Differences in the Korea Acute Myocardial Infarction Registry Compared with Western Registries

Abstract

The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry that reflects current therapeutic approaches and acute myocardial infarction (AMI) management in Korea. The results of the KAMIR demonstrated different risk factors and responses to medical and interventional treatments. The results indicated that the incidence of ST-elevation myocardial infarction (STEMI) was relatively high, and that the prevalence of dyslipidemia was relatively low with higher triglyceride and lower high-density lipoprotein cholesterol levels. Percutaneous coronary intervention (PCI) rates were high for both STEMI and non-ST-elevation myocardial infarction (NSTEMI) with higher use of drug-eluting stents (DESs). DES were effective and safe without increased risk of stent thrombosis in Korean AMI patients. Triple antiplatelet therapy, consisting of aspirin, clopidogrel, and cilostazol, was effective in preventing adverse clinical outcomes after PCI. Statin therapy was effective in Korean AMI patients, including those with very low levels of low-density lipoprotein cholesterol and those with cardiogenic shock. The KAMIR score had a greater predictive value than Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) scores for long-term mortality in AMI patients. Based on these results, the KAMIR will be instrumental for establishing new therapeutic strategies and effective methods for secondary prevention of AMI and guidelines for Asian patients.

Keywords: Hydroxymethylglutaryl-CoA reductase inhibitors; Myocardial infarction; Percutaneous coronary intervention; Risk factors.

Figure 1

(A) Annual incidence rates of STEMI and NSTEMI from 2006 to 2013. (B) Annual in-hospital mortality rates of STEMI and NSTEMI from 2006 to 2013. NSTEMI = non-ST-elevation myocardial infarction; STEMI = ST-elevation myocardial infarction.

Figure 2

(A) A new risk score for predicting 1-year death from AMI. (B) Receiver operator characteristic curves for 1-year mortality in patients with AMI. AMI = acute myocardial infarction; GRACE = Global Registry of Acute Coronary Events; LVEF = left ventricular ejection fraction; PCI = percutaneous coronary intervention.