| Cardiovascular disease has become the leading cause of death in the population worldwide,and has gradually become a major public health problem due to the huge economic burden it brings to people and society.The incidence of acute myocardial infarction,as an acute and critical disease,is increasing year by year,and the age of onset is becoming younger,with a high rate of disability and death,which seriously threatens the life and health of our people.Chinese medicine plays an important role in the whole process of acute myocardial infarction treatment,and the holistic concept of Chinese medicine and the way of thinking of evidence-based treatment guide the clinical prevention and treatment of myocardial infarction.In particular,it aids reperfusion therapy,improves symptoms and promotes recovery of cardiac function.With the popular application of inpatient electronic medical record system,hospitals have accumulated a huge amount of medical big data,which is scattered in various medical systems with EMR as the core,covering information on chief complaints,diagnoses,tests and examinations,medical prescriptions,and disease courses.Real-world studies identify and quantify the advantages,risks and outcomes of various intervention options through solid patient data,providing an important basis for clinical support.Purpose:To further understand the current situation and prognosis of Chinese medicine treatment for acute myocardial infarction in Chinese hospitals,this project carried out clinical data analysis and follow-up of real-world Chinese and Western medicine combined treatment for myocardial infarction patients based on EMR,to understand the onset of acute myocardial infarction patients,summarize and analyze Chinese medicine comprehensive intervention strategies,prognosis of acute myocardial infarction patients in Chinese hospitals,and explore the advantages of Chinese medicine multiple treatment.Methods:In this study,we retrospectively compiled the basic information and medical records of patients with acute myocardial infarction who were hospitalized in Cardiovascular ZoneⅡ and CCU by collecting the inpatient electronic medical records from January 1,2018 to December 31,2020 at Dongzhimen Hospital Tongzhou Campus of Beijing University of Chinese Medicine.Follow-up was performed by telephone follow-up,and the prognosis of patients with acute myocardial infarction was observed 2～5 years after discharge from the hospital.SPSS 23.0 statistical software was used for statistical analysis and processing.Kaplan-Meier curves were plotted to describe the survival curves of patients with acute myocardial infarction.Results:1.A total of 470 patients with first-time acute myocardial infarction were included in this study,with more males than females and up to 18.94%of cases under 50 years of age,showing a trend towards younger age.In this study,there were more NSTEMI than STEMI,and the infarct site appeared in the inferior wall the most.The three solar terms of the Beginning of Summer,the Beginning of Winter and Greater Snow had the highest number of onset.The TCM classification is mainly phlegm blockage and blood stasis in real evidence and Qi deficiency and blood stasis in deficiency evidence.The tongue is dark,the tongue coating is white and greasy,and the pulse is mainly string and slippery.Chinese medicine treatment was widely applied and varied,89.15%of patients used Chinese herbal soup,41.70%used prepared Chinese medicine,and 92.34%used Chinese medicine injection during hospitalization.The main appropriate techniques of TCM applied were:acupoint application(91.06%),auricular pressure pills(87.66%),and electric wax therapy(59.15%).The proportions of anticoagulants,antiplatelet drugs,β-blockers,ACEI/ARB,and statins during hospitalization were 93.4%,99.36%,79.79%,27.23%,and 98.72%,respectively.Percutaneous coronary angiography was performed in 73.20%of patients and emergency coronary angiography was performed in 62.21%.The proportions of antiplatelet drugs,β-blockers,ACEI/ARB,statins,prepared Chinese medicine and Chinese herbal soup in the discharge with medication were 90.43%,66.17%,19.15%,87.23%,46.94%and 34.68%.2.In this study,232 patients were successfully followed up with a median follow-up time of 1172.00 days,with a mortality rate of 6.03%within one year of discharge and an overall mortality rate of 12.07%during the follow-up period.Out-of-hospital medication adherence was at a moderate level,with application rates of 79.74%,77.16%,33.62%,13.80%,and 20.26%for antiplatelet agents,lipid-lowering agents,β-blockers,ACEI/ARB,and Chinese herbs/Chinese medicines,respectively.Survival analysis showed that all-cause mortality was higher in NSTEMI than in STEMI(P<0.05).Patients who did not undergo PCI had higher all-cause mortality compared with those who underwent PCI(P<0.001). |
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