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Observational Study
. 2016 Nov;31(11):1740-1751.
doi: 10.1007/s00380-015-0791-9. Epub 2016 Jan 12.

Current characteristics and management of ST elevation and non-ST elevation myocardial infarction in the Tokyo metropolitan area: from the Tokyo CCU network registered cohort

Hideki Miyachi  1   2 , Atsushi Takagi  3 , Katsumi Miyauchi  3 , Masao Yamasaki  3 , Hiroyuki Tanaka  3 , Masatomo Yoshikawa  3 , Mike Saji  3 , Makoto Suzuki  3 , Takeshi Yamamoto  3 , Wataru Shimizu  4 , Ken Nagao  3 , Morimasa Takayama  3
Affiliations
Observational Study

Current characteristics and management of ST elevation and non-ST elevation myocardial infarction in the Tokyo metropolitan area: from the Tokyo CCU network registered cohort

Hideki Miyachi et al. Heart Vessels. 2016 Nov.

Abstract

Limited data exists on ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) managed by a well-organized cardiac care network in a metropolitan area. We analyzed the Tokyo CCU network database in 2009-2010. Of 4329 acute myocardial infarction (AMI) patients including STEMI (n = 3202) and NSTEMI (n = 1127), percutaneous coronary intervention (PCI) was performed in 88.8 % of STEMI and 70.4 % of NSTEMI patients. Mean onset-to-door and door-to-balloon times in STEMI patients were shorter than those in NSTEMI patients (167 vs 233 and 60 vs 145 min, respectively, p < 0.001). Coronary artery bypass graft surgery was performed in 4.2 % of STEMI and 11.4 % of NSTEMI patients. In-hospital mortality was significantly higher in STEMI patients than NSTEMI patients (7.7 vs 5.1 %, p < 0.007). Independent correlates of in-hospital mortality were advanced age, low blood pressure, and high Killip classification, statin-treated dyslipidemia and PCI within 24 h were favorable predictors for STEMI. High Killip classification, high heart rate, and hemodialysis were significant predictors of in-hospital mortality, whereas statin-treated dyslipidemia was the only favorable predictor for NSTEMI. In conclusion, patients with MI received PCI frequently (83.5 %) and promptly (door-to-balloon time; 66 min), and had favorable in-hospital prognosis (in-hospital mortality; 7.0 %). In addition to traditional predictors of in-hospital death, statin-treated dyslipidemia was a favorable predictor of in-hospital mortality for STEMI and NSTEMI patients, whereas hemodialysis was the strongest predictor for NSTEMI patients.

Keywords: In-hospital mortality; Non-ST elevation myocardial infarction; Risk factors; ST elevation myocardial infarction.

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Conflict of interest statement

Compliance with ethical standards All procedures performed in the study involving human participants were in accordance with the ethical standards of each institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Japanese and Tokyo map. This map shows the regional distribution of 67 hospitals participating in Tokyo CCU network
See this image and copyright information in PMC

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