{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:11:04Z","timestamp":1793409064552,"version":"4.5.0"},"reference-count":39,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Ministry of Education of China","award":["B16005"],"award-info":[{"award-number":["B16005"]}]},{"name":"the Ministry of Science and Technology of China","award":["2017YFC1310803"],"award-info":[{"award-number":["2017YFC1310803"]}]},{"name":"the Ministry of Science and Technology of China","award":["2017YFC1310801"],"award-info":[{"award-number":["2017YFC1310801"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2021,9,7]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Access to acute cardiovascular care has improved and health services capacity has increased over the past decades. We assessed national changes in (1) patient characteristics, (2) in-hospital management and (3) patient outcomes among patients presenting with ST segment elevation myocardial infarction (STEMI) in 2011\u20132015 in China.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a nationally representative sample of hospitals in China, we created two random cohorts of patients in 2011 and 2015 separately. We weighted our findings to estimate nationally representative numbers and assessed changes from 2011 to 2015. Data were abstracted from medical charts centrally using standardised definitions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>While the proportion of patients with STEMI among all patients with acute myocardial infarction decreased over time from 82.5% (95% CI 81.7 to 83.3) in 2011 to 68.5% (95% CI 67.7 to 69.3) in 2015 (p&lt;0.0001), the weighted national estimate of patients with STEMI increased from 210\u2009000 to 380\u2009000. The rate of reperfusion eligibility among patients with STEMI decreased from 49.3% (95% CI 48.1 to 50.5) to 42.2% (95% CI 41.1 to 43.4) in 2015 (p&lt;0.0001); ineligibility was principally driven by larger proportions with prehospital delay exceeding 12 hours (67.4%\u201376.7%, p&lt;0.0001). Among eligible patients, the proportion receiving reperfusion therapies increased from 54% (95% CI 52.3 to 55.7) to 59.7% (95% CI 57.9 to 61.4) (p&lt;0.0001). Crude and risk-adjusted rates of in-hospital death did not differ significantly between 2011 and 2015.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this most recent nationally representative study of STEMI in China, the use of acute reperfusion increased, but no significant improvement occurred in outcomes. There is a need to continue efforts to prevent cardiovascular diseases, to monitor changes in in-hospital treatments and outcomes, and to reduce prehospital delay.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001666","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T11:00:56Z","timestamp":1633086056000},"page":"e001666","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Changes in ST segment elevation myocardial infarction hospitalisations in China from 2011 to 2015"],"prefix":"10.1136","volume":"8","author":[{"given":"Tianna","family":"Zhou","sequence":"first","affiliation":[{"name":"Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China"},{"name":"Central China Subcenter of the National Center for Cardiovascular Diseases, Zhengzhou, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5264-2169","authenticated-orcid":false,"given":"Yuan","family":"Lu","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Murugiah","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueke","family":"Bai","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Hu","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Gao","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick A","family":"Masoudi","sequence":"additional","affiliation":[{"name":"Medicine, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA"},{"name":"Research and Analytics, MO, Ascension Health, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harlan M","family":"Krumholz","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8840-8638","authenticated-orcid":false,"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"key":"2025081710011117000_8.2.e001666.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60278-5"},{"key":"2025081710011117000_8.2.e001666.2","article-title":"[Guideline for diagnosis and treatment of patients with ST-elevation myocardial infarction]","volume":"38","year":"2010","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"2025081710011117000_8.2.e001666.3","article-title":"[Guideline for diagnosis and treatment of patients with unstable angina and non-ST-segment elevation myocardial infarction]","volume":"35","year":"2007","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"2025081710011117000_8.2.e001666.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60921-1"},{"key":"2025081710011117000_8.2.e001666.5","unstructured":"Xinhua News Agency . 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Doctor-reported hospital management of acute coronary syndrome in China: a nationwide survey of 1029 hospitals in 30 provinces. 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