Abstract: Abstract: Objective To investigate whether the establishment of chest pain center (CPC) can improve the rescue efficacy in the treatment of patients with ST-segment elevation myocardial infarction (STEMI). Methods A series of consecutive acute STEMI patients (n=274) within 12 hours after symptom onset were screened, who were admitted in the 2nd Hospital of Tianjin Medical University between November 1, 2015 and January 1, 2017. According to the time of the establishment of CPC (June 1, 2016), patients were divided into the group before the establishment of CPC (early group, n= 140) and the group after the establishment of CPC (late group, n=134). Data of door-to-double dual antiplatelet therapy (D DAPT) time, door-to-heparin (D-H) time, door-to-balloon (D-to-B) time, symptom onset to door (SO-Door) time, total ischemia time, the results of coronary angiography, the major adverse cardiovascular events (MACE), the average length of hospital stay and hospital expenses were compared between two groups. Results Compared with the early group, data of D DAPT time, D-H time, D-to-B time, SO-Door time and total ischemia time were significantly shorter in the late group (all P＜0.01). LVEF was significantly higher, but the rate of Killip class Ⅲ/Ⅳand the level of NT-proBNP were lower in the late group than those of the early group (P＜0.05). The ratio of infarct related artery reperfusion was increased (41.1% vs. 25.8%, P=0.016), while the proportion of patients with stent implantation was decreased (77.5% vs. 90.0%, P=0.008) in the late group. The incidences of acute heart failure and death were significantly decreased during hospitalization (both P＜0.05). In addition, the average of hospitalization expenditure and length of hospital stay were significantly lower in the late group. Multivariable Logistic regression analysis showed that long SO-Door time, anterior myocardial infarction and hypertension were independent risk factors of in-hospital MACE in patients. Conclusion The establishment of the chest pain center, which is aimed to shorten the total ischemia time, can improve rescue efficiency of STEMI, reduce the risk of the in-hospital death and heart failure, and save medical resources.

Key words: myocardial infarction, angioplasty, transluminal, percutaneous coronary, emergency medical services, chest pain center, total ischemia time, pre-hospital care