Fibrinolytic therapy use for ST-segment elevation myocardial infarction and long-term outcomes in China: 2-year results from the China Acute Myocardial Infarction Registry

• Published in: BMC cardiovascular disorders Vol. 23; no. 1; pp. 103 - 10
• Main Authors: Wu, Chao, Li, Ling, Wang, Shuqing, Zeng, Jianping, Yang, Jingang, Xu, Haiyan, Zhao, Yanyan, Wang, Yang, Li, Wei, Jin, Chen, Gao, Xiaojin, Yang, Yuejin, Qiao, Shubin
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 22-02-2023; BioMed Central; BMC
• Subjects: Care and treatment; China; Clinical outcomes; Data collection; Developing countries; Diagnosis; Dosage and administration; Fibrin; Fibrinolysis; Fibrinolytic Agents - adverse effects; Forecasts and trends; Heart attack; Heart attacks; Hospitalization; Humans; LDCs; Medical prognosis; Mortality; Myocardial infarction; Myocardial Infarction - diagnosis; Outcomes; Patient outcomes; Patients; Percutaneous Coronary Intervention - adverse effects; Quality control; Registries; Regression analysis; Reperfusion; ST Elevation Myocardial Infarction - therapy; ST-segment elevation myocardial infarction; Thrombolytic drugs; Thrombolytic Therapy - adverse effects; Transluminal angioplasty; Treatment Outcome; China; ST-segment elevation myocardial infarction; Fibrinolysis; Outcomes
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-023-03105-1

Data on fibrinolytic therapy use for ST-segment elevation myocardial infarction (STEMI) and long-term clinical outcomes in developing countries are limited. We aimed to investigate the management and 2-year mortality of fibrinolytic-treated patients in China.
A total of 19,112 patients with STEMI from 108 hospitals participated in the China Acute Myocardial Infarction registry between January 2013 and September 2014. We investigated the 2-year all-cause mortality among patients treated with fibrinolysis. Non-invasive clinical indexes were used to diagnose successful fibrinolysis or not.
Only 1823 patients (9.5%) enrolled in the registry underwent fibrinolysis and 679 (37.2%) could be treated within 3 h after symptom onset. The overall use of rescue percutaneous coronary intervention was 8.9%. Successful fibrinolysis, which could be achieved in 1428 patients (78.3%), was related to types of fibrinolytic agents, symptom to needle time, infarction site, and Killip class. Follow-up data were available for 1745 patients (95.7%). After multivariate adjustment, successful fibrinolysis was strongly associated with a decreased risk of death compared with failed fibrinolysis at 2 years (8.5% vs. 29.0%, hazard ratio: 0.27, 95% confidence interval: 0.20-0.35).
Within a minority of STEMI patients in the CAMI registry underwent fibrinolysis, most of them could achieve successful clinical reperfusion, presenting a much benign 2-year survival outcome than those with failed fibrinolysis. Quality improvement initiatives focusing on fibrinolysis are warranted to achieve its promise fully.
URL: https// www.
gov . Unique identifier: NCT01874691. Registered 11/06/2013.