Key result
While proven therapies for acute coronary syndrome were widely reported, primary PCI for STEMI was used more often in tertiary hospitals compared to secondary hospitals.
Cross-Sectional (n=1,029)
Yes
Answers are grounded in this paper and cite their sources.
Doctor-reported management of ACS in China largely aligns with current guidelines, though significant gaps remain in secondary hospitals regarding the use of unproven therapies and underuse of primary PCI.
Background: Despite recent improvements in the hospital treatment of ACS, little is known about current cardiological practice in China or use of evidence-based approach in Chinese hospitals. Methods: A questionnaire about doctor-reported hospital management of ACS was posted to the head of the cardiology department of 1397 hospitals across 30 provinces of China. Reported use of various clinical procedures and treatments were analysed and compared between different types of hospital. Results: Of the 1029 (74%) hospitals that responded, 43% were tier III (tertiary) hospitals. For STEMI, primary PCI was used as the main reperfusion therapy by 50.2% of tier III and 9.3% of tier II/I (secondary) hospitals. Most of hospitals also used various proven therapy routinely for STEMI and NSTEMI/UA, including anti-platelet therapy (98% and 93%), anticoagulant (96% and 90%), statin (97% and 94%), oral β-blockers (87% and 86%) and ACE-I (88% and 83%). However, certain therapies with little or no proven value (eg, G.I.K., magnesium and Chinese tradition medicine) remained used routinely by 25% - 40% of tier II/I hospitals. After discharge, statin, antiplatelet, β-blockers and ACE-I were reportedly used routinely by 85% - 95% of the responders for secondary prevention. Conclusions: With a few exceptions, doctor-reported hospital management of ACS in China is largely consistent with that recommended by current guidelines. Large nationwide registries are needed to assess long-term adherence to treatments after hospital discharge.
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Chen et al. (2012) conducted a cross-sectional in Acute coronary syndrome (n=1,029). Tertiary hospital care vs. Secondary hospital care was evaluated on Use of primary PCI as main reperfusion therapy for STEMI (p=<0.0001). While proven therapies for acute coronary syndrome were widely reported, primary PCI for STEMI was used more often in tertiary hospitals compared to secondary hospitals.
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