Study The Therapeutic Status Of Hospitalized Patients With Acute Myocardial Infarction In Single Center

Objective：To retrospective analysis the current therapy of patients with acute myocardialinfarction in hospital,discover and summarize the existing problems andinsufficiency in the treatment of acute myocardial infarction,in order to furtherimprove the level of the therapy.At the same time to compare different therapeuticmethods for the influence of adverse cardiovascular events.Materials and Methods：By retrospective analysis,the study was collected from288hospitalize patientswith AMI in the first clinical hospital department2of Jilin University from January2013to October2013,including186men and102women.The average age of totalpatients was61.24±12.36years old.There were39.2%of patients with smoking,47.2%of patients with hypertension,25%of patients with diabetes,21.9%of patientswith hyperlipidemia.we evaluated the therapeutic status of AMI according to theguideline of diagnosis and treatment of AMI which was issued by Chinese MedicalAssociation Branch in2011,to understand the application status of aspirin,clopidogrel,low molecular heparin calcium, beta blockers, ACEI/ARB, statin andreperfusion treatment on AMI patients in hospital.At the same time,to comparedifferent therapeutic methods for the influence of adverse cardiovascular events.Statistical methods:Using SPSS18.0Chinese version of the software for datastatistics analysis.normal distribution measurement data were expressed as (±S)；Non-normal distribution measurement data were presented as medians; Count datawere expressed as(n,%),comparative analysis using X2test. P＜0.05was statisticallysignificant. Result：1. Among219patients with acute myocardial infarction in patients withSTEMI,13.7%of patients with STEMI received thrombolytic therapy.18.3%received primary PCI,21.0%received selective PCI.The rate of early reperfusionwas32%.The rate of total reperfusion was53.0%. The rate of reperfusion of patientswith NSTEMI was13.0%.2.219patients with STEMI who arrived at the hospital from symptom onset in3hours accounted for27.4%,3-6hours(18.7%),6-12hours(17.8%),＞12hours(36.1%). The median time from symptom to arriving at hospital was6.1hours.3. The median time of door-to-needle was50minutes among patients ofthrombolysis;only13.3%of patients with thrombolysis receiveed thrombolysistreatment in30minutes;The rate of delayed thrombolysis treatment was86.7%.Themedian time of door-to-balloon among patients with primary PCI was90minutes;52.5%of patients with primary PCI received PCI in90minutes.the rate of delayprimary PCI treatment was47.5%.4. The rates of medicine usage of patients with AMI in hospital were asfollow:the asprine+clopidogrel100%,statins100%,low molecular heparin calcium99.7%, ACEI/ARB86.5%, beta blockers85.5%,nitrates91.3%.5. Proportion of patients who received reperfusion therapy of cardiac function(Killip classification)Ⅲ,Ⅳlevel was lower than that which the no reperfusiontherapy in hospital(P＜0.05),while proportion of cardiac function(Killipclassification) Ⅰ,Ⅱlevel was higher than that which the no reperfusion therapy(P＜0.05);The incidence of cardiac death and recurrence of angina pectoris in patientswho received reperfusion therapy was lower than that which no reperfusiontherapy(P＜0.05).There was no statistically significant difference in the incidence ofventricular arrhythmia in the two treatment methods (P＞0.05).Conclusion：1. The rate of reperfusion therapy is low in patients with acute myocardialinfarction.2. The time from symptom onset to door is longer than the domestic andforeign researches.The rate of therapy of the patients with primary PCI which comply with the requirements time of the guideline is better than the domesticrelated research,but the rate of thrombolysis therapy is slightly low.3. The using rate of aspirin,clopidogrel,low molecular heparin calcium, statins,nitrates in acute myocardial infarction in hospital close to requirements of guidelinein hospital. The using rate of ACEI/ARB,beta blockers is slightly low,but in linewith the domestic related research.4. Compared with no reperfusion therapy,the reperfusion therapy can decreasethe incidence of cardiac mortality in-hospital, angina pectoris and early heart failure.