Background Acute myocardial infarction (AMI) is the most serious type of coronary heart disease. However, less than 30% of these patients have been treated effectively in China. Delayed treatment is a leading cause....Background Acute myocardial infarction (AMI) is the most serious type of coronary heart disease. However, less than 30% of these patients have been treated effectively in China. Delayed treatment is a leading cause. This study aimed to evaluate a new regional cooperative model for improving the first medical contact-to-device time and the therapeutic effects on AMI patients. Methods A retrospective analysis of 458 ST-elevation myocardial infarction (STEMI) patients was performed. Patients were divided into two groups in terms of before or after the model were implemented. First medical contact-to-device time (FMC2D), Door to device time (D2D), referral time, cardiac functions, mean cost, days of hospitalization, and major adverse cardiac events (MACE) were analyzed. Results The mean FMC2D time, D2D time and referral time of the model group were significantly lower than the control group. The left ventricular ejection fraction of the model group increased but the left ventricular end-diastolic dimension decreased compared with the control group at 6 months after discharge. These re- sults also showed that mean costs and days of hospitalization were reduced. The MACE rate was reduced in the model group. Conclusions These results suggested that the new model decreased the FMC2D time, which could improve the cardiac function and therapeutic effect of STEMI patients as well as decreased the financial burden.展开更多
Background:It remains unclear whether the outcomes of ST-elevation myocardial infarction(STEMI)patients treated with primary percutaneous coronary intervention(PPCI)during off-hours are as favorable as those treated d...Background:It remains unclear whether the outcomes of ST-elevation myocardial infarction(STEMI)patients treated with primary percutaneous coronary intervention(PPCI)during off-hours are as favorable as those treated during on-hours,especially those with a first medical contact-to-device(FMC-to-device)time within 90 min.We aimed to determine whether off-hours admission impacted late outcomes in patients undergoing PPCI and with an FMC-to-device time<90 min.Methods:This multicenter retrospective study included 670 STEMI patients who underwent successful PPCI and had an FMC-to-device time<90 min from 19 chest pain centers in Beijing from January 2018 to December 2018.Patients were divided into on-hours group and off-hours group based on their arrival time.Baseline characteristics,clinical data,and key time intervals during treatment were collected from the Quality Control&Improvement Center of Cardiovascular Intervention of Beijing by the 4tHeart and Brain Green Channel”app.Results:Overall,the median age of the patients was 58.8 years and 19.9%(133/670)were female.Of these,296(44.2%)patients underwent PPCI during on-hours and 374(55.8%)patients underwent PPCI during off-hours.Compared with the on-hours group,the off-hours group had a longer FMC-to-device time and fewer patients with FMC-to-device time<60 min(P<0.05).During the mean follow-up period of 24 months,a total of 64(9.6%)participants experienced a major adverse cardiovascular event(MACE),with 28(9.1%)in the on-hours group and 36(9.6%)in the off-hours group(P>0.05).According to the Cox regression analyses,off-hours admission was not a predictor of 2-year MACEs(P=0.788).Similarly,the Kaplan-Meier curves showed that the risks of a MACE,all-cause death,reinfarction,and target vessel revascularization were not significantly different between the two groups(P>0.05).Conclusions:This real-world,multicenter retrospective study demonstrated that for STEMI patients who underwent PPCI within 90 min,off-hours admission was safe,with no difference in the risk of 2-year展开更多
AIM:To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment.METHODS:An observational study comprised of 201 uveitic patients presenting for the first time t...AIM:To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment.METHODS:An observational study comprised of 201 uveitic patients presenting for the first time to our centre from January 2019 to June 2020.Detailed information regarding systemic investigations undertaken by specialists at the time of first contact and the cost of these investigations were reviewed on the first visit to our centre.Compliance with the treatment was determined and reasons behind non-compliance were evaluated on the first follow-up in patients who had no improvement in clinical signs and symptoms.RESULTS:The mean age of the study group was 35.35±14.1y and gender composition was 59.7%males and 40.3%females.Anterior uveitis was observed in 45.3%of patients,intermediate uveitis in 31.8%of patients,posterior uveitis in 14.9%of patients and panuveitis in 8.0%of patients.Association with a systemic disease was evident in 17.9%of patients.When compared with standard guidelines and uveitis patterns,systemic investigations were identified to be relevant only in 38.3%of patients.Non-compliance to treatment was documented in 22.4%of patients.Common reasons for non-compliance were inadequate counselling by the treating physician about treatment in 26.7%of patients and a busy schedule at work/school in 22.2%of patients.CONCLUSION:Significant number of investigations performed at first contact is found to be contrary to standard guidelines and are not contributory to the care.About a quarter of patients in this study are found to be non-compliant with the treatment.Compliance is more challenging to achieve in school-going children and working adults.The availability of comprehensive,periodically updated,evidence-based guidelines on the role of investigations and the use of trained counsellors may help to channelize proper evaluation and improve compliance to treatment,respectively,in patients with uveitis.展开更多
文摘Background Acute myocardial infarction (AMI) is the most serious type of coronary heart disease. However, less than 30% of these patients have been treated effectively in China. Delayed treatment is a leading cause. This study aimed to evaluate a new regional cooperative model for improving the first medical contact-to-device time and the therapeutic effects on AMI patients. Methods A retrospective analysis of 458 ST-elevation myocardial infarction (STEMI) patients was performed. Patients were divided into two groups in terms of before or after the model were implemented. First medical contact-to-device time (FMC2D), Door to device time (D2D), referral time, cardiac functions, mean cost, days of hospitalization, and major adverse cardiac events (MACE) were analyzed. Results The mean FMC2D time, D2D time and referral time of the model group were significantly lower than the control group. The left ventricular ejection fraction of the model group increased but the left ventricular end-diastolic dimension decreased compared with the control group at 6 months after discharge. These re- sults also showed that mean costs and days of hospitalization were reduced. The MACE rate was reduced in the model group. Conclusions These results suggested that the new model decreased the FMC2D time, which could improve the cardiac function and therapeutic effect of STEMI patients as well as decreased the financial burden.
基金a grant from the National Natural Science Foundation of China(No.81670415).
文摘Background:It remains unclear whether the outcomes of ST-elevation myocardial infarction(STEMI)patients treated with primary percutaneous coronary intervention(PPCI)during off-hours are as favorable as those treated during on-hours,especially those with a first medical contact-to-device(FMC-to-device)time within 90 min.We aimed to determine whether off-hours admission impacted late outcomes in patients undergoing PPCI and with an FMC-to-device time<90 min.Methods:This multicenter retrospective study included 670 STEMI patients who underwent successful PPCI and had an FMC-to-device time<90 min from 19 chest pain centers in Beijing from January 2018 to December 2018.Patients were divided into on-hours group and off-hours group based on their arrival time.Baseline characteristics,clinical data,and key time intervals during treatment were collected from the Quality Control&Improvement Center of Cardiovascular Intervention of Beijing by the 4tHeart and Brain Green Channel”app.Results:Overall,the median age of the patients was 58.8 years and 19.9%(133/670)were female.Of these,296(44.2%)patients underwent PPCI during on-hours and 374(55.8%)patients underwent PPCI during off-hours.Compared with the on-hours group,the off-hours group had a longer FMC-to-device time and fewer patients with FMC-to-device time<60 min(P<0.05).During the mean follow-up period of 24 months,a total of 64(9.6%)participants experienced a major adverse cardiovascular event(MACE),with 28(9.1%)in the on-hours group and 36(9.6%)in the off-hours group(P>0.05).According to the Cox regression analyses,off-hours admission was not a predictor of 2-year MACEs(P=0.788).Similarly,the Kaplan-Meier curves showed that the risks of a MACE,all-cause death,reinfarction,and target vessel revascularization were not significantly different between the two groups(P>0.05).Conclusions:This real-world,multicenter retrospective study demonstrated that for STEMI patients who underwent PPCI within 90 min,off-hours admission was safe,with no difference in the risk of 2-year
文摘AIM:To ascertain the pattern of investigations at first contact in uveitic patients and evaluate compliance to treatment.METHODS:An observational study comprised of 201 uveitic patients presenting for the first time to our centre from January 2019 to June 2020.Detailed information regarding systemic investigations undertaken by specialists at the time of first contact and the cost of these investigations were reviewed on the first visit to our centre.Compliance with the treatment was determined and reasons behind non-compliance were evaluated on the first follow-up in patients who had no improvement in clinical signs and symptoms.RESULTS:The mean age of the study group was 35.35±14.1y and gender composition was 59.7%males and 40.3%females.Anterior uveitis was observed in 45.3%of patients,intermediate uveitis in 31.8%of patients,posterior uveitis in 14.9%of patients and panuveitis in 8.0%of patients.Association with a systemic disease was evident in 17.9%of patients.When compared with standard guidelines and uveitis patterns,systemic investigations were identified to be relevant only in 38.3%of patients.Non-compliance to treatment was documented in 22.4%of patients.Common reasons for non-compliance were inadequate counselling by the treating physician about treatment in 26.7%of patients and a busy schedule at work/school in 22.2%of patients.CONCLUSION:Significant number of investigations performed at first contact is found to be contrary to standard guidelines and are not contributory to the care.About a quarter of patients in this study are found to be non-compliant with the treatment.Compliance is more challenging to achieve in school-going children and working adults.The availability of comprehensive,periodically updated,evidence-based guidelines on the role of investigations and the use of trained counsellors may help to channelize proper evaluation and improve compliance to treatment,respectively,in patients with uveitis.