Objectives: The acute ST-segment elevation myocardial infarction (STEMI) has severe burden of disease and economic burden in China. This study aims to evaluate the effect of chest pain center (CPC) on the treatment of patients with acute STEMI in Tianjin, in order to provide the real-world evidence to spread the mode of chest pain center in China. Methods: The retrospective study was processed using de-identified dataset derived from China Cardiovascular Association. The dataset covered diagnosed acute STEMI patients of 33 hospitals in Tianjin between October 2014 and February 2019, and were divided into CPC group and Non-CPC group. The Wilcoxon rank-sum test was used to assess the significant difference of outcomes between S106 VALUE IN HEALTH - MAY 2020
a) "confirmed" ATTR-CM patients identified though new ICD10 codes specific for ATTR-CM (E85.82) and (b) CA patients ("approximate" ATTR-CM) with combined diagnoses of amyloidosis and HF or CM using both ICD9 and ICD10 codes. HF patients without CA were used as comparators for 6 month follow up. All patients had .= 6 months of continuous Medicare enrollment prior to and .=6 months after their first CA medical claim. Those with organ or stem cell transplants, light chain amyloidosis, chemotherapy or dementia were excluded. Patients dying during the follow-up period were included. Results: Study included 894 CA patients matched 1:1 to 894 (of 602,801) HF patients on demographics. CA cohort had more males prior to matching vs. the HF comparator (63.09% vs 45.58%, p,0.001). Age and gender were comparable after the match. CA and HF cohorts had similar all-cause hospital admissions (66.7% vs. 63.98%, p = 0.23) and cardiovascular-related admissions (63.65% vs. 60.51%, p = 0.17). However, CA cohort experienced more HF 30-day readmissions (11.41% vs. 7.61 %, p = 0.006), and greater all-cause mortality (22.8% vs 12.98%, p,0.001) compared to HF patients. Conclusions: This retrospective analysis demonstrated increased 30-day HF readmissions and mortality among CA patients compared to HF patients covered by Medicare Advantage. Additional research is needed to describe the overall burden of the disease.
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