{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T02:51:24Z","timestamp":1768791084516,"version":"3.49.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,6,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Spironolactone, the only aldosterone antagonist available in China, improves outcomes in acute myocardial infarction (\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              ) among patients with systolic dysfunction and either diabetes or heart failure (\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              ). However, national practice patterns in the use of spironolactone in China are unknown.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              From a nationally representative sample of\n              <jats:styled-content style=\"fixed-case\">AMI<\/jats:styled-content>\n              patients from in 2001, 2006, and 2011, we identified 6906 patients with either diabetes or\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              and classified them into 1 of 4 groups according to their eligibility for spironolactone\u2014\u201cideal\u201d(left ventricular ejection fraction [\n              <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>\n              ] \u226440% and without contraindications), \u201ccontraindicated,\u201d \u201cnot indicated\u201d (neither ideal nor contraindicated), and \u201cunknown indications\u201d (\n              <jats:styled-content style=\"fixed-case\">LVEF<\/jats:styled-content>\n              unmeasured)\u2014to determine how frequently patient eligibility for this drug is assessed in the hospital, how it is used in several groups, and to identify factors associated with the use in these groups. From 2001 to 2011, the proportion of patients whose eligibility for spironolactone was not assessed decreased (66.9% in 2001 to 32.8% in 2011). Spironolactone use significantly increased among ideal patients over this period (28.6% to 72.4%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001 for trend), but also in contraindicated patients (11.4% to 27.5%;\n              <jats:italic>P<\/jats:italic>\n              =0.002 for trend) and in other patients groups (not indicated: 27.5% to 38.3%; unknown indications: 21.3% to 35.1%; both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01 for trend). In all 4 groups, patients presenting with\n              <jats:styled-content style=\"fixed-case\">HF<\/jats:styled-content>\n              on admission were more likely to receive spironolactone.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Although the appropriate use of spironolactone and assessment of eligibility increased in China over the past decade, there remains marked opportunities for improvement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">URL<\/jats:styled-content>\n              :\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              Unique identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              01624883.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.114.001718","type":"journal-article","created":{"date-parts":[[2015,6,13]],"date-time":"2015-06-13T03:05:56Z","timestamp":1434164756000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["National Quality Assessment Evaluating Spironolactone Use During Hospitalization for Acute Myocardial Infarction (AMI) in China: China Patient\u2010centered Evaluation Assessment of Cardiac Events (PEACE)\u2010Retrospective AMI Study, 2001, 2006, and 2011"],"prefix":"10.1161","volume":"4","author":[{"given":"Wenchi","family":"Guan","sequence":"first","affiliation":[{"name":"National Clinical Research Center of 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, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karthik","family":"Murugiah","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Yale\u2010New Haven Hospital, New Haven, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Downing","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Yale\u2010New Haven Hospital, New Haven, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of 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, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Wang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of 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, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph S.","family":"Ross","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Yale\u2010New Haven Hospital, New Haven, CT"},{"name":"Section of General Internal Medicine, Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT"},{"name":"Department of Health Policy and Management, Yale School of Public Health, New Haven, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nihar R.","family":"Desai","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Yale\u2010New Haven Hospital, New Haven, CT"},{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick A.","family":"Masoudi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute\/University of Missouri Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of 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, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harlan M.","family":"Krumholz","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Yale\u2010New Haven Hospital, New Haven, CT"},{"name":"Section of Cardiovascular Medicine, Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT"},{"name":"Department of Health Policy and Management, Yale School of Public Health, New Haven, CT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lixin","family":"Jiang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center of 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, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the China PEACE Collaborative Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","first-page":"e82","article-title":"ACC\/AHA guidelines for the management of patients with ST\u2010elevation myocardial infarction: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (committee to revise the 1999 Guidelines for the management of patients with Acute Myocardial Infarction)","volume":"110","author":"Antman EM","year":"2004","unstructured":"Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC Jr, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons 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