title: Current Trends for ST-segment Elevation Myocardial Infarction during the Past 5 Years in Rural Areas of China's Liaoning Province: A Multicenter Study.
abstract: BACKGROUND
  Since 2010, two versions of National Guidelines aimed at promoting the management of ST-segment elevation myocardial infarction (STEMI) have been formulated by the Chinese Society of Cardiology. However, little is known about the changes in clinical characteristics, management, and in-hospital outcomes in rural areas.
  
  
  METHODS
  In the present multicenter, cross-sectional study, participants were enrolled from rural hospitals located in Liaoning province in Northeast China, during two different periods (from June 2009 to June 2010 and from January 2015 to December 2015). Data collection was conducted using a standardized questionnaire. In total, 607 and 637 STEMI patients were recruited in the 2010 and 2015 cohorts, respectively.
  
  
  RESULTS
  STEMI patients in rural hospitals were older in the second group (63 years vs. 65 years, P = 0.039). We found increases in the prevalence of hypertension, prior percutaneous coronary intervention (PCI), and prior stroke. Over the past 5 years, the cost during hospitalization almost doubled. The proportion of STEMI patients who underwent emergency reperfusion had significantly increased from 42.34% to 54.47% (P < 0.0001). Concurrently, the proportion of primary PCI increased from 3.62% to 10.52% (P < 0.0001). The past 5 years have also seen marked increases in the use of guideline-recommended drugs and clinical examinations. However, in-hospital mortality and major adverse cardiac events did not significantly change over time (13.01% vs. 10.20%, P = 0.121; 13.34% vs. 13.66%, P = 0.872).
  
  
  CONCLUSIONS
  Despite the great progress that has been made in guideline-recommended therapies, in-hospital outcomes among rural STEMI patients have not significantly improved. Therefore, there is still substantial room for improvement in the quality of care.
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Guang-Xiao
authors.initials: GX
authors.lastname: Li
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Department of Geriatric Cardiology, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Guo-Xian
authors.initials: GX
authors.lastname: Qi
authors.affiliation: Department of Cardiology, The First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning 116000, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Dandong Center Hospital, Dandong, Liaoning 118000, China.
authors.forename: Da-Ming
authors.initials: DM
authors.lastname: Jiang
authors.affiliation: Department of Special Clinic, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Gui-Mei
authors.initials: GM
authors.lastname: Wu
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Ma
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Qiong-Rui
authors.initials: QR
authors.lastname: Zhao
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Experiment Teaching Center, School of Public Health, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning 110001, China.
authors.forename: Jing-Pu
authors.initials: JP
authors.lastname: Shi
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D000072657:ST Elevation Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D011795:Surveys and Questionnaires