STEMI Outcomes in Guangzhou and Hong Kong: Two-Centre Retrospective Interregional Study

• Published in: PloS one 2016-03, Vol.11 (3), p.e0149981-e0149981
• Main Authors: Chen, Xiaohui, Li, Min, Jiang, Huilin, Li, Yunmei, Mo, Junrong, Lin, Peiyi, Graham, Colin A, Rainer, Timothy H
• Format: Article
• Language: English
• Subjects: Aged; Analysis; Biology and Life Sciences; Body weight; Cardiovascular disease; China; Comparative analysis; Electrocardiography; Emergency management; Emergency medical care; Emergency medical services; Emergency preparedness; Female; Glucose; Health aspects; Health care; Heart attack; Hong Kong; Hospital emergency services; Hospitals; Humans; Hyperglycemia; Hyperlipidemia; Male; Males; Management; Medicine and Health Sciences; Mortality; Myocardial infarction; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Odds Ratio; Patient outcomes; Patient Selection; Patients; People and places; Physical Sciences; Reperfusion; Retrospective Studies; Risk factors; Statistical analysis; Teaching methods; Thrombolysis; Treatment Outcome; Ultrasonography
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0149981

Healthcare systems are organized very differently in Hong Kong (HK) and Guangzhou (GZ). This study compared managements of the emergency departments (ED) and one-year mortalities of ST-segment elevation myocardial infarction (STEMI) patients in two teaching hospitals in Guangzhou and Hong Kong. Retrospective observational study of STEMI mortalities and treatments in the Prince of Wales Hospital (PWH) and the Second Affiliated Hospital of Guangzhou Medical University (AHGZMU), was conducted between January and December 2010. The primary outcome was one-year all cause mortality. Univariate analysis of 76 cases from PWH and 111 cases from AHGZMU showed similar clinical characteristics, except for lower proportions of males (74% vs 92%, P = 0.002), hyperlipidemia (5% vs 25%, P10 mmol/L). Aged over 65 years, presence of anterior wall infarct, body weight ≤65 kg, SBP 10 mmol/L were the independent predictors of in-hospital MACE. There was no statistically significant difference between the standardized one-year all-cause mortalities of STEMI patients in the setting mainly using thrombolysis with shorter door-to-treatment time and the setting mainly using PCI with longer door-to-treatment time. Aged over 67 years and glucose level over 10 mmol/L were the independent predictors of one-year mortality. Older age, presence of anterior wall infarct, lower body weight, lower SBP at ED and hyperglycemia were the independent predictors of in-hospital MACE.