Li Yi-Heng, Chiu Yu-Wei, Cheng Jun-Jack, Hsieh I-Chang, Lo Ping-Han, Lei Meng-Huan, Ueng Kwo-Chang, Chiang Fu-Tien, Sung Shih-Hsien, Kuo Jen-Yuan, Chen Ching-Pei, Lai Wen-Ter, Lee Wen-Lieng, Chen Jyh-Hong
National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.
Far Eastern Memorial Hospital, New Taipei City.
Acta Cardiol Sin. 2019 Jan;35(1):1-10. doi: 10.6515/ACS.201901_35(1).20180716B.
Patients with acute coronary syndrome (ACS), including ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation (NSTE)-ACS have a significant risk of morbidity and mortality. This study evaluated the practice patterns of ACS care in Taiwan from 2005 to 2018.
Data from two nationwide ACS registries (2008-2010 and 2012-2015) were used. ACS patients who received percutaneous coronary interventions (PCIs) during admission were compared between the two registries.
In STEMI, the door-to-balloon time for primary PCI decreased by 25 min from a median of 96 to 71 min (p < 0.0001) from the first to second registry. More complex PCI procedures and drug-eluting stents were used for ACS. However, the onset-to-door time was still long for both STEMI and NSTE-ACS. The D2B time for NSTE-ACS was long, especially in the elderly and female patients. Although the prescription rate of secondary preventive medications for ACS increased, it was still relatively low compared with Western data, especially in NSTE-ACS.
The registry data showed that ACS care quality has improved in Taiwan. However, areas including onset-to-door time and use of secondary preventive medications still need further improvements.
急性冠状动脉综合征（ACS）患者，包括ST段抬高型心肌梗死（STEMI）和非ST段抬高型（NSTE）-ACS患者，有显著的发病和死亡风险。本研究评估了2005年至2018年台湾地区ACS护理的实践模式。
使用了两个全国性ACS登记处（2008 - 2010年和2012 - 2015年）的数据。比较了两个登记处中入院期间接受经皮冠状动脉介入治疗（PCI）的ACS患者。
在STEMI患者中，从第一个登记处到第二个登记处，直接PCI的门球时间从中位数96分钟降至71分钟，减少了25分钟（p < 0.0001）。更复杂的PCI手术和药物洗脱支架用于ACS患者。然而，STEMI和NSTE-ACS患者的发病到入院时间仍然较长。NSTE-ACS患者的D2B时间较长，尤其是老年和女性患者。尽管ACS二级预防药物的处方率有所提高，但与西方数据相比仍然较低，尤其是在NSTE-ACS患者中。
登记处数据显示台湾地区ACS护理质量有所改善。然而，包括发病到入院时间和二级预防药物使用等方面仍需进一步改进。
