Affiliated Hospital of Hangzhou Normal University, Department of Cardioogy, Hangzhou, China.
Zhejiang Academy of Medical Sciences, Hangzhou, China.
Patient Educ Couns. 2020 Aug;103(8):1581-1586. doi: 10.1016/j.pec.2020.02.041. Epub 2020 Feb 29.
Patient delay in the recognition of and response to the symptoms of acute coronary syndrome (ACS) is a worldwide problem. A community education program about chest pain was implemented in China, and was aimed at providing better community intervention. In this study, the impact of this program on the time of symptom onset to the first medical contact (SO-to-FMC) in ACS patients was investigated, as was the incidence of major adverse cardiac and cerebrovascular events (MACCE) in these patients.
A total of 10 local communities were included in this study. A 9-month intensive community education program about chest pain was conducted in these communities. The data on the demographics, mode of transportation, procedures, clinical outcomes, and discharge diagnoses of all ACS patients in these communities were collected.
The study communities had a combined population of 361,609, and all community population sizes ranged from 12,823 to 66,127. The average SO-to-FMC time of the control period was 510 min, whereas, following community intervention, the average SO-to-FMC time was 256 min (P < 0.001). Furthermore, comparative analyses revealed that, following discharge from the hospital, the 1.5-year MACCE-free survival rate was higher in the community intervention group than in the control group (95.0 % vs. 90.5 %, P = 0.025), and the 1.5-year mortality rate was lower in the community intervention group than in the control group (3.3 % vs. 6.3 %, P = 0.03).
The Hangzhou Chest Pain Science Education Project(HCPSEP) was found to reduce the SO-to-FMC time and improve the outcome of ACS patients. This indicates that a scientific, educational program on chest pain can be effective in improving the knowledge and alertness of the local residents about chest pain. This type of program may be recognized and carried out in other regions.
急性冠状动脉综合征（ACS）患者对症状的识别和反应出现延迟是一个全球性问题。在中国实施了一项关于胸痛的社区教育计划，旨在提供更好的社区干预。本研究旨在调查该计划对 ACS 患者症状发作至首次医疗接触（SO-to-FMC）时间的影响，以及这些患者主要不良心脏和脑血管事件（MACCE）的发生率。
本研究纳入了 10 个社区。在这些社区中开展了为期 9 个月的胸痛强化社区教育计划。收集了这些社区中所有 ACS 患者的人口统计学、交通方式、治疗程序、临床结局和出院诊断数据。
研究社区总人口为 361609 人，社区人口规模均在 12823 至 66127 人之间。对照组的平均 SO-to-FMC 时间为 510 分钟，而社区干预后，平均 SO-to-FMC 时间为 256 分钟（P<0.001）。此外，比较分析显示，出院后社区干预组的 1.5 年 MACCE 无事件生存率高于对照组（95.0%比 90.5%，P=0.025），社区干预组的 1.5 年死亡率低于对照组（3.3%比 6.3%，P=0.03）。
杭州胸痛科学教育计划（HCPSEP）可缩短 SO-to-FMC 时间，改善 ACS 患者结局。这表明，针对胸痛的科学教育计划可有效提高当地居民对胸痛的知识水平和警惕性。此类计划可能会在其他地区得到认可和实施。
