A Follow-up Study Of Endpiont Events Occurrence Of Discharged Patients With Myocardial Infarction In The Hospital Of Traditional Chinese Medicine

Part I:The Follow‐up Design of Evidence‐based Traditional Chinese Medicine Cohort StudyFollow‐up is the key links for cohort study,it’s result can directly affect the conclusion of study.During the follow‐up investigation, The major problem need to be solved by the researchers are how to improve the success rate, get the actively cooperate with the objects of study and reduce the lost to follow‐up.We discussed the pupose and the methods of follow‐up,the produce of follow‐up cases report, the implementation of the follow‐up investigation, and the organize the follow‐up data in the field of evidence‐based traditional Chinese medicine,as the reference for fellows.Part II:Follow‐up Study of Endpiont Events Occurrence of 511 Patients with Myocardial Infarction in the Hospital of Traditional Chinese MedicineObjectivesConduct a follow‐up investigation on myocardial infarction patients after discharge the hospital of traditional Chinese medicine, Learning the status of Chinese and western medicine treatment and the occurrence of end point events after discharge,discuss the relationship between end point events occurrence and treatment of Chinese medicine, the follow‐up period and point events occurrence, the rate of lost and follow‐up period, to provide evidence of evidence‐based medicine(EBM) for myocardial infarction efficacy evaluation of traditional Chinese medicine, and provide methodology for follow‐up study experience. Produce “Cohort Study Follow‐up Questionnaire of Traditional Chinese Medicine Hospital Patients with Myocardial Infarction(MI) ”.MethodsConduct a follow‐up investigation through the hospital medical record information management system,in the three TCM hospital of Shandong province, zibo city and rizhao city, choose to January 1, 2008 to December 31, 2012 treated 453 cases of patients with myocardial infarction after discharge. Conduct a follow‐up investigation for usage of Chinese medicine and the occurrence of end point events with those patients after discharge respectively mainly by telephone, and also outpatient and visit. Use Epidata software, establishthe information databaseof the follow‐up cohort study of traditional Chinese medicine hospital MI patients, then input data.Statistical exposed group(Using traditional Chinese medicine 1 month or longer) end point events happening, And USES the multi‐factor logistic regression analysis data of TCM intervention respectively intensity and the relationship between different follow‐up period and end events occurrence.Results1. Situation of lost to follow‐up :We followed up 453 discharged patients in total,there were 102 cases which unable to contact or unwilling to co‐operate. lost to follow‐up rate was 19.96%.Men in the majority(66%), age greater than 70(42%), age less than 50(10%),.The longer the follow‐up, the more the number of lost to follow‐up.2. The usage of traditional Chinese medicine: We followed up the situation of medicine taking of 453 discharged patients after discharge in 3 different hospital,found that there were 62.68% of them can keep using traditional Chinese medicine treatment. We collected 30 kinds of oral proprietary Chinese medicine, the use of high frequency was Instant‐effect Jiuxin Pills, Compound Danshen dropping pill and Shexiang Baoxin Pill, 17 kinds of medicinal decoction, use frequency is higher for add and subtract of Shengmai San,Xuefuzhuyu Tang and Gualouxiebaibanxia Tang.3. The occurrence of end point events: Frequencies for cardiovascular readmission,cardiac death, infarction, acute heart failure, again reascularization, severe arrhythmia, angina pectoris after infarction, stroke, he was dead, tumor, cardiac arrest, low blood pressure, cardiac shock, again reascularization and hemorrhage.Refractory ischemia, aneurysm formation, lack of statistics to cases.4. Logistic analysis: Different exposure group have correlation with end point events happened during the follow‐up period(p < 0.05), high exposed group(Using traditional Chinese medicine 6 month or longer) can reduce the degree of danger of end point events(OR < 1), and other exposed groups with the loss of the exposure,end point events increase the risk of(OR > 1). Exposure is the related factors of 4kinds of end point events(P < 0.05) of discharged patients of myocardial infarction:cardiovascular readmission, cardiac death, infarction and acute heart failure. Order from large to small is cardiac death, acute heart failure, and then infarction and cardiovascular hospital readmission. According to the B value is positive, and the OR value > 1, known as the exposure is reduced, the degree of danger of corresponding endpoint events are increasingly improved.ConclusionTraditional Chinese medicine had shown advantage in the prevention of end point events such as myocardial infarction patients, cardiac death and reentry cardiovascular infarction, and acute heart failure; Taking Chinese traditional medicine long after discharge can reduce the degree of danger of end point events occurrence.