Time to hospital arrival among patients with acute myocardial infarction in China: a report from China PEACE prospective study

Guan, Wenchi; Venkatesh, Arjun K.; Bai, Xueke; Xuan, Si; Li, Jing; Li, Xi; Zhang, Haibo; Zheng, Xin; Spertus, John A.; Krumholz, Harlan M.; Jiang, Lixin

doi:10.1093/ehjqcco/qcy022

Cited by 32 publications

(27 citation statements)

References 31 publications

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“… 7 , 8 In other countries, the median pre-hospital delay time was 2 hours in Turkey, 23 2 to 5 hours in Sweden, 24 , 25 and 2.5 to 4 hours in China. 26 , 27 The mean age of the participants in this study was similar to that in a study in Malaysia. 28 Previous studies found that females were more likely to arrive late compared with males, but our findings failed to find statistically significant differences between males and females.…”

Section: Discussionsupporting

confidence: 81%

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Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia

ALAhmadi¹,

ALSaedi²,

Alahmadi³

et al. 2020

SMJ

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Objectives: To estimate the pre-hospital delay time among patients diagnosed with acute myocardial infarction and to determine factors associated with prehospital delay. Methods: A cross-sectional study was conducted among 200 patients with myocardial infarction at Madinah Cardiac Center, Al Madinah Al Munawarah, Saudi Arabia between November 2019 and March 2020. Data were collected by direct physician-subject interviews. We used the validated version of the modified response to symptoms questionnaire. Chi-square test, t test, Original Article and multivariate analysis were used to examine factors associated with pre-hospital delay. Results: The median pre-hospital delay time was 3.7 hours. Among all the patients, 126 patients (63%) arrived at the hospital later than 2 hours from the onset of symptoms. Factors that were significantly associated with pre-hospital delay included a previous information on acute coronary syndrome (adjusted odds ratio [adj OR]=0.35, 95% confidence interval [CI] 0.1-0.6), history of hypercholesteremia (adj OR=2.3, 95% CI 1.1-4.7), arrived by ambulance (adj OR=0.3, 95% CI 0.1-0.8), and increased pain intensity (adj OR=0.7, 95% CI 0.6-0.9). Conclusion: Approximately two-thirds of the patients arrived later than 2 hours from the onset of symptoms. A previous information about acute coronary syndrome, history of hypercholesteremia, arrived by ambulance, and increased pain intensity were associated with pre-hospital delay. The study recognizes the need for educational programs about acute myocardial infarction symptoms and the benefits of availing an ambulance service.

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Section: Discussionsupporting

confidence: 81%

“…28,33 Patients who perceived the symptoms as cardiac in origin were less likely to arrive late to a hospital. 27,34,35 A similar finding was reported in the current study.…”

supporting

confidence: 91%

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia

ALAhmadi¹,

ALSaedi²,

Alahmadi³

et al. 2020

SMJ

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“…Reperfusion injury is not a factor in the PL procedure, and thus the research focus is on the initial tissue injury response. However, although timely reperfusion is critical for human patients, studies have shown that a significant portion of patients receive therapy late, and 15-30% of patients are admitted to hospital too late after onset of the MI for reperfusion therapy to provide any benefit (Cohen et al, 2010;Gharacholou et al, 2010;Guan et al, 2018). Therefore, Gomez et al, 2008 C57/BL6 60 25% (n=9) 70% (n=15) Michael et al, 1995 FVB 30 60 13.7% (n=5) 20.5% n=762% (n=16) 66% (n=18) Michael et al, 1999 C57/BL6 120 30% (n=10) 60% (n=35) Yang et al, 2008 C57/BL6 45 25% n=8100% n=8a sizeable portion of the MI patient population experience a longterm ischaemic condition, for which modelling by the PL procedure could be more relevant.…”

Section: Clinical Relevancementioning

confidence: 99%

Mouse models of myocardial infarction: comparing permanent ligation and ischaemia-reperfusion

Villiers

Riley

2020

Disease Models &Amp; Mechanisms

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Myocardial infarction (MI) is a disease of major consequence in the modern world, causing permanent, irreversible damage to the heart. Survivors are at risk for developing further cardiovascular pathologies such as heart failure. Further study of MI injury is crucial to improve the understanding and treatment of the post-MI heart. The most commonly used model for MI in vivo is surgical ligation of the left anterior descending coronary artery (LAD). There are two predominant approaches: permanent ligation (PL), where the LAD is permanently occluded with a suture, or ischaemia-reperfusion (IR), where the LAD is temporarily occluded before removing the suture to restore blood flow and tissue reperfusion. PL results in the majority of the area at risk becoming infarcted, leading to significant apoptotic cell death and a large scar. Conversely, IR salvages some of the area at risk; thus, the scar is smaller and includes reperfusion injury, an additional, albeit smaller, second wave of necrotic damage. PL may be a more appropriate model choice for studies of heart tissue injury and wound healing, owing to the larger, more consistent infarcts, while IR enables the study of reperfusion injury. Both are clinically relevant, and the choice of model depends upon the precise pre-clinical research questions to be addressed.

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“…It has been reported that acute myocardial infarction contributes to high rates of morbidity and mortality in the past few decades in China [ 1 ]. In recent 20 years, the prompt myocardial revascularization can recover the myocardium blood flow and reduce ischemia-induced injury [ 2 ]. However, it may inevitably cause contractile dysfunction, severe arrhythmias, extremely to death, the complicated pathophysiological process of which was referred to as myocardial ischemia/reperfusion (I/R) injury [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The co-treatment of rosuvastatin with dapagliflozin synergistically inhibited apoptosis via activating the PI3K/AKt/mTOR signaling pathway in myocardial ischemia/reperfusion injury rats

et al. 2020

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Objective The purpose of the present study was to evaluate the role of co-treatment of rosuvastatin (RSV) and dapagliflozin (DGZ) preconditioning in myocardium ischemia/reperfusion (I/R) injury and to further investigate the underlying mechanism. Methods Sprague-Dawley (SD) rats (n = 25) were divided into five groups randomly: (1) Sham, (2) I/R, (3) I/R + RSV (10 mg/kg), (4) IR + DGZ (1 mg/kg), and (5) I/R + RSV (10 mg/kg) + DGZ (1 mg/kg). The I/R model was induced with 30 min of left anterior descending occlusion followed by 120 min of reperfusion. Results In vivo pretreatment with RSV and DGZ, respectively, showed a significant reduction of infarction size, a significant increase in the levels of left ventricular systolic pressure, and maximal rate increase in left ventricular pressure (+dp/dt max), decrease in the levels of left ventricular end-diastolic pressure (LVEDP), maximal rate of decrease of left ventricular pressure (−dp/dt max) and activity of cardiac enzymes of creatine kinase (CK), creatine kinase MB isoenzymes (CK-MB), and hyper-tensive cardiac troponin I compared with the I/R group. H9C2 cells were exposed to hypoxia/reoxygenation to simulate an I/R model. In vitro administration of 25 µM RSV and 50 µM DGZ significantly enhanced cell viability, upregulated the expression levels of p-PI3K, p-Akt, p-mTOR, and Bcl-2, whereas it downregulated cleaved-caspase3, Bax. TUNEL assay indicated that pretreatment with RSV and DGZ decreased the apoptosis of H9C2 cells. Conclusion The combination of RSV and DGZ significantly enhances the cardioprotective effects compared with RSV or DGZ alone. RSV and DGZ have the potential cardioprotective effects against I/R injury by activating the PI3K/AKt/mTOR signaling pathway.

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Time to hospital arrival among patients with acute myocardial infarction in China: a report from China PEACE prospective study

Abstract: https://clinicaltrials.gov/ct2/show/NCT01624909 ClinicalTrials.gov Identifier: NCT01624909.

Cited by 32 publications

References 31 publications

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia

Mouse models of myocardial infarction: comparing permanent ligation and ischaemia-reperfusion

The co-treatment of rosuvastatin with dapagliflozin synergistically inhibited apoptosis via activating the PI3K/AKt/mTOR signaling pathway in myocardial ischemia/reperfusion injury rats

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