Abstract 17467: Percutaneous Coronary Intervention Among Patients With non-ST-segment Elevation Myocardial Infarction and Unstable Angina: Findings From the Improving Care for Cardiovascular Disease in China Project
Introduction: The clinical guidelines recommended PCI for high risk patients of non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA), few studies have assessed PCI treatment based on risk classification among NSTEMI/UA patients in China. This study examined guideline adherence of risk classification and PCI treatment in NSTEMI/UA patients of China.
Methods: A nation-wide registry study named Improving Care for Cardiovascular Disease in China-ACS project was launched in 2014 as a collaborative study of AHA and Chinese Society of Cardiology. Totally 150 hospitals reported STEMI and NSTEMI/UA cases with strictly quality assurance for accuracy of the information. The detailed clinical information was collected with standardized definitions.
Results: A total of 11,044 NSTEMI/UA patients (mean age 65.6±11.8, 31.1% female) were reported from November 2014 to February 2016. Mean 59.1% of NSTEMI/UA patients were given the risk stratification. The proportions with risk stratification varied from 0% (in 16 hospitals) to 100% (in 4 hospitals) among the hospitals. There were 58.3% (6437/11,044) NSTEMI/UA patients whom received PCI treatment during hospitalization. Among patients with risk classification, PCI rates were 66.4%, 65.6% and 56.2% respectively in patients with low, intermediate and high risk. Only 2.6% of high risk patients underwent PCI within 2 hours and 68.1% patients underwent PCI after 72 hours. Compared with patients receiving PCI in the high risk group, the patients without PCI were older, with more severe complications and co-morbidities.
Conclusion: The guidelines adherence rate for early risk stratification in NSTEMI/UA patients need to improve in China. The reasons why a larger proportion of high risk NSTEMI/UA patients did not receive PCI and substantial proportion of low risk patients had PCI should be further clarified.
Author Disclosures: Q. Yang: None. Y. Wang: None. J. Liu: None. J. Liu: None. Y. Hao: None. Y. Huo: None. S. Smith: None. G. Fonarow: None. C. Ma: None. J. Ge: None. K. Taubert: None. L. Morgan: None. Y. Guo: None. W. Wang: None. Y. Zhou: None. D. Zhao: None.
- © 2016 by American Heart Association, Inc.