Jun Liu1, Dong Zhao1, Jing Liu1, Yue Qi1, Jiayi Sun1, Ying Wang1, Wei Wang2. 1. Department of Epidemiology, Institute of Beijing Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. 2. Department of Epidemiology, Institute of Beijing Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. Email: wangwei_8851@sina.com.
Abstract
OBJECTIVE: To observe the changes in the diagnosis and treatment of hospitalized patients with acute coronary syndrome (ACS) from 2006 to 2012 in China. METHODS: Hospitalized patients with ACS in 2006 from 65 hospitals distributed in 31 provinces, autonomous regions, and municipalities (data derived from the BRIG project phase I study, n = 3 323) and hospitalized in 2012 from 34 hospitals distributed in 21 provinces, autonomous regions, and municipalities (data derived from the BRIG project phase III study, n = 3 391) were included. Patients with susceptible ACS, patients admitted to hospital due to trauma, or patients participated in any drug clinical trials were excluded. Only patients with complete data were analyzed. Data between 3 124 ACS patients from BRIG project-I and 3 124 ACS patients from BRIG project-III were compared. RESULTS: (1) The ACS patients hospitalized in 2012 were younger than those hospitalized in 2006 ((61.9 ± 11.2) years vs. (64.7 ± 11.5) years, P < 0.01), and the percentage of patients ≤ 60 years was higher in patients hospitalized in 2012 ((42.5% (1 327/3 124)) compared with those hospitalized in 2006 (32.1% (1 004/3 124), P < 0.05).(2) The percentages of ACS patients complicated with hypertension ((61.2% (1 853/3 124) vs. 53.0% (1 655/3 124)), diabetes (24.3% (760/3 124) vs. 16.4% (513/3 124)), and hypercholesterolemia (20.3% (633/3 124) vs. 6.3% (197/3 124)) were consistently higher in ACS patients hospitalized in 2012 than in hospitalized ACS patients in 2006 (all P < 0.01).(3) The rate of coronary angiogram examination increased from 28.6% (894/3 124) in 2006 to 68.6% (2 144/3 124) in 2012 (P < 0.01) . Moreover, the rate of intervention treatment was increased from 24.6% (770/3 124) in 2006 to 51.0% (1 594/3 124) in 2012 (P < 0.01). (4) The administration rate of aspirin (95.2% (2 975/3 124) vs. 91.7% (2 864/3 124) ), clopidogrel (85.6% (2 673/3 124) vs. 42.2% (1 318/3 124) ), and statins (90.0% (2 812/3 124) vs. 69.8% (2 180/3 124) ) was significantly higher in 2012 than in 2006 (all P < 0.01). CONCLUSION: Compared with 2006, there is a trend of younger onset age for ACS and higher proportions of complicated cardiovascular diseases, as well as improved diagnosis and treatment strategies for Chinese ACS patients in 2012.
OBJECTIVE: To observe the changes in the diagnosis and treatment of hospitalized patients with acute coronary syndrome (ACS) from 2006 to 2012 in China. METHODS: Hospitalized patients with ACS in 2006 from 65 hospitals distributed in 31 provinces, autonomous regions, and municipalities (data derived from the BRIG project phase I study, n = 3 323) and hospitalized in 2012 from 34 hospitals distributed in 21 provinces, autonomous regions, and municipalities (data derived from the BRIG project phase III study, n = 3 391) were included. Patients with susceptible ACS, patients admitted to hospital due to trauma, or patients participated in any drug clinical trials were excluded. Only patients with complete data were analyzed. Data between 3 124 ACSpatients from BRIG project-I and 3 124 ACSpatients from BRIG project-III were compared. RESULTS: (1) The ACSpatients hospitalized in 2012 were younger than those hospitalized in 2006 ((61.9 ± 11.2) years vs. (64.7 ± 11.5) years, P < 0.01), and the percentage of patients ≤ 60 years was higher in patients hospitalized in 2012 ((42.5% (1 327/3 124)) compared with those hospitalized in 2006 (32.1% (1 004/3 124), P < 0.05).(2) The percentages of ACSpatients complicated with hypertension ((61.2% (1 853/3 124) vs. 53.0% (1 655/3 124)), diabetes (24.3% (760/3 124) vs. 16.4% (513/3 124)), and hypercholesterolemia (20.3% (633/3 124) vs. 6.3% (197/3 124)) were consistently higher in ACSpatients hospitalized in 2012 than in hospitalized ACSpatients in 2006 (all P < 0.01).(3) The rate of coronary angiogram examination increased from 28.6% (894/3 124) in 2006 to 68.6% (2 144/3 124) in 2012 (P < 0.01) . Moreover, the rate of intervention treatment was increased from 24.6% (770/3 124) in 2006 to 51.0% (1 594/3 124) in 2012 (P < 0.01). (4) The administration rate of aspirin (95.2% (2 975/3 124) vs. 91.7% (2 864/3 124) ), clopidogrel (85.6% (2 673/3 124) vs. 42.2% (1 318/3 124) ), and statins (90.0% (2 812/3 124) vs. 69.8% (2 180/3 124) ) was significantly higher in 2012 than in 2006 (all P < 0.01). CONCLUSION: Compared with 2006, there is a trend of younger onset age for ACS and higher proportions of complicated cardiovascular diseases, as well as improved diagnosis and treatment strategies for Chinese ACSpatients in 2012.