The China Patient-Centered Evaluative Assessment of Cardiac Events (China PEACE) retrospective study of acute myocardial infarction: study design

Abstract

Background: Cardiovascular diseases are rising as a cause of death and disability in China. To improve outcomes for patients with these conditions, the Chinese government, academic researchers, clinicians, and >200 hospitals have created China Patient-Centered Evaluative Assessment of Cardiac Events (China PEACE), a national network for research and performance improvement. The first study from China PEACE, the Retrospective Study of Acute Myocardial Infarction (China PEACE-Retrospective AMI Study), is designed to promote improvements in acute myocardial infarction (AMI) quality of care by generating knowledge about the characteristics, treatments, and outcomes of patients hospitalized with AMI across a representative sample of Chinese hospitals during the past decade.

Methods and results: The China PEACE-Retrospective AMI Study will examine >18 000 patient records from 162 hospitals identified using a 2-stage cluster sampling design within economic-geographic regions. Records were chosen from 2001, 2006, and 2011 to identify temporal trends. Data quality will be monitored by a central coordinating center and will, in particular, address case ascertainment, data abstraction, and data management. Analyses will examine patient characteristics, diagnostic testing patterns, in-hospital treatments, in-hospital outcomes, and variation in results by time and site of care. In addition to publications, data will be shared with participating hospitals and the Chinese government to develop strategies to promote quality improvement.

Conclusions: The China PEACE-Retrospective AMI Study is the first to leverage the China PEACE platform to better understand AMI across representative sites of care and during the past decade in China. The China PEACE collaboration among government, academicians, clinicians, and hospitals is poised to translate research about trends and patterns of AMI practices and outcomes into improved care for patients.

Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01624883.

Keywords: epidemiology; morbidity; mortality; myocardial infarction.

Conflict of interest statement

Disclosures. There are no relevant conflicts of interest

Figures

Figure 1

The China PEACE Initiative. Key partners include the Chinese government, collaborating hospitals, the China National Center for Cardiovascular Disease, and the Yale-New Haven Hospital Center for Outcomes Research and Evaluation. The China PEACE-Retrospective AMI Study is 1 of 5 initial studies from the China PEACE initiative. The topic areas for these 5 projects concern acute myocardial infarction, coronary catheterization/percutaneous coronary intervention, and multi-vessel coronary artery disease. Future studies will focus on cerebrovascular disease and other cardiovascular conditions. AMI, acute myocardial infarction; PCI, percutaneous coronary intervention. 3VD, Revascularization in Patients with Triple-vessel Disease Figure 2.

Figure 2

China PEACE Retrospective Study of Acute Myocardial Infarction Flow Chart and Associated Quality Assurance Strategies. Flow chart should be read from top to bottom. NCCD, China National Center for Cardiovascular Diseases; CRF, case report form; Q&A, questions and answers.

Figure 3

Geographic Distribution of Participating Hospitals in the China PEACE Retrospective Study of Acute Myocardial Infarction. Of 175 sampled hospitals, 13 were unable or unwilling to participate and 162 provided cases for the China PEACE-Retrospective AMI Study.