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. 2018 Jun 14:20:1-6.
doi: 10.1016/j.ijcha.2018.06.003. eCollection 2018 Sep.

Nationwide real-world database of 20,462 patients enrolled in the Japanese Acute Myocardial Infarction Registry (JAMIR): Impact of emergency coronary intervention in a super-aging population

Sunao Kojima  1 , Kensaku Nishihira  2 , Misa Takegami  3 , Yoko M Nakao  3 , Satoshi Honda  2 , Jun Takahashi  4 , Morimasa Takayama  5 , Hiroaki Shimokawa  4 , Tetsuya Sumiyoshi  5 , Hisao Ogawa  2 , Kazuo Kimura  6 , Satoshi Yasuda  2 ; JAMIR Investigators
Affiliations

Nationwide real-world database of 20,462 patients enrolled in the Japanese Acute Myocardial Infarction Registry (JAMIR): Impact of emergency coronary intervention in a super-aging population

Sunao Kojima et al. Int J Cardiol Heart Vasc. .

Abstract

Background: Cardiovascular diseases, including acute myocardial infarction (AMI), are leading causes of death among the Japanese, who have the longest life expectancy in the world. Over the past 50 years in Japan, the percentage of elderly individuals has increased 4-fold, from 5.7% in 1960 to 23.1% in 2010. To explore medical practices and emergency care for AMI in this aging society, the Japan Acute Myocardial Infarction Registry (JAMIR) was established as a nationwide real-world database.

Methods: JAMIR conducted retrospective analysis of 20,462 AMI patients (mean age, 68.8 ± 13.3 years; 15,281 men [74.7%]) hospitalized between January 2011 and December 2013.

Results: The rates of ambulance use and emergency PCI were 78.9% and 87.9%, respectively. The median door-to-balloon time was 80 min (interquartile range, 53-143 min). Overall in-hospital mortality was 8.3%, including 6.6% due to cardiac death. JAMIR included 4837 patients aged ≥80 years (23.6%). In this age group, patients who underwent PCI (79.9%) had significantly lower in-hospital mortality than those who did not (11.1% vs. 36.9%, P < 0.001).

Conclusions: The large JAMIR database, with 24% of AMI patients aged ≥80 years, could provide useful information about medical care in an aging society. The reasonable in-hospital outcomes observed may justify consideration of PCI for patients with AMI aged ≥80 years.

Keywords: Acute myocardial infarction; Aging; Coronary intervention; Registry.

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Figures

Fig. 1
Fig. 1
Distribution of age among male (blue) and female (red) acute myocardial infarction patients In the JAMIR study, 23.6% of patients were aged ≥80 years (n = 4837 [2543 men and 2294 women]). JAMIR, Japan Acute Myocardial infarction Registry.
Fig. 2
Fig. 2
A: Frequency of emergency PCI (left) and in-hospital mortality (right) in patients aged 80–89 years versus ≥ 90 years B: In-hospital mortality in patients aged 80–89 years (left) and ≥ 90 years (right) with and without PCI. PCI, percutaneous coronary intervention.
See this image and copyright information in PMC

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