Summary of best evidence for treatment and management of acute myocardial infarction under the mode of chest pain center_West China Medical Journal

Authors：

WU Yan ¹ ,  ZHAO Changwei ² , MAIMAITI Yisireyili ² , DU Tingting ² , HOU Ming ³ , ZHANG Fengye ¹

1. School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang 830017, P. R. China;
2. Research and Education Center, Xinjiang Uygur Autonomous Region People’s Hospital, Urumqi, Xinjiang 830001, P. R. China;
3. Department of Nursing, Xinjiang Uygur Autonomous Region People’s Hospital, Urumqi, Xinjiang 830001, P. R. China;

Corresponding author：

ZHAO Changwei, Email: 78498595@qq.com

Keywords：

Acute myocardial infarction; chest pain center; summary of evidence

DOI：

10.7507/1002-0179.202507307

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To search, evaluate and summarize the relevant evidence of the treatment and management of patients with acute myocardial infarction (AMI) under the chest pain center mode by using the evidence-based medicine method, so as to provide references for optimizing the clinical pathway, improving the medical quality and improving the prognosis of patients. Methods Relevant evidences on the treatment and management of AMI patients in relevant databases and websites at home and abroad were retrieved, and the retrieval time limit was from the establishment of databases to January 1, 2025. The quality of the included literature was evaluated, and the evidence was extracted and summarized. Results A total of 15 literatures were included, including 2 clinical decisions, 2 systematic reviews, 8 guidelines, and 3 expert consensus. Finally, 23 best evidences were extracted, including the basic conditions of chest pain center, the evaluation and treatment of patients with acute chest pain, the integration of pre-hospital emergency system and hospital green channel, and training and education. Conclusions The best evidence for the treatment and management of AMI under the chest pain center mode can provide evidence-based basis for clinical practice. It is necessary to combine the situation of the chest pain center, fully consider the validity and feasibility of the evidence, and help the chest pain center improve the medical quality and improve the prognosis of patients in a standardized and scientific way.

1.	侯义勇, 谢春巧. 胸痛中心持续改进机制对急性 ST 段抬高型心肌梗死患者救治效率及近期预后的影响. 临床医学研究与实践, 2024, 9(27): 195-198.
2.	黄菁, 姚娟. 胸痛中心管理模式对急性心肌梗死患者的救治效果. 检验医学与临床, 2023, 20(19): 2923-2925.
3.	许盼, 余世成, 冯俊, 等. 胸痛中心建设对急性心肌梗死患者救治效率及预后的影响研究. 中国循证心血管医学杂志, 2024, 16(7): 810-812, 841.
4.	刘明波, 何新叶, 杨晓红, 等. 《中国心血管健康与疾病报告 2024》要点解读. 临床心血管病杂志, 2025, 41(7): 492-511.
5.	Graff LG, Dallara J, Ross MA, et al. Impact on the care of the emergency department chest pain patient from the chest pain evaluation registry (CHEPER) study. Am J Cardiol, 1997, 80(5): 563-568.
6.	Gibler WB, Runyon JP, Levy RC, et al. A rapid diagnostic and treatment center for patients with chest pain in the emergency department. Ann Emerg Med, 1995, 25(1): 1-8.
7.	苏州工业园区东方华夏心血管健康研究院, 国家放射与治疗临床医学研究中心胸痛中心专家委员会, 霍勇, 等. 《胸痛中心质控报告(2024)》概要. 中国介入心脏病学杂志, 2025, 33(7): 361-367.
8.	朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成. 护士进修杂志, 2017, 32(21): 1991-1994.
9.	Dicenso A, Bayley L, Haynes RB. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evid Based Nurs, 2009, 12(4): 99-101.
10.	Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
11.	胡雁, 郝玉芳. 循证护理学. 2 版. 北京: 人民卫生出版社, 2018: 1.
12.	熊俊, 陈日新. 系统评价/Meta 分析方法学质量的评价工具 AMSTAR. 中国循证医学杂志, 2011, 11(9): 1084-1089.
13.	邢唯杰, 胡雁, 周英凤, 等. 推动证据向临床转化(六)证据总结的制作与撰写. 护士进修杂志, 2020, 35(12): 1129-1132.
14.	王春青, 胡雁. JBI 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 2015(11): 964-967.
15.	Reeder GS, Kennedy HL. Overview of the acute management of ST-elevation myocardial infarction. Waltham: UpToDate, 2024.
16.	Gibson CM, Cutlip D. Acute ST-elevation myocardial infarction: selecting a reperfusion strategy. Waltham: UpToDate, 2024.
17.	Brunetti ND, De Gennaro L, Correale M, et al. Pre-hospital electrocardiogram triage with telemedicine near halves time to treatment in STEMI: a meta-analysis and meta-regression analysis of non-randomized studies. Int J Cardiol, 2017, 232: 5-11.
18.	刘妍, 陈洪娇, 张娜, 等. 区域协同救治体系对急性 ST 段抬高型心肌梗死救治效率及预后影响的 Meta 分析. 中国急救复苏与灾害医学杂志, 2024, 19(1): 8-15.
19.	Acute Coronary Syndromes Guideline Committee. Acute coronary syndromes. London: National Institute for Health and Care Excellence, 2020.
20.	Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation, 2021, 144(22): e368-e454.
21.	HTA DoH (MY). Management of acute ST segment elevation myocardial infarction (STEMI). Scotland: Guidelines International Network, 2019.
22.	Beygui F, Castren M, Brunetti ND, et al. Pre-hospital management of patients with chest pain and/or dyspnoea of cardiac origin. A position paper of the Acute Cardiovascular Care Association (ACCA) of the ESC. Eur Heart J Acute Cardiovasc Care, 2020, 9(Suppl 1): 59-81.
23.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会, 《中国循环杂志》编辑委员会. 急性心肌梗死诊断和治疗指南. 中华心血管病杂志, 2001, 29(12): 710-725.
24.	国家胸痛中心专家委员会, 胸痛中心执行委员会. 胸痛救治单元建设方案及验收标准(第 2 版). 北京: 国家胸痛中心专家委员, 2023.
25.	中国胸痛中心联盟, 中国胸痛中心执行委员会. 中国基层胸痛中心认证标准. 中国介入心脏病学杂志, 2016, 24(3): 131-133.
26.	中国胸痛中心联盟, 中国胸痛中心执行委员会. 中国胸痛中心认证标准. 中国介入心脏病学杂志, 2016, 24(3): 121-130.
27.	“胸痛中心”建设中国专家共识组. “胸痛中心”建设中国专家共识. 中华危重症医学杂志(电子版), 2011, 4(6): 381-393.
28.	中华医学会急诊医学分会, 中国医师协会急诊医师分会, 中国县级医院急诊联盟, 等. 中国县级医院急诊科建设规范专家共识. 临床急诊杂志, 2019, 20(5): 335-342.
29.	颜红兵, 向定成, 刘红梅, 等. ST 段抬高型急性心肌梗死院前溶栓治疗中国专家共识. 中国介入心脏病学杂志, 2018, 26(4): 181-190.
30.	刘四琴, 周丽芳, 朱丽利, 等. 多学科合作优化急诊流程在急诊胸痛患者诊疗中的应用. 齐鲁护理杂志, 2023, 29(2): 79-81.
31.	李元和, 张义强, 高国贵. 胸痛中心多学科协作模式对急性胸痛患者救治质量与预后的影响分析. 岭南急诊医学杂志, 2025, 30(1): 37-39.
32.	汪晶晶, 马欣欣, 管晓明. 规范化全流程管理在胸痛中心建设中的应用. 现代医院管理, 2024, 22(3): 28-32.
33.	夏金兰, 曾庆宏, 潘艳珍, 等. 规范化胸痛中心建设在急性 ST 段抬高型心肌梗死患者救治中的应用效果. 中国医学创新, 2023, 20(15): 158-161.
34.	向定成. 信息技术支撑区域协同救治体系中胸痛中心的发展方向. 中国数字医学, 2015(9): 2-4.
35.	姜峰林, 许玲. 急性心肌梗死转诊急诊 PCI 中应用微信的 Meta 分析. 中国医学创新, 2018, 15(36): 128-131.
36.	De Luca G, Suryapranata H, Ottervanger JP, et al. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. Circulation, 2004, 109(10): 1223-1225.
37.	高润霖. 从急性心肌梗死治疗指南看再灌注治疗策略的选择. 中华心血管病杂志, 2005, 33(11): 1061-1064.
38.	向定成. 中国胸痛中心建设这十年. 疑难病杂志, 2022, 21(10): 1005-1007.
39.	曹俊达, 王琦, 刘海龙, 等. 基于胸痛中心的区域协同救治体系对急性 ST 段抬高型心肌梗死患者救治及预后的影响. 江西医药, 2021, 56(4): 445-447.
40.	汪蒙. 胸痛中心在区域协同救治体系建设中的作用分析. 兰州: 甘肃中医药大学, 2022.
41.	Tummala SR, Farshid A. Patients’ understanding of their heart attack and the impact of exposure to a media campaign on pre-hospital time. Heart Lung Circ, 2015, 24(1): 4-10.
42.	熊司琦. 基于 BCW 的健康教育在急性心肌梗死患者中的应用研究. 天津: 天津中医药大学, 2020.

1. 侯义勇, 谢春巧. 胸痛中心持续改进机制对急性 ST 段抬高型心肌梗死患者救治效率及近期预后的影响. 临床医学研究与实践, 2024, 9(27): 195-198.
2. 黄菁, 姚娟. 胸痛中心管理模式对急性心肌梗死患者的救治效果. 检验医学与临床, 2023, 20(19): 2923-2925.
3. 许盼, 余世成, 冯俊, 等. 胸痛中心建设对急性心肌梗死患者救治效率及预后的影响研究. 中国循证心血管医学杂志, 2024, 16(7): 810-812, 841.
4. 刘明波, 何新叶, 杨晓红, 等. 《中国心血管健康与疾病报告 2024》要点解读. 临床心血管病杂志, 2025, 41(7): 492-511.
5. Graff LG, Dallara J, Ross MA, et al. Impact on the care of the emergency department chest pain patient from the chest pain evaluation registry (CHEPER) study. Am J Cardiol, 1997, 80(5): 563-568.
6. Gibler WB, Runyon JP, Levy RC, et al. A rapid diagnostic and treatment center for patients with chest pain in the emergency department. Ann Emerg Med, 1995, 25(1): 1-8.
7. 苏州工业园区东方华夏心血管健康研究院, 国家放射与治疗临床医学研究中心胸痛中心专家委员会, 霍勇, 等. 《胸痛中心质控报告(2024)》概要. 中国介入心脏病学杂志, 2025, 33(7): 361-367.
8. 朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成. 护士进修杂志, 2017, 32(21): 1991-1994.
9. Dicenso A, Bayley L, Haynes RB. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S model. Evid Based Nurs, 2009, 12(4): 99-101.
10. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-E842.
11. 胡雁, 郝玉芳. 循证护理学. 2 版. 北京: 人民卫生出版社, 2018: 1.
12. 熊俊, 陈日新. 系统评价/Meta 分析方法学质量的评价工具 AMSTAR. 中国循证医学杂志, 2011, 11(9): 1084-1089.
13. 邢唯杰, 胡雁, 周英凤, 等. 推动证据向临床转化(六)证据总结的制作与撰写. 护士进修杂志, 2020, 35(12): 1129-1132.
14. 王春青, 胡雁. JBI 证据预分级及证据推荐级别系统(2014 版). 护士进修杂志, 2015(11): 964-967.
15. Reeder GS, Kennedy HL. Overview of the acute management of ST-elevation myocardial infarction. Waltham: UpToDate, 2024.
16. Gibson CM, Cutlip D. Acute ST-elevation myocardial infarction: selecting a reperfusion strategy. Waltham: UpToDate, 2024.
17. Brunetti ND, De Gennaro L, Correale M, et al. Pre-hospital electrocardiogram triage with telemedicine near halves time to treatment in STEMI: a meta-analysis and meta-regression analysis of non-randomized studies. Int J Cardiol, 2017, 232: 5-11.
18. 刘妍, 陈洪娇, 张娜, 等. 区域协同救治体系对急性 ST 段抬高型心肌梗死救治效率及预后影响的 Meta 分析. 中国急救复苏与灾害医学杂志, 2024, 19(1): 8-15.
19. Acute Coronary Syndromes Guideline Committee. Acute coronary syndromes. London: National Institute for Health and Care Excellence, 2020.
20. Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation, 2021, 144(22): e368-e454.
21. HTA DoH (MY). Management of acute ST segment elevation myocardial infarction (STEMI). Scotland: Guidelines International Network, 2019.
22. Beygui F, Castren M, Brunetti ND, et al. Pre-hospital management of patients with chest pain and/or dyspnoea of cardiac origin. A position paper of the Acute Cardiovascular Care Association (ACCA) of the ESC. Eur Heart J Acute Cardiovasc Care, 2020, 9(Suppl 1): 59-81.
23. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会, 《中国循环杂志》编辑委员会. 急性心肌梗死诊断和治疗指南. 中华心血管病杂志, 2001, 29(12): 710-725.
24. 国家胸痛中心专家委员会, 胸痛中心执行委员会. 胸痛救治单元建设方案及验收标准(第 2 版). 北京: 国家胸痛中心专家委员, 2023.
25. 中国胸痛中心联盟, 中国胸痛中心执行委员会. 中国基层胸痛中心认证标准. 中国介入心脏病学杂志, 2016, 24(3): 131-133.
26. 中国胸痛中心联盟, 中国胸痛中心执行委员会. 中国胸痛中心认证标准. 中国介入心脏病学杂志, 2016, 24(3): 121-130.
27. “胸痛中心”建设中国专家共识组. “胸痛中心”建设中国专家共识. 中华危重症医学杂志(电子版), 2011, 4(6): 381-393.
28. 中华医学会急诊医学分会, 中国医师协会急诊医师分会, 中国县级医院急诊联盟, 等. 中国县级医院急诊科建设规范专家共识. 临床急诊杂志, 2019, 20(5): 335-342.
29. 颜红兵, 向定成, 刘红梅, 等. ST 段抬高型急性心肌梗死院前溶栓治疗中国专家共识. 中国介入心脏病学杂志, 2018, 26(4): 181-190.
30. 刘四琴, 周丽芳, 朱丽利, 等. 多学科合作优化急诊流程在急诊胸痛患者诊疗中的应用. 齐鲁护理杂志, 2023, 29(2): 79-81.
31. 李元和, 张义强, 高国贵. 胸痛中心多学科协作模式对急性胸痛患者救治质量与预后的影响分析. 岭南急诊医学杂志, 2025, 30(1): 37-39.
32. 汪晶晶, 马欣欣, 管晓明. 规范化全流程管理在胸痛中心建设中的应用. 现代医院管理, 2024, 22(3): 28-32.
33. 夏金兰, 曾庆宏, 潘艳珍, 等. 规范化胸痛中心建设在急性 ST 段抬高型心肌梗死患者救治中的应用效果. 中国医学创新, 2023, 20(15): 158-161.
34. 向定成. 信息技术支撑区域协同救治体系中胸痛中心的发展方向. 中国数字医学, 2015(9): 2-4.
35. 姜峰林, 许玲. 急性心肌梗死转诊急诊 PCI 中应用微信的 Meta 分析. 中国医学创新, 2018, 15(36): 128-131.
36. De Luca G, Suryapranata H, Ottervanger JP, et al. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: every minute of delay counts. Circulation, 2004, 109(10): 1223-1225.
37. 高润霖. 从急性心肌梗死治疗指南看再灌注治疗策略的选择. 中华心血管病杂志, 2005, 33(11): 1061-1064.
38. 向定成. 中国胸痛中心建设这十年. 疑难病杂志, 2022, 21(10): 1005-1007.
39. 曹俊达, 王琦, 刘海龙, 等. 基于胸痛中心的区域协同救治体系对急性 ST 段抬高型心肌梗死患者救治及预后的影响. 江西医药, 2021, 56(4): 445-447.
40. 汪蒙. 胸痛中心在区域协同救治体系建设中的作用分析. 兰州: 甘肃中医药大学, 2022.
41. Tummala SR, Farshid A. Patients’ understanding of their heart attack and the impact of exposure to a media campaign on pre-hospital time. Heart Lung Circ, 2015, 24(1): 4-10.
42. 熊司琦. 基于 BCW 的健康教育在急性心肌梗死患者中的应用研究. 天津: 天津中医药大学, 2020.

West China Medical Journal

Latest ArticlesSummary of best evidence for treatment and management of acute myocardial infarction under the mode of chest pain center

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