| Summary: | The burden of cardiovascular disease is predicted
to escalate in developing countries. The aim of this study
is to assess the characteristics, management strategies and outcomes of the
patients with acute coronary syndrome (ACS) who were admitted to hospitals under
the chest pain center mode in southwest P. R. China. Adults hospitalized with a diagnosis of ACS were enrolled in the retrospective,
observational registry between January 2017 and June 2019 at 11 hospitals in
Chengdu, P. R. China. The collected data included the patients’ baseline
characteristics, clinical management and in-hospital outcomes. After Statistical analysis,
(1) A total of 2857 patients with ACS, among which 1482 have ST-segment elevation
myocardial infarction (STEMI), 681 have non-STEMI (NSTEMI) and 694 have unstable
angina (UA) were enrolled in the study. (2) 61.3% of the ACS patients received
reperfusion therapy. More patients with STEMI
underwent percutaneous coronary intervention
(PCI) compared with NSTEMI/UA patients (80.6% vs. 38.8%, P < 0.001),
while thrombolytics were administered in only 1.8% of STEMI
patients. (3) The median time
from symptoms to hospital was 190
min (IQR 94-468) in STEMI, 283 min (IQR
112-1084) in NSTEMI and 337 min (IQR 97-2220) in UA (P < 0.001), and the door-to-balloon time for primary PCI (pPCI) was 85 min (IQR
55-121) in STEMI. (4) The in-hospital outcomes for STEMI patients included death
(8.1%) and acute heart failure (22.6%), while the outcomes for those with
NSTEMI and UA were better: death (4.0% and 0.9%, P < 0.001) and
acute heart failure (15.3% and 9.9%, P < 0.001). (5) Antiplatelet
drugs, lipid-lowering drugs, β-blockers and angiotensin-converting enzyme
inhibitors (ACEI) /angiotensin receptor blockers (ARB) were used in about 98.3%,
95.0%, 67.7% and 54.3% of the ACS patients, respectively.
Therefore, the management capacity in Chengdu has relatively
increased compared with previous studies, but important gaps still exist compared
with developed countries, especially
regarding the management of the NSTEMI/UA patients.
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