Role Of The Chest Pain Center In Treatment Of Patients With Acute ST-elevated Myocardial Infarction

Objective: To observe the changes of the key time points and short-term prognosis in patiens with ST-segment elevation myocardial infarction(STEMI)before and after certification of Chest pain center(CPC)in the First Affiliated Hospital of Dalian Medical University.To investigate the effect of establishing chest pain center on the treatment of acute ST-segment elevation myocardial infarction,thus confirming the importance of CPC in the treatment of STEMI patients and social benefits.Methods:1.According to the International Association of Chest Pain certification standards.By improving our hospital’s CPC(Chest pain center)management system,hardware facilities,personnel training and treatment process,Chest pain patients are taken the most rapid and standardized treatment.2.A retrospective non-synchronous cohort study method was used,during May 2015 and April 2016,293 STEMI patients who were admitted to the First Affiliated Hospital of Dalian Medical University was Screened out as the observation group by using case inquiry system.242 STEMI patients were received as control group before the establishment of the chest pain center(from May 2014 to April 2015),a total of 535 cases were observed in the observation group and the control group.The basic information are recorded in detail on STEMI patients undergoing emergency percutaneous coronary intervention(PCI)within 12 hours of onset.3.We comperd the items in patients with STEMI before and after the establishment of CPC in the First Affiliated Hospital of Dalian Medical University,such as baseline data(age,sex,history of smoking,prevalence of underlying disease,number of criminals,number of lesions),time Objectives(Door-to-Balloon,first medical contact to ballon,Symptom onset to Door)and prognostic indicators:(the incidence of heart failure,hospital mortality,aneurysm incidence and left ventricular ejection fraction).Results:The basic information are recorded in detail on 535 STEMI patients of the hospital before and after the CPC certification.There was no significant difference in the age,sex,history of smoking,prevalence of underlying diseases,criminals’ blood vessels and the number of vascular lesions after chest pain center certification compared with that before chest pain center certification(P>0.05).Compared with the control group,patients in the observation group had significantly shorter on D2 B time,shorter FMC2 B time,lower incidence of HF during hospitalization and average days of hospitalization with a significant difference(P <0.001),but the symptoms-balloon has not shortened.There were no significant differences in hospital mortality,hospitalization costs and aneurysm incidence between the two groups.The left ventricular ejection fraction(LVEF)has improves,but the difference was not statistically significant(P>0.05).Conclusion:The chest pain center certification is a time node,according to the standard chest pain diagnosis and treatment process,the D2 B,FMC2B time in STEMI patients are significantly reduced after the certification of chest pain center,but the symptomsballoon time has not shortened.The incidence of acute heart failure in STEMI patients is significantly lower in CPC mode.At the same time,the average length of stay in hospitals is significantly shortened,the medical resources are saved,and the better social benefits are achieved.In summary,It is worth being vigorously promoted by the whole society.