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Wang J, Xu L, Tian L, Sun Q. Circulating microRNA-208 family as early diagnostic biomarkers for acute myocardial infarction: A meta-analysis. Medicine (Baltimore) 2021; 100:e27779. [PMID: 34941030 PMCID: PMC8702233 DOI: 10.1097/md.0000000000027779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/28/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Many recent studies have demonstrated that serum miRNA-208 (miR-208) could be a powerful biomarker in the early diagnosis of acute myocardial infarction (AMI). However, the result of previous studies was not accurate due to the small sample sizes and controversial issues. Therefore, this study was performed to investigate the relationship between the expression levels of miR-208 and AMI. MATERIALS AND METHODS According to the inclusion and exclusion criteria, a preliminary literature search was performed. The study was based on articles published in PubMed, Embase, Cochrane databases before September 30, 2019. Two staff members extracted data from the included articles for meta-analysis. These data were analyzed for sensitivity, specificity, diagnostic odds ratio, and summary receiver operator curve (SROC) analyses. RESULTS This study included 13 pieces of literature, which contains 1703 patients with AMI and 1589 controls. The main results of our meta-analysis were as follows: The pool sensitivity and specificity of miR-208 for diagnosing AMI was 83% and 97%. The area under the SROC curve (AUC) was 93%. Mir-208 had a highly effective diagnostic capacity to distinguish AMI from chest pain patients with an AUC of 93%. CONCLUSIONS The results showed that circulating miR-208 was a reliable biomarker both for diagnosting ST-elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). MiR-208 was sufficient to distinguish AMI patients with chest pain from healthy controls.
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Zhou T, Li X, Lu Y, Murugiah K, Bai X, Hu S, Gao Y, Masoudi FA, Krumholz HM, Li J. Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015. Open Heart 2021; 8:openhrt-2021-001666. [PMID: 34599073 PMCID: PMC8488733 DOI: 10.1136/openhrt-2021-001666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Access to acute cardiovascular care has improved and health services capacity has increased over the past decades. We assessed national changes in (1) patient characteristics, (2) in-hospital management and (3) patient outcomes among patients presenting with ST segment elevation myocardial infarction (STEMI) in 2011–2015 in China. Methods In a nationally representative sample of hospitals in China, we created two random cohorts of patients in 2011 and 2015 separately. We weighted our findings to estimate nationally representative numbers and assessed changes from 2011 to 2015. Data were abstracted from medical charts centrally using standardised definitions. Results While the proportion of patients with STEMI among all patients with acute myocardial infarction decreased over time from 82.5% (95% CI 81.7 to 83.3) in 2011 to 68.5% (95% CI 67.7 to 69.3) in 2015 (p<0.0001), the weighted national estimate of patients with STEMI increased from 210 000 to 380 000. The rate of reperfusion eligibility among patients with STEMI decreased from 49.3% (95% CI 48.1 to 50.5) to 42.2% (95% CI 41.1 to 43.4) in 2015 (p<0.0001); ineligibility was principally driven by larger proportions with prehospital delay exceeding 12 hours (67.4%–76.7%, p<0.0001). Among eligible patients, the proportion receiving reperfusion therapies increased from 54% (95% CI 52.3 to 55.7) to 59.7% (95% CI 57.9 to 61.4) (p<0.0001). Crude and risk-adjusted rates of in-hospital death did not differ significantly between 2011 and 2015. Conclusions In this most recent nationally representative study of STEMI in China, the use of acute reperfusion increased, but no significant improvement occurred in outcomes. There is a need to continue efforts to prevent cardiovascular diseases, to monitor changes in in-hospital treatments and outcomes, and to reduce prehospital delay.
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Affiliation(s)
- Tianna Zhou
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Xi Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China .,Central China Subcenter of the National Center for Cardiovascular Diseases, Zhengzhou, People's Republic of China
| | - Yuan Lu
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Xueke Bai
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China
| | - Shuang Hu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China
| | - Yan Gao
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China
| | - Frederick A Masoudi
- Medicine, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA.,Research and Analytics, MO, Ascension Health, St. Louis, Missouri, USA
| | | | - Jing Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China
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Wang X, Tian L, Sun Q. Diagnostic and prognostic value of circulating miRNA-499 and miRNA-22 in acute myocardial infarction. J Clin Lab Anal 2020; 34:2410-2417. [PMID: 32529742 PMCID: PMC7439427 DOI: 10.1002/jcla.23332] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/20/2020] [Accepted: 02/22/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Currently, acute myocardial infarction (AMI) represents a serious cardiovascular disease with high morbidity and mortality. Therefore, this study aimed to systematically evaluate the roles of miRNA-499 and miRNA-22 as potential biomarkers for AMI. METHODS According to the inclusion and exclusion criteria, we measured circulating levels of miRNAs in 50 AMI patients and 50 non-MI populations. The expression levels of plasma miRNA-499 and miRNA-22 were analyzed by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). A statistical analysis of clinical data of AMI patients was conducted by 90-day follow-up. RESULTS Real-time PCR analysis showed that the relative expression level of miRNA-499 increased gradually among the three groups (P < .05). However, the expression of miRNA-22 showed a downward trend (P < .05). According to logistic analysis, the relative levels of miRNA-499 and miRNA-22 were important predictors of AMI. When the miRNA-499 and miRNA-22 levels were 0.377 and 0.946 separately, the diagnostic value of miRNA-499 and miRNA-22 for AMI was 86.00% and 86.00% for sensitivity, and 98.00% and 94.00% for specificity, respectively. In addition, compared to the baseline GRACE scoring system, the combination of miRNA-499, miRNA-22, and GRACE scores had a stronger discriminating power for MACE occurrence, with a sensitivity of 100.00% and a specificity of 79.40%. CONCLUSIONS The results showed that plasma miRNA-499 and miRNA-22 were more sensitive and specific for the diagnosis of AMI, suggesting that they can be used as potential biomarkers for clinical diagnosis of AMI.
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Affiliation(s)
- Xiaoqing Wang
- Clinical Laboratory, Hospital Affiliated to Chengde Medical University, Chengde, China
| | - Lu Tian
- Clinical Laboratory, Hospital Affiliated to Chengde Medical University, Chengde, China
| | - Qiyu Sun
- Clinical Laboratory, Hospital Affiliated to Chengde Medical University, Chengde, China
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Song C, Fu R, Li S, Yang J, Wang Y, Xu H, Gao X, Liu J, Liu Q, Wang C, Dou K, Yang Y. Simple risk score based on the China Acute Myocardial Infarction registry for predicting in-hospital mortality among patients with non-ST-segment elevation myocardial infarction: results of a prospective observational cohort study. BMJ Open 2019; 9:e030772. [PMID: 31515430 PMCID: PMC6747644 DOI: 10.1136/bmjopen-2019-030772] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To simplify our previous risk score for predicting the in-hospital mortality risk in patients with non-ST-segment elevation myocardial infarction (NSTEMI) by dropping laboratory data. DESIGN Prospective cohort. SETTING Multicentre, 108 hospitals across three levels in China. PARTICIPANTS A total of 5775 patients with NSTEMI enrolled in the China Acute Myocardial Infarction (CAMI) registry. PRIMARY OUTCOME MEASURES In-hospital mortality. RESULTS The simplified CAMI-NSTEMI (SCAMI-NSTEMI) score includes the following nine variables: age, body mass index, systolic blood pressure, Killip classification, cardiac arrest, ST-segment depression on ECG, smoking status, previous angina and previous percutaneous coronary intervention. Within both the derivation and validation cohorts, the SCAMI-NSTEMI score showed a good discrimination ability (C-statistics: 0.76 and 0.83, respectively); further, the SCAMI-NSTEMI score had a diagnostic performance superior to that of the Global Registry of Acute Coronary Events risk score (C-statistics: 0.78 and 0.73, respectively; p<0.0001 for comparison). The in-hospital mortality increased significantly across the different risk groups. CONCLUSIONS The SCAMI-NSTEMI score can serve as a useful tool facilitating rapid risk assessment among a broader spectrum of patients admitted owing to NSTEMI. TRIAL REGISTRATION NUMBER NCT01874691.
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Affiliation(s)
- Chenxi Song
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
| | - Rui Fu
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
| | - Sidong Li
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingang Yang
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
| | - Yan Wang
- Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Beijing, China
| | - Haiyan Xu
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
| | - Xiaojin Gao
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
| | - Jia Liu
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qianqian Liu
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
| | - Chunyue Wang
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
| | - Kefei Dou
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
| | - Yuejin Yang
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Peking Union Medical College, Beijing, China
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Li P, Li SY, Liu M, Ruan JW, Wang ZD, Xie WC. Value of the expression of miR-208, miR-494, miR-499 and miR-1303 in early diagnosis of acute myocardial infarction. Life Sci 2019; 232:116547. [PMID: 31176780 DOI: 10.1016/j.lfs.2019.116547] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/22/2019] [Accepted: 06/06/2019] [Indexed: 02/08/2023]
Abstract
AIMS This study aims to investigate the value of the expression of miR-208, miR-494, miR-499 and miR-1303 in the early diagnosis of acute myocardial infarction (AMI). MAIN METHODS Patients were divided into two groups: AMI group (n = 41), and Stable angina pectoris (SAP) group (n = 32). Peripheral venous blood was sampled from these patients at the time of admission (T0), 6 h after onset (T6) and 12 h after onset (T12), while blood was sampled once from healthy subjects who underwent physical examination in the same time period (control group, n = 10). The expression of miR-208, miR-494, miR-499 and miR-1303 in serum were detected by real-time quantitative polymerase chain reaction (qRT-PCR), and differences in miRNA expression among these three groups of patients were analyzed. KEY FINDINGS Serum miR-208, miR-494, miR-499 and miR-1303 expression levels at different time points were significantly higher in the AMI group than in the SAP group and control group. The differences among these groups were statistically significant (P < 0.05), while the difference between the SAP group and control group was not statistically significant (P > 0.05). Variation trend: The miRNA levels above began to increase at T0 in the AMI group, the peak levels of miR-208, miR-494 and miR-499 appeared before T12, and the peak level of miR-1303 appeared between T6 and T12, or after T12. SIGNIFICANCE miR-208, miR-494, miR-499 and miR-1303 were not superior to hs-cTnI as myocardial markers in the diagnosis of early acute myocardial infarction.
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Affiliation(s)
- Ping Li
- Department of Cardiology, Yulin First People's Hospital (The Sixth Affiliated Hospital of Guangxi Medical University), Yulin, Guangxi 537000, China
| | - Si-Yao Li
- Department of Cardiology, Yulin First People's Hospital (The Sixth Affiliated Hospital of Guangxi Medical University), Yulin, Guangxi 537000, China
| | - Ming Liu
- Department of Cardiology, Yulin First People's Hospital (The Sixth Affiliated Hospital of Guangxi Medical University), Yulin, Guangxi 537000, China.
| | - Jiang-Wen Ruan
- Department of Cardiology, Yulin First People's Hospital (The Sixth Affiliated Hospital of Guangxi Medical University), Yulin, Guangxi 537000, China
| | - Zheng-Dong Wang
- Department of Cardiology, Yulin First People's Hospital (The Sixth Affiliated Hospital of Guangxi Medical University), Yulin, Guangxi 537000, China
| | - Wen-Chao Xie
- Department of Cardiology, Yulin First People's Hospital (The Sixth Affiliated Hospital of Guangxi Medical University), Yulin, Guangxi 537000, China
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Murugiah K, Wang Y, Nuti SV, Li X, Li J, Zheng X, Downing NS, Desai NR, Masoudi FA, Spertus JA, Jiang L, Krumholz HM. Are non-ST-segment elevation myocardial infarctions missing in China? EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2017; 3:319-327. [DOI: 10.1093/ehjqcco/qcx025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/25/2017] [Indexed: 12/18/2022]
Abstract
Abstract
Aims
ST-segment elevation myocardial infarctions (STEMI) in China and other low- and middle-income countries outnumber non-ST-segment elevation myocardial infarctions (NSTEMI). We hypothesized that the STEMI predominance was associated with lower biomarker use and would vary with hospital characteristics.
Methods and results
We hypothesized that the STEMI predominance was associated with lower biomarker use and would vary with hospital characteristics. Using data from the nationally representative China PEACE-Retrospective AMI Study during 2001, 2006, and 2011, we compared hospital NSTEMI proportion across categories of use of any cardiac biomarker (CK, CK-MB, or troponin) and troponin, as well as across region, location, level, and teaching status. Among 15 416 acute myocardial infarction (AMI) patients, 14% had NSTEMI. NSTEMI patients were older, more likely female, and to have comorbidities. Median hospital NSTEMI proportion in each study year was similar across categories of any cardiac biomarker use, troponin, region, location, level, and teaching status. For instance, in 2011 the NSTEMI proportion at hospitals without troponin testing was 11.2% [inter quartile range (IQR) 4.4–16.7%], similar to those with ≥ 75% troponin use (13.0% [IQR 8.7–23.7%]) (P-value for difference 0.77). Analysed as continuous variables there was no relationship between hospital NSTEMI proportion and proportion biomarker use. With troponin use there was no relationship in 2001 and 2006, but a modest correlation in 2011 (R = 0.16, P = 0.043). Admissions for NSTEMI increased from 0.3/100 000 people in 2001 to 3.3/100 000 people in 2011 (P-value for trend < 0.001).
Conclusion
STEMI is the dominant presentation of AMI in China, but the proportion of NSTEMI is increasing. Biomarker use and hospital characteristics did not account for the low NSTEMI rate.
Clinical trial registration
www.clinicaltrials.gov (NCT01624883).
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Affiliation(s)
- Karthik Murugiah
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 330 Cedar St, Boardman 110, P.O. Box 208056, New Haven, Connecticut 06520-8056, USA
| | - Yongfei Wang
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 330 Cedar St, Boardman 110, P.O. Box 208056, New Haven, Connecticut 06520-8056, USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, 1 Church Street, Suite 200, New Haven, Connecticut 06510-3330, USA
| | - Sudhakar V. Nuti
- Department of Internal Medicine, Yale University School of Medicine, 330 Cedar St, Boardman 110, P.O. Box 208056, New Haven, Connecticut 06520-8056, USA
| | - Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China
| | - Jing Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China
| | - Xin Zheng
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China
| | - Nicholas S. Downing
- Department of Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA
| | - Nihar R. Desai
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 330 Cedar St, Boardman 110, P.O. Box 208056, New Haven, Connecticut 06520-8056, USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, 1 Church Street, Suite 200, New Haven, Connecticut 06510-3330, USA
| | - Frederick A. Masoudi
- Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Campus Box B132, 12401 East 17th Avenue, Room 522, Aurora, Colorado 80045, USA
| | - John A. Spertus
- Saint Luke’s Mid America Heart Institute/University of Missouri-Kansas City, 4401 Wornall Road, Kansas City, Missouri 64111, USA
| | - Lixin Jiang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China
| | - Harlan M. Krumholz
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, 330 Cedar St, Boardman 110, P.O. Box 208056, New Haven, Connecticut 06520-8056, USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, 1 Church Street, Suite 200, New Haven, Connecticut 06510-3330, USA
- Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, SHM I-456 P.O. Box 208088, New Haven, Connecticut 06520, USA
- Department of Health Policy and Management, Yale School of Public Health, 60 College Street, P.O. Box 208034, New Haven CT 06520-8034, USA
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Zhang Q, Zhao D, Xie W, Xie X, Guo M, Wang M, Wang W, Liu W, Liu J. Recent Trends in Hospitalization for Acute Myocardial Infarction in Beijing: Increasing Overall Burden and a Transition From ST-Segment Elevation to Non-ST-Segment Elevation Myocardial Infarction in a Population-Based Study. Medicine (Baltimore) 2016; 95:e2677. [PMID: 26844503 PMCID: PMC4748920 DOI: 10.1097/md.0000000000002677] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Comparable data on trends of hospitalization rates for ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remain unavailable in representative Asian populations.To examine the temporal trends of hospitalization for acute myocardial infarction (AMI) and its subtypes in Beijing.Patients hospitalized for AMI in Beijing from January 1, 2007 to December 31, 2012 were identified from the validated Hospital Discharge Information System. Trends in hospitalization rates, in-hospital mortality, length of stay (LOS), and hospitalization costs were analyzed by regression models for total AMI and for STEMI and NSTEMI separately. In total, 77,943 patients were admitted for AMI in Beijing during the 6 years, among whom 67.5% were males and 62.4% had STEMI. During the period, the rate of AMI hospitalization per 100,000 population increased by 31.2% (from 55.8 to 73.3 per 100,000 population) after age standardization, with a slight decrease in STEMI but a 3-fold increase in NSTEMI. The ratio of STEMI to NSTEMI decreased dramatically from 6.5:1.0 to 1.3:1.0. The age-standardized in-hospital mortality decreased from 11.2% to 8.6%, with a significant decreasing trend evident for STEMI in males and females (P < 0.001) and for NSTEMI in males (P = 0.02). The rate of percutaneous coronary intervention increased from 28.7% to 55.6% among STEMI patients. The total cost for AMI hospitalization increased by 56.8% after adjusting for inflation, although the LOS decreased by 1 day.The hospitalization burden for AMI has been increasing in Beijing with a transition from STEMI to NSTEMI. Diverse temporal trends in AMI subtypes from the unselected "real-world" data in Beijing may help to guide the management of AMI in China and other developing countries.
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Affiliation(s)
- Qian Zhang
- From the Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases (QZ, DZ, WX, MW, WW, JL), and Beijing Public Health Information Center, Beijing, China (XX, MG, WL)
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