reGional Network for Acute Myocardial Infarction

Study Overview
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Brief Summary
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Incidence of ST-segment Elevation Myocardial Infarction (STEMI) is rising and the existing emergency medical aid system for STEMI was not enough for timely perfusion treatment. No existing research with high-quality data focuses on the characteristic of STEMI incidence and regional network construction. Aiming of Guangdong GAMI(reGional network for Acute Myocardial Infarction) project is to establish effective collaborative regional network system for STEMI patients treatment.

Detailed Description
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The project of Guangdong GAMI(reGional network for Acute Myocardial Infarction) is being conducted during 2015-2019 in eight districts with diverse economic development across southern China (Integrated care model was conducted in four regions, which mainly included community public education, non primary-PCI capable centre and referral system improvement, and inhospital green-channal optimization for primary-PCI capable centre. Other four centers were underwent usual care of acute myocardial infacrtion public and medical health service). All the ST-segment elevation myocardial infarction (STEMI) patients admitted in the hospital within 30 days from the symptom onset were enrolled. The key data of the timeline of STEMI onset and treatment were precisely recorded. Other details of STEMI treatment in hospitals such as laboratory data and medication were also collected. During the research period, actions of both optimizing the regional STEMI patients transfer and treatment to shorten the medical delay, as well as educating the public to improve their awareness of early treatment of STEMI were taken meanwhile. In addition, laboratory data, medication, and follow-up information were recorded in a database for further analysis regarding the STEMI patient treatment.

Official Title
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Construction of Modern reGional Network for Acute Myocardial Infarction

Conditions
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Coronary Heart Disease, Acute Myocardial Infarction, STEMI - ST Elevation Myocardial Infarction

Intervention / Treatment
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* Behavioral: public education and network construction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All adult patients who suspected diagnosis with STEMI. Exclusion Criteria: patients refused to undergo coronary angiography; patients were confirmed as non-STEMI by coronary angiography or the course of STEMI over 1 month; patients occurred onset STEMI during hospitalization in hospitals

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>community public education, non-PCI center and emergency transfer system improvement, and inhospital green-channal optimization for PCI center. | Behavioral: public education and network construction<br>* Publication education includes multiple methods of acute myocardial infarction knowledge education. Network construction includes regional connection of ST-Segment Elevation Myocardial Infarction patients transfer for percutaneous coronary intervention treatment, as well as physicians skill improvement in primary hospital.<br>|
| No Intervention: Control group<br>Usual care of AMI public and medical health service | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Receipt of reperfusion therapy within 12 hoursInfarction patients | The primary outcome was the proportion of patients who received symptom-to-reperfusion treatment within 12 hours. | From 1 month before hospitalization to 24 hours after hospitalization | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Onset-to-admission time within 12 hours | The proportion of patients who take a symptom-to-admission period within 12 hours. | From 1 month before hospitalization to 24 hours after hospitalization | 
| Door-to-balloon time within 90 minutes | The proportion of patients who take a door-to-balloon period within 90 minutes. | 24 hours | 
| In-hospital clinical outcomes | The incidence of several in-hospital outcomes (in-hospital death; and major adverse cardiac events [MACEs], which mainly included in-hospital death, recurrence of myocardial infarction, and stroke); the length of stay. | 30 days | 
| 1-year all-cause mortality | Total mortality between 30 days and 1 year after discharge. | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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STEMI, Acute myocardial infarction, regional network