PMID- 34930741
OWN - NLM
STAT- MEDLINE
DCOM- 20220307
LR  - 20220307
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 11
IP  - 12
DP  - 2021 Dec 20
TI  - 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.
PG  - e053510
LID - 10.1136/bmjopen-2021-053510 [doi]
LID - e053510
AB  - 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.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Zhang, You
AU  - Zhang Y
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
AD  - Henan Institute of Cardiovascular Epidemiology, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
FAU - Wang, Shan
AU  - Wang S
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
AD  - Henan Institute of Cardiovascular Epidemiology, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
FAU - Cheng, Qianqian
AU  - Cheng Q
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
FAU - Zhang, Junhui
AU  - Zhang J
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
AD  - Henan Institute of Cardiovascular Epidemiology, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
FAU - Qi, Datun
AU  - Qi D
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
FAU - Wang, Xianpei
AU  - Wang X
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
FAU - Zhu, Zhongyu
AU  - Zhu Z
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
FAU - Li, Muwei
AU  - Li M
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
FAU - Hu, Dayi
AU  - Hu D
AD  - Henan Institute of Cardiovascular Epidemiology, Zhengzhou, Henan, China.
AD  - Institute of Cardiovascular Disease, Peking University People's Hospital, 
      Beijing, China.
FAU - Gao, Chuanyu
AU  - Gao C
AUID- ORCID: 0000-0001-7079-2283
AD  - Department of Cardiology, Central China Fuwai Hospital of Zhengzhou University, 
      Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China 
      gaocy6802@zzu.edu.cn.
AD  - Henan Institute of Cardiovascular Epidemiology, Zhengzhou, Henan, China.
AD  - Henan Key Laboratory for Prevention and Control of Coronary Heart Disease, 
      Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China.
CN  - Henan STEMI registry Study Group
LA  - eng
SI  - ClinicalTrials.gov/NCT02641262
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20211220
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Hospital Mortality
MH  - Humans
MH  - *Percutaneous Coronary Intervention
MH  - Prospective Studies
MH  - Reperfusion
MH  - *ST Elevation Myocardial Infarction
MH  - Tertiary Care Centers
MH  - Thrombolytic Therapy
MH  - Treatment Outcome
PMC - PMC8689172
OTO - NOTNLM
OT  - adult intensive & critical care
OT  - coronary heart disease
OT  - coronary intervention
OT  - myocardial infarction
OT  - quality in health care
COIS- Competing interests: None declared.
FIR - Gao, Chuanyu
IR  - Gao C
FIR - Wang, Zhifang
IR  - Wang Z
FIR - Su, Shuhong
IR  - Su S
FIR - Dong, Pingshuan
IR  - Dong P
FIR - Yang, Xuming
IR  - Yang X
FIR - Li, Shengli
IR  - Li S
FIR - Xia, Hualing
IR  - Xia H
FIR - Li, Wuxing
IR  - Li W
FIR - Ding, Shuiyin
IR  - Ding S
FIR - Bai, Baoqiang
IR  - Bai B
FIR - Yang, Xinyuan
IR  - Yang X
FIR - Tian, Changming
IR  - Tian C
FIR - Li, Jinbo
IR  - Li J
FIR - Wang, Chuntong
IR  - Wang C
FIR - Yang, Yi
IR  - Yang Y
FIR - Gao, Yanhui
IR  - Gao Y
FIR - Sun, Haiyan
IR  - Sun H
FIR - Yan, Jixia
IR  - Yan J
FIR - Li, Heping
IR  - Li H
FIR - Li, Wanke
IR  - Li W
FIR - Zhao, Zhenfu
IR  - Zhao Z
FIR - Zhou, Huading
IR  - Zhou H
FIR - Zhang, Chuanqian
IR  - Zhang C
FIR - Wang, Hengliang
IR  - Wang H
FIR - Jing, Dequan
IR  - Jing D
FIR - Chen, Suxia
IR  - Chen S
FIR - Ji, Xiaoli
IR  - Ji X
FIR - Zheng, Haijun
IR  - Zheng H
FIR - Lin, Fengxian
IR  - Lin F
FIR - Zhao, Guiye
IR  - Zhao G
FIR - Wei, Wei
IR  - Wei W
FIR - Liu, Peng
IR  - Liu P
FIR - Liu, Yanggui
IR  - Liu Y
FIR - Cheng, Xiangyang
IR  - Cheng X
FIR - Ma, Xiaowen
IR  - Ma X
FIR - Zhang, Chengwen
IR  - Zhang C
FIR - Wang, Liangping
IR  - Wang L
FIR - Tong, Changgang
IR  - Tong C
FIR - Zhang, Ling
IR  - Zhang L
FIR - Lang, Huihui
IR  - Lang H
FIR - Xu, Haojie
IR  - Xu H
FIR - Wei, Hengshan
IR  - Wei H
FIR - Wang, Haitao
IR  - Wang H
FIR - Xue, Ruilu
IR  - Xue R
FIR - Geng, Hongxu
IR  - Geng H
FIR - Shi, Yonghong
IR  - Shi Y
FIR - Tang, Qiwei
IR  - Tang Q
FIR - Li, Yuchun
IR  - Li Y
FIR - Liu, Yonggang
IR  - Liu Y
FIR - Wang, Dongsheng
IR  - Wang D
FIR - Jia, Jianbo
IR  - Jia J
FIR - Li, Xianzhang
IR  - Li X
FIR - Deng, Xinling
IR  - Deng X
FIR - Xu, Qinghua
IR  - Xu Q
FIR - Zhao, Linming
IR  - Zhao L
FIR - Zhang, Hongxia
IR  - Zhang H
FIR - Li, Lipeng
IR  - Li L
FIR - Chen, Suqin
IR  - Chen S
FIR - Liang, Keqi
IR  - Liang K
FIR - Zhang, Linwu
IR  - Zhang L
FIR - Jiang, Jiandang
IR  - Jiang J
FIR - Xiao, Weitian
IR  - Xiao W
FIR - Zhang, Hongwen
IR  - Zhang H
FIR - Zhu, Shengke
IR  - Zhu S
FIR - Liu, Baofu
IR  - Liu B
FIR - Pan, Chengxuan
IR  - Pan C
FIR - Lu, Fengyun
IR  - Lu F
FIR - Yang, Jie
IR  - Yang J
FIR - Li, Yaoze
IR  - Li Y
FIR - Liu, Zheng
IR  - Liu Z
FIR - Zhang, Qingchun
IR  - Zhang Q
FIR - Qiao, Yintao
IR  - Qiao Y
FIR - Sun, Na
IR  - Sun N
FIR - Li, Lianjie
IR  - Li L
EDAT- 2021/12/22 06:00
MHDA- 2022/03/08 06:00
PMCR- 2021/12/20
CRDT- 2021/12/21 06:03
PHST- 2021/12/21 06:03 [entrez]
PHST- 2021/12/22 06:00 [pubmed]
PHST- 2022/03/08 06:00 [medline]
PHST- 2021/12/20 00:00 [pmc-release]
AID - bmjopen-2021-053510 [pii]
AID - 10.1136/bmjopen-2021-053510 [doi]
PST - epublish
SO  - BMJ Open. 2021 Dec 20;11(12):e053510. doi: 10.1136/bmjopen-2021-053510.