Role Of The Chest Pain Center In Treatment Of Patients With NSTE ACS

Objective: By comparison and analysis of the diffierent clinical situation of acute Non ST segment elevation acute coronary syndrome(NSTE ACS)before and after the establishment of the chest pain center,to understand whether the chest pain center can improve the prognosis during hospitalization of patients with NSTE ACS.It can provide reference for further development and construction of the chest pain center.Methods: Retrospective analysis of clinical data of 286 patients with NSTE ACS in each of the two years before and after the establishment of the Chest Pain Center of the Affiliated Hospital of Zunyi Medical University.Before the establishment(116 cases),after the establishment(170 cases).We collect and analyze statistically the following datas: the general basic clinical datas(including gender,age,Smoking and Combined disease,etc.)and S2 FMC,FMC2ECG,First electrocardiographic time,D-to-B,FMC-to-B,CAG results,MACE during hospitalization,days of hospitalization,outcomes,etc.Results : By comparing the general baseline data of the two groups of patients,the difference was not statistically significant.There was a statistical difference between the admission pattern of the patients before and after the establishment of the chest pain center and the composition of the first medical contact.S2 FMC time [before establishment: 1440.00(360.00,4320.00),after the establishment: 482.50(138.50,1431.25)],D-to-B time [before the establishment: 2112.50(343.75,4138.75),after the establishment: 239.50(130.75,815.50)],FMC-to-B time [before the establishment: 2108.50(341.50,4138.00),after the establishment:309.50(151.00,821.50)] and other related time nodes were significantly lower than before,the difference was statistically significant(P<0.01)D-to-B time comparison for patients at different risk levels: very high risk patients [before the establishment: 1255.00(160.00,1125.00),after the establishment: 234.00(106.50,548.50)] decreased after the establishment,the difference was statistically significant(P=0.027);high-risk patients [before the establishment: 2888.00(347.00,4347.50),after the establishment: 868.61(133.00,730.00)]were significantly lower than before,the difference was statistically significant(P<0.01);Intermediate risk patients [before the establishment: 2020.44(640.00,3347.50),after theestablishment: 1605.73(262.00,3046.00)],the difference was not statistically significant(P=0.325).The incidence of heart failure in the hospital [before the establishment(7.76%),after the establishment(2.35%)] decreased,the difference was statistically significant(P<0.05),the incidence of in-hospital cardiogenic shock [before the establishment(1.72%),After the establishment(0.59%)],the in-hospital mortality rate [before the establishment(0.86%),after the establishment(0.59%)] was improved compared with the previous one,the difference was not statistically significant(P>0.05),hospitalization time [before the establishment 9.26(7.00,11.00),7.01(5.00,8.00)after the establishment was reduced,the difference was statistically significant(P <0.01).The NT-ProBNP level levels within 24 hours after surgery[before the establishment: 689.45(255.82,2785.00),after the establishment: 476.15(184.58,1386.00)] has a downward trend(P>0.05),the difference is not statistically significant.There was a slight improvement in cardiac function related indexes(P>0.05)within one week after surgery,and there was no statistically significant difference between the two groups.Conclusion: The chest pain center model can shorten the reperfusion time and the reduction of hospitalization days in patients with NSTE ACS,and can also reduce the incidence of MACE during hospitalization and improve the prognosis.