage we obtained case data for rates of STEMI, treatments, and baseline characteristics from patients attending each sampled hospital with a systematic sampling approach. We weighted our findings to estimate nationally representative rates and assess changes from 2001 to 2011. This study is registered with ClinicalTrials.gov, number NCT01624883. FINDINGSWe sampled 175 hospitals (162 participated in the study) and 18,631 acute myocardial infarction admissions, of which 13,815 were STEMI admissions. 12,264 patients were included in analysis of treatments, procedures, and tests, and 11,986 were included in analysis of in-hospital outcomes. Between 2001 and 2011, estimated national rates of hospital admission for STEMI per 100,000 people increased (from 3·5 in 2001, to 7·9 in 2006, to 15·4 in 2011; ptrend<0·0001) and the prevalence of risk factors-including smoking, hypertension, diabetes, and dyslipidaemia-increased. We noted significant increases in use of aspirin within 24 h (79·7% [95% CI 77·9-81·5] in 2001 vs 91·2% [90·5-91·8] in 2011, ptrend<0·0001) and clopidogrel (1·5% [95% CI 1·0-2·1] in 2001 vs 82·1% [81·1-83·0] in 2011, ptrend<0·0001) in patients without documented contraindications. Despite an increase in the use of primary percutaneous coronary intervention (10·6% [95% CI 8·6-12·6] in 2001 vs 28·1% [26·6-29·7] in 2011, ptrend<0·0001), the proportion of patients who did not receive reperfusion did not significantly change (45·3% [95% CI 42·1-48·5] in 2001 vs 44·8% [43·1-46·5] in 2011, ptrend=0·69). The median length of hospital stay decreased from 12 days (IQR 7-18) in 2001 to 10 days (6-14) in 2011 (ptrend<0·0001). Adjusted in-hospital mortality did not significantly change between 2001 and 2011 (odds ratio 0·82, 95% CI 0·62-1·10, ptrend=0·07). INTERPRETATIONDuring the past decade in China, hospital admissions for STEMI have risen; in these patients, comorbidities and the intensity of testing and treatment have increased. Quality of care has improved for some treatments, but important gaps persist and in-hospital mortality has not decreased. National efforts are needed to improve the care and outcomes for patients with STEMI in China. FUNDINGNational Health and Family Planning Commission of China.
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3Hu, Shuang
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6Spertus, John A
7Krumholz, Harlan M
8Jiang, Lixin
titleST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data.
descriptionBACKGROUNDDespite the importance of ST-segment elevation myocardial infarction (STEMI) in China, no nationally representative studies have characterised the clinical profiles, management, and outcomes of this cardiac event during the past decade. We aimed to assess trends in characteristics, treatment, and outcomes for patients with STEMI in China between 2001 and 2011. METHODSIn a retrospective analysis of hospital records, we used a two-stage random sampling design to create a nationally representative sample of patients in China admitted to hospital for STEMI in 3 years (2001, 2006, and 2011). In the first stage, we used a simple random-sampling procedure stratified by economic-geographical region to generate a list of participating hospitals. In the second stage we obtained case data for rates of STEMI, treatments, and baseline characteristics from patients attending each sampled hospital with a systematic sampling approach. We weighted our findings to estimate nationally representative rates and assess changes from 2001 to 2011. This study is registered with ClinicalTrials.gov, number NCT01624883. FINDINGSWe sampled 175 hospitals (162 participated in the study) and 18,631 acute myocardial infarction admissions, of which 13,815 were STEMI admissions. 12,264 patients were included in analysis of treatments, procedures, and tests, and 11,986 were included in analysis of in-hospital outcomes. Between 2001 and 2011, estimated national rates of hospital admission for STEMI per 100,000 people increased (from 3·5 in 2001, to 7·9 in 2006, to 15·4 in 2011; ptrend<0·0001) and the prevalence of risk factors-including smoking, hypertension, diabetes, and dyslipidaemia-increased. We noted significant increases in use of aspirin within 24 h (79·7% [95% CI 77·9-81·5] in 2001 vs 91·2% [90·5-91·8] in 2011, ptrend<0·0001) and clopidogrel (1·5% [95% CI 1·0-2·1] in 2001 vs 82·1% [81·1-83·0] in 2011, ptrend<0·0001) in patients without documented contraindications. Despite an increase in the use of primary percutaneous coronary intervention (10·6% [95% CI 8·6-12·6] in 2001 vs 28·1% [26·6-29·7] in 2011, ptrend<0·0001), the proportion of patients who did not receive reperfusion did not significantly change (45·3% [95% CI 42·1-48·5] in 2001 vs 44·8% [43·1-46·5] in 2011, ptrend=0·69). The median length of hospital stay decreased from 12 days (IQR 7-18) in 2001 to 10 days (6-14) in 2011 (ptrend<0·0001). Adjusted in-hospital mortality did not significantly change between 2001 and 2011 (odds ratio 0·82, 95% CI 0·62-1·10, ptrend=0·07). INTERPRETATIONDuring the past decade in China, hospital admissions for STEMI have risen; in these patients, comorbidities and the intensity of testing and treatment have increased. Quality of care has improved for some treatments, but important gaps persist and in-hospital mortality has not decreased. National efforts are needed to improve the care and outcomes for patients with STEMI in China. FUNDINGNational Health and Family Planning Commission of China.
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0Aged–Administration & Dosage
1Aspirin–Epidemiology
2China–Administration & Dosage
3Clopidogrel–Trends
4Female–Statistics & Numerical Data
5Fibrinolytic Agents–Statistics & Numerical Data
6Healthcare Disparities–Epidemiology
7Hospital Mortality–Therapy
8Hospitals, Rural–Trends
9Hospitals, Urban–Statistics & Numerical Data
10Humans–Administration & Dosage
11Male–Analogs & Derivatives
12Middle Aged–Analogs & Derivatives
13Myocardial Infarction–Analogs & Derivatives
14Myocardial Reperfusion–Analogs & Derivatives
15Patient Admission–Analogs & Derivatives
16Percutaneous Coronary Intervention–Analogs & Derivatives
17Quality of Health Care–Analogs & Derivatives
18Retrospective Studies–Analogs & Derivatives
19Ticlopidine–Analogs & Derivatives
20Treatment Outcome–Analogs & Derivatives
21Fibrinolytic Agents
22Clopidogrel
23Ticlopidine
24Aspirin
25NCT01624883
26ClinicalTrials.gov
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titleST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data.
authorLi, Jing ; Li, Xi ; Wang, Qing ; Hu, Shuang ; Wang, Yongfei ; Masoudi, Frederick A ; Spertus, John A ; Krumholz, Harlan M ; Jiang, Lixin ; Li, Jing
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3Clopidogrel–Trends
4Female–Statistics & Numerical Data
5Fibrinolytic Agents–Statistics & Numerical Data
6Healthcare Disparities–Epidemiology
7Hospital Mortality–Therapy
8Hospitals, Rural–Trends
9Hospitals, Urban–Statistics & Numerical Data
10Humans–Administration & Dosage
11Male–Analogs & Derivatives
12Middle Aged–Analogs & Derivatives
13Myocardial Infarction–Analogs & Derivatives
14Myocardial Reperfusion–Analogs & Derivatives
15Patient Admission–Analogs & Derivatives
16Percutaneous Coronary Intervention–Analogs & Derivatives
17Quality of Health Care–Analogs & Derivatives
18Retrospective Studies–Analogs & Derivatives
19Ticlopidine–Analogs & Derivatives
20Treatment Outcome–Analogs & Derivatives
21Fibrinolytic Agents
22Clopidogrel
23Ticlopidine
24Aspirin
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58Guo, Yansong
59Chen, Xinjing
60Xiang, Liquan
61Ning, Lin
62Chen, Mei
63Jin, Xin
64Li, Guiling
65Li, Xiuqi
66Wu, Xing'an
67Tan, Congjun
68Feng, Mingfang
69Wang, Meili
70Wen, Liangfa
71Fu, Xiang
72Xie, Qunxing
73Zhang, Wei
74Zhuang, Yanni
75Lu, Hua
76Lu, Jiaqian
77Huang, Yu
78Zhou, Yin
79Hu, Qiuling
80Xiao, Chunhui
81Hu, Xiaoli
82Wu, Yongshuan
83Wang, Qiuli
84Xu, Youlin
85Yu, Xuefei
86Gao, Chuanyu
87Zhang, Jianhong
88Zhang, You
89Niu, Wentang
90Ma, Xiaolei
91Wang, Yong
92Pan, Xiaowen
93Liu, Yanlong
94Miao, Lifu
95Yin, Yanping
96Zhang, Zhiying
97Feng, Shutang
98Wang, Aiping
99Zhang, Jiangli
100...
atitleST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data.
jtitleLancet (London, England)
risdate20150131
volume385
issue9966
spage441
epage451
pages441-451
eissn1474-547X
formatjournal
genrearticle
ristypeJOUR
abstractBACKGROUNDDespite the importance of ST-segment elevation myocardial infarction (STEMI) in China, no nationally representative studies have characterised the clinical profiles, management, and outcomes of this cardiac event during the past decade. We aimed to assess trends in characteristics, treatment, and outcomes for patients with STEMI in China between 2001 and 2011. METHODSIn a retrospective analysis of hospital records, we used a two-stage random sampling design to create a nationally representative sample of patients in China admitted to hospital for STEMI in 3 years (2001, 2006, and 2011). In the first stage, we used a simple random-sampling procedure stratified by economic-geographical region to generate a list of participating hospitals. In the second stage we obtained case data for rates of STEMI, treatments, and baseline characteristics from patients attending each sampled hospital with a systematic sampling approach. We weighted our findings to estimate nationally representative rates and assess changes from 2001 to 2011. This study is registered with ClinicalTrials.gov, number NCT01624883. FINDINGSWe sampled 175 hospitals (162 participated in the study) and 18,631 acute myocardial infarction admissions, of which 13,815 were STEMI admissions. 12,264 patients were included in analysis of treatments, procedures, and tests, and 11,986 were included in analysis of in-hospital outcomes. Between 2001 and 2011, estimated national rates of hospital admission for STEMI per 100,000 people increased (from 3·5 in 2001, to 7·9 in 2006, to 15·4 in 2011; ptrend<0·0001) and the prevalence of risk factors-including smoking, hypertension, diabetes, and dyslipidaemia-increased. We noted significant increases in use of aspirin within 24 h (79·7% [95% CI 77·9-81·5] in 2001 vs 91·2% [90·5-91·8] in 2011, ptrend<0·0001) and clopidogrel (1·5% [95% CI 1·0-2·1] in 2001 vs 82·1% [81·1-83·0] in 2011, ptrend<0·0001) in patients without documented contraindications. Despite an increase in the use of primary percutaneous coronary intervention (10·6% [95% CI 8·6-12·6] in 2001 vs 28·1% [26·6-29·7] in 2011, ptrend<0·0001), the proportion of patients who did not receive reperfusion did not significantly change (45·3% [95% CI 42·1-48·5] in 2001 vs 44·8% [43·1-46·5] in 2011, ptrend=0·69). The median length of hospital stay decreased from 12 days (IQR 7-18) in 2001 to 10 days (6-14) in 2011 (ptrend<0·0001). Adjusted in-hospital mortality did not significantly change between 2001 and 2011 (odds ratio 0·82, 95% CI 0·62-1·10, ptrend=0·07). INTERPRETATIONDuring the past decade in China, hospital admissions for STEMI have risen; in these patients, comorbidities and the intensity of testing and treatment have increased. Quality of care has improved for some treatments, but important gaps persist and in-hospital mortality has not decreased. National efforts are needed to improve the care and outcomes for patients with STEMI in China. FUNDINGNational Health and Family Planning Commission of China.
doi10.1016/S0140-6736(14)60921-1
urlhttp://search.proquest.com/docview/1658421559/
issn01406736
date2015-01-31