Long-term prognosis of patients with acute myocardial infarction: Is mortality and mortidity as low as the incidence of ischemic heart disease in Japan?

Saito, Muneyasu; Fukami, Kenichi; Hiramori, Katsuhiko; Haze, Kazuo; Sumiyoshi, Tetsuya; Kasagi, Humiyoshi; Horibe, Hiroshi

doi:10.1016/0002-8703(87)90049-4

Cited by 48 publications

(16 citation statements)

References 21 publications

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“…Finally, the rates of all-cause and cardiac mortality in the non-CE group (ie, de novo AMI subjects without CE) in this study were much lower than those in Western countries. 36,37 However, a recent large prospective registry study in Japan demonstrated that allcause mortality at 2 years of follow-up was 6.3% in patients with acute coronary syndrome. 38 Our observed mortality rate was consistent with that result.…”

Section: Limitationsmentioning

confidence: 99%

Prevalence, Clinical Features, and Prognosis of Acute Myocardial Infarction Attributable to Coronary Artery Embolism

et al. 2015

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Atrial fibrillation (AF) is associated with a high risk of thromboembolic events, and its prevalence is projected to increase because of population aging. 17 Indeed, the thromboembolic complications of AF are an important cause of morbidity and mortality. The CHADS 2 and CHA 2 DS 2 -VASc scores are useful for thromboembolic risk stratification. 18,19 Background-Coronary artery embolism (CE) is recognized as an important nonatherosclerotic cause of acute myocardial infarction. Its prevalence, clinical features, and prognosis remain insufficiently characterized. Methods and Results-We screened 1776 consecutive patients who presented with de novo acute myocardial infarction between 2001 and 2013. CE was diagnosed based on criteria encompassing histological, angiographic, and other diagnostic imaging findings. The prevalence, clinical characteristics, treatment strategies, in-hospital outcomes, and long-term risk of CE recurrence or major adverse cardiac and cerebrovascular events (cardiac death, fatal arrhythmia, or recurrent thromboembolism) were evaluated. The prevalence of CE was 2.9% (n=52), including 8 (15%) patients with multivessel CE. Atrial fibrillation was the most common cause (n=38, 73%). Only 39% of patients with CE were treated with vitamin K antagonists, and the median international normalized ratio was 1.42 (range, 0.95-1.80). Eighteen of the 30 CE patients with nonvalvular atrial fibrillation had a CHADS 2 score of 0 or 1. When those patients were reevaluated using CHA 2 DS 2 -VASc, 61% were reassigned to a higher risk category. During a median follow-up of 49 months, CE and thromboembolism recurred in 5 atrial fibrillation patients. The 5-year rate of major adverse cardiac and cerebrovascular events was 27.1%. In the propensity score-matched cohorts (n=45 each), Kaplan-Meier analysis showed a significantly higher incidence of cardiac death in the CE group than in the non-CE group (hazard ratio, 9.29; 95% confidence interval, 1.13-76.5; P<0.001). Correspondence to Teruo Noguchi, MD, PhD, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, 565-8565, Japan. E-mail tnoguchi@hsp. The present study was designed to evaluate the prevalence, clinical characteristics, and initial management of CE, and early and late outcomes, as well, in a large consecutive series of patients. We also propose new diagnostic criteria for CE based on histological, angiographic, and other diagnostic imaging findings. Conclusions-Atrial Methods Study Population and PCI ProcedureWe retrospectively analyzed a total of 2135 consecutive patients with AMI from January 2001 to December 2013 in the National Cerebral and Cardiovascular Center AMI database. We excluded 359 patients with a history of previous myocardial infarction (n=241), PCI (n=90), coronary artery bypass grafting (n=18), or both PCI and coronary artery bypass grafting (n=10), resulting in a total of 1776 patients with de novo AMI that were ultimately analyzed in this study (Figure 1). All study patients under...

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Section: Limitationsmentioning

confidence: 99%

Prevalence, Clinical Features, and Prognosis of Acute Myocardial Infarction Attributable to Coronary Artery Embolism

et al. 2015

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“…1 Kaplan-Meier curve for all-cause mortality before propensity score matching. The mortality rate during a mean follow-up period of 4.1 years was 18.9% in the nitrate group and 11.0% in the control group and a lower rate of subsequent cardiac events after the occurrence of myocardial infarction compared with Western patients [14][15][16], so it remains possible that investigation of a larger patient population might have revealed a statistically significant difference [17].…”

Section: Discussionmentioning

confidence: 95%

Long-Term Nitrate Use in Acute Myocardial Infarction (The Heart Institute of Japan, Department of Cardiology Nitrate Evaluation Program)

Takao

Hagiwara

Kasanuki

et al. 2008

Cardiovasc Drugs Ther

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“…Histological basis was given by Maes et al, who found a linear relation between percent fibrosis and MIBI uptake [10]. Considering that Japanese patients have different backgrounds for risk factors and lower cardiac hard event rate, we designed this multi-center cohort study with a larger number of patients [25,26]. Our study showed that sensitivity and specificity of functional recovery by non-gated %uptake were 68% and 64%, and those of ES %uptake were 80% and 52%, showing higher sensitivity of %ES uptake.…”

Section: Precedent Studies On Viability Assessmentmentioning

confidence: 99%

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Nakajima

Tamaki

Kuwabara

et al. 2008

Eur J Nucl Med Mol Imaging

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Backgrounds Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies. Methods A total of 252 patients with recent myocardial infarction (n=74) and old myocardial infarction (n=175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99m Tc-MIBI, and repeated the study after revascularization after an average follow-up period of 132±81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5040 segments. Results Non-gated segmental %uptake and end-systolic (ES) %uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66±17% and 55±18%, p<0.0001 for non-gated, 64±16% and 51±17% for ES %uptake, p<0.0001). The area under the curve (AUC) of receiver-operating characteristics curve (ROC) for non-gated %uptake, ES %uptake, end-diastolic (ED) %uptake and visual perfusion defect score was 0.70, 0.71, 0.61 and 0.56, respectively. Sensitivity and specificity of %uptake were 68% and 64% for non-gated map and 80% and 52% for ES %uptake map. An optimal threshold for predicting segmental improvement was 63% for non-gated and 52% for ES %uptake values. Conclusion Segmental 99m Tc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES %uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study.

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Long-term prognosis of patients with acute myocardial infarction: Is mortality and mortidity as low as the incidence of ischemic heart disease in Japan?

Cited by 48 publications

References 21 publications

Prevalence, Clinical Features, and Prognosis of Acute Myocardial Infarction Attributable to Coronary Artery Embolism

Prevalence, Clinical Features, and Prognosis of Acute Myocardial Infarction Attributable to Coronary Artery Embolism

Long-Term Nitrate Use in Acute Myocardial Infarction (The Heart Institute of Japan, Department of Cardiology Nitrate Evaluation Program)

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

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