Comparison of current clinical practice in therapy of acute myocardial infarction

Objective: To understand the gap between the current practice of medications on patients with acute myocardial infarction(AMI) in hospital and guideline application.Methods: Ninety-two patients with AMI from Tongcheng People's Hospital received different therapies in Department of Cardiology from December 2002 to November 2005.The application of aspirin,low molecular heparin(LWMH),Nitrates,β-blocker,angiotensin converting enzyme inhibitors(ACEI),reperfusion,percutaneous corongary intervention(PCI) and cholesterol lowering agents were analyzed on different AMI patients.Results: Percentage of medications in AMI patients in different periods was:aspirin 90.32% to 93.10%,LWMH 70.97% to 82.76%,Nitrates 78.13% to 80.65%,β-blocker 62.50% to 65.52%,ACEI 46.88% to 58.62%,cholesterol lowering agents 6.25% to 68.79%,Fibrinolytics 31.25% to 41.38%,PCI3.13% to 17.24%.Conclusions: Application of medications proved effective by evidence-based medicine in clinical practice is mostly better in the class A gradeⅡ hospitals,and partly equal to the class A grade Ⅲ hospitals.But the application in China could be further improved.The gap of PCI application is quite big and it's hard to improve fast.Fibrinolytics is still the main method of reperfusion in the early period.