[Current clinical practice patterns and outcome for acute coronary syndromes in China: results of BRIG project.].

OBJECTIVE

To analyze current clinical management patterns and outcome of inpatients with ST segment elevation acute coronary syndromes (ACS) in China.

METHODS

Totally 1304 in-patients with ST segment elevation ACS from 64 hospitals across China were recruited and a standard questionnaire was used to get information of the patients including demographic, treatments and in-hospital outcomes.

RESULTS

(1) There were no significant differences in baseline characteristics between the patients from tertiary hospitals and that from the secondary hospitals. (2) Reperfusion therapy was applied more often in tertiary hospitals (57.9%) than in secondary hospitals (42.3%). Thrombolysis was more often used in secondary hospitals than that in tertiary hospitals (37.4% vs. 14.5%). The median time from pain onset to hospital was 240 min, the median time from admission to reperfusion was 60 min for thrombolysis and 110 min for PCI. (3) Statins and glycoprotein IIb/IIIa antagonists were given more frequently in tertiary hospitals. (4) Major in-hospital events and death rates were significantly higher in secondary hospitals than in tertiary hospitals. Multivariate logistic regression analysis showed that age >/= 75 years, hypertension, diabetes, reperfusion, aspirin, beta-blocker and ACE/ARB inhibitor use were associated independently with in-hospital mortality.

CONCLUSIONS

There is a big gap between guidelines and current management of ST segment elevation ACS in China, especially in secondary hospitals.