Chinese Cardiologists Visit UNC Medical Center as Part of AHA Collaboration

A delegation of medical professionals from across China toured Chapel Hill’s emergency department, cardiac catheterization lab and other facilities to learn about UNC’s STEMI system of care.

Chinese Cardiologists Visit UNC Medical Center as Part of AHA Collaboration click to enlarge Chinese cardiologists tour UNC Medical Center

Media Contact: Carleigh Gabryel, 919-864-0580, carleigh.gabryel@unchealth.unc.edu

December 11, 2017

CHAPEL HILL, NC – Time is muscle: a saying used by physicians to express the importance of quick treatment in patients experiencing ST-segment elevation myocardial infarction (STEMI), a very serious type of heart attack that can leave patients with chronic heart failure or send them into sudden cardiac arrest.  Guidelines established by the American Heart Association (AHA) -- including the Mission: Lifeline program -- recommend how a hospital should prepare for treatment of STEMI by developing a complete system of care. Now the AHA is working to implement those same guidelines in China with help from UNC cardiologists.

“For the last several years, the AHA has been engaged with the Chinese Society of Cardiology (CSC) in a variety of quality improvement projects in China,” said Louise Morgan, MSN, and director of international quality improvement for the AHA.

The China National Health and Family Planning Commission (NHFPC) invited the AHA to cooperate with the CSC on a project related to STEMI systems of care. In 2016 the formation of the project, Improving Care for Cardiovascular Disease in China (CCC), allowed the AHA to visit several Chinese hospitals and view their methods of treatment. In return the AHA invited a group of Chinese cardiologists to visit U.S. health care facilities.

“Part of the reason we’re in North Carolina is the state-wide effort of the Regional Approach to Cardiovascular Emergencies (RACE) initiative. And of course UNC’s Dr. Sidney Smith, with his wonderful relationships with the China cardiologists, was instrumental to bringing that China-U.S. connection together,” said Morgan.

Sidney Smith, Jr., MD, UNC professor of medicine and past president of the AHA, has been aiding the AHA in its work with the CSC.

“Hospitalizations from STEMI represent an increasing health burden for China,” he explained. “There are a number of highly effective therapies that can significantly improve outcomes and reduce recurrent events in patients, but adherence to evidence-based guidelines for cardiovascular care that implement these therapies for patients remains incomplete and highly variable.”

The CCC project aims to develop and implement an emergency medical system and hospital-based program to care for heart attack patients in China, where cardiovascular disease accounts for 45 percent of total deaths, as opposed to about 33 percent of deaths in the U.S.

During a visit to the UNC Medical Center Wednesday, about a dozen Chinese cardiologists from hospitals in Tianjin, Jiangsu, Hangzhou, Beijing and Shanghai toured an Orange County EMS ambulance, and toured UNC’s emergency department, helipad and cardiac catheterization lab. They also discussed UNC’s STEMI system of care with multiple UNC representatives.  Jason Katz, MD, associate professor of medicine and medical director of the Cardiac ICU, and Cristie Dangerfield, RN, BSN, and nurse manager of the Cardiac ICU, gave presentations about the management of patients who have been resuscitated from cardiac arrest. Kaitlin Strauss, RN, BSN, and coordinator of the medical center’s Chest Pain Center, explained UNC’s methods of gathering patient data, and noted they could improve that system by learning from Chinese methods, a benefit of the AHA partnership.

“I know that the AHA is working in collaboration with the Chinese Heart Association to enroll more hospitals in national data registries, and I think this work will help drive quality improvement for both patients with acute coronary syndromes, along with a variety of other cardiovascular diagnoses,” said Strauss.

Qinhua Jin, the associate director of the Cardiology Department at the military 301 Hospital in Beijing, also commented on areas she now believes her hospital could improve, starting with patient education.

“In China we have problems with the patient’s recognition of this kind of cardiovascular disease. They have symptoms and come to the hospital many hours later, delaying treatment. Patients also wait to undergo procedures until family members have signed consent forms, again prolonging much needed care,” said Jin.

The group also heard about the UNC Stroke Program from its director David Huang, MD, PhD, professor of medicine, along with Stroke Program Nurse Coordinator Nicole Burnett, RN, BSN. Xuming Dai, MD, PhD, clinical assistant professor of medicine and interventional cardiologist at UNC explained the treatment of patients who experience a STEMI while hospitalized for a different reason. Dai also interpreted the presentations.

After getting a glimpse into STEMI systems of care like UNC’s, the AHA and CSC will work to create similar programs for hospital systems across China.

“I think the group of cardiologists on this tour is starting to realize that there’s true opportunity to make a difference in China,” said Morgan.

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