Impact Of Chest Pain Center Construction On Prognosis Of Hospitalized Patients With Acute STEMI

Objective:By comparison and analysis of the diffierent clinical situation of acute ST segment elevation myocardial infarction(STEMI)before and after the establishment of the chest pain center in Affiliated Hospital of Zunyi Medical College,to understand whether the chest pain center can improve the prognosis during hospitalization of patients with acute STEMI.It can provide reference for further development and construction of the chest pain center of the Affiliated Hospital of Zunyi Medical College.Methods:The clinical datas of STEMI patients admitted to hospital from March 2016 to November 2017 in the Affiliated Hospital of Zunyi Medical College were analyzed retrospectively.We collect and analyze statistically the following datas: the general basic clinical datas(including gender,age,and Blood pressure,etc.)and FMC,First electrocardiographic time,Signing time of Surgery informed consent,D2 B,CAG results,MACE during hospitalization,days of hospitalization,outcomes,etc.Results :After screening according to exclusion and inclusion criteria,a total of 404 STEMI patients who had undergone PCI were included before the establishment of 159 centers for chest pain,including 127 males(84.11%)and 124 females(15.89%).The age ranged from 30 to 93 years and the average age was 58.79±12.47 years.There were 263 cases after the establishment of the chest pain center,including 197 males(74.90%)and 66 females(25.10%),aged 33-89 years old,with an average age of 60.79.±12.12 years old.There was a statistically significant difference in smoking history between the two groups(P<0.05),but there was no statistically significant difference in gender,mean age,hypertension,diabetes,Killip classification,and admission arrhythmia(P>0.05).There was a statistically significant difference in admissions between the two groups(P<0.05).before the establishment,FMC1011.0±3128.0min,the first ECG time 11.25±15.41 min,signing time of Surgery informed consent 14.50±19.78 min,D2B 105.88±54.48 min,after the establishment of chest pain center,FMC689.54±1472.7 min,the first electrocardiogram time was 8.18±10.72 min,the signing time of Surgery informed consent was 14.24±13.64 min,and D2 B 88.76±36.59 min.There was a statistically significant difference between the two groups in the first electrocardiogram time(P=0.018).The average time of D2 B after chest pain center was88.76±36.59 min,which was statistically significant compared with that before chest pain center 105.88±54.48min(P<0.05).The incidence of MACE before chest pain center was7.95%,3.8% after chest pain center,which was significantly lower than before.There was no statistically significant difference in FMC,Signing time of Surgery informed consent,coronary angiography results between the two groups.The number of days of hospitalization before the establishment of chest pain center was 7.17±3.00 days,and the days was 6.98±3.38 days after the establishment.there was no significant difference between the two groups(P>0.05).There was statistical difference between the two groups in outcome(P>0.05).Conclusion: The chest pain center model can shorten the reperfusion time,the first ECG time,and the reduction of hospitalization days in patients with acute STEMI,and can also reduce the incidence of MACE during hospitalization and improve the prognosis.However,chest pain centers need to continuously improve and strengthen construction,At the same time,to improve the diagnosis and treatment ability of ACS can by further standardize the STEMI diagnosis and treatment process.