Effect Of Community Education And Chest Pain Center On Prognosis In Acute ST-segment Elevation Myocardial Infarction

ObjectiveTo sudy the role of community education and chest pain center in the treat of acute ST segment elevation myocardial infarction(STEMI)patients after percutaneous coronary intervention,optimize the diagnosis and treatment,reduce the major cardiovascular events(MACE)of STEMI patients.MethodsAfter a 2-years follow-up study,there were seven hundred and one acute STEMI patients who were divided into two groups by the way that were admitted to hospital,the patients who were not admitted on their own(Group 1,n=473)which were from emergency medical transport(EMT)and grass-roots hospitals,and admitted on their own(Group 2,n=228).According as FMC-D time,we divide Group 1 into Group A(FMC-D<90 minutes,n=195)and Group B(FMC-D?90 minutes,n=172).Compair the general information of patients between Group A and B,to verify independent factor of prehospital delays.After targeted community education,we divide all of the patients into the group who were educated(n=348),and the group who were not educated(n=353),to find the effect for FMC-D and D-B time.In the end,we summarized the influence on the prognosis of patients.In this study we used statistical software SPSS(version 20.0).Results1.The result of single factor analysis showed that sex,age,the degree of education and economy-income level were the risk factors related FMC-D time(P<0.05)(table 1).Community education could reduce the number of patients whose FMC-D time more than or equal to 90 minutes(P<0.01)(P<0.05)(table 2).2.Community education could increase the proportion of patients who admitted by emergency medical transport(EMT),patients who has symptom to device less than 90 minutes(P<0.05)(table 3).However,the time of patients admitted to hospital after diagnosis,the time to wait for the operation,there was not any significant difference between two groups(P>0.05);There was significant difference in the time of patients after admission,the time of patients' s preoperative preparation(P>0.05).3.Compare the rates of adverse cardiovascular events between the group which had and did not have community education at discharge,community education group has lower incidence of major cardiovasc,much less patients with cardiac function in level ? or above,and the number of patients with ejection fraction lower than 45%and left ventricular asynergy is much less,rehospitalization rate and mortality in within one month is reduced(P<0.05)with statistical significance.But the number of patient with early stent thrombosis and the average length of stay,there is no significant difference(P>0.05).Conclusion:The prognosis of patients with STEMI is influenced by many factors,FMC-D and D-B time is independent risk factors.The present study demonstrated that FMC-D time and D-B time tended to be greatly shorted by community education from chest pain center formed.As a consequence,timeline of STEMI treatment could be optimized,and the prognosis of patients with STEMI could be improved.