Comparison of the efficacy of reperfusion therapies for early mortality from acute myocardial infarction in Japan: Registry of Miyagi Study Group for AMI (MsAMI)

Katsuhiko Sakurai, Jun Watanabe, Kaoru Iwabuchi, Yoshito Koseki, Yuji Kon-no, Mitsumasa Fukuchi, Tatsuya Komaru, Tsuyoshi Shinozaki, Masahito Miura, Masahito Sakuma, Yutaka Kagaya, Shigenori Kitaoka, Kunio Shirato

Research output: Contribution to journalArticlepeer-review

45 Citations (Scopus)

Abstract

The current reperfusion strategy in Japan for acute myocardial infarction (AMI) is that the majority of early arrival patients are treated with primary percutaneous coronary intervention (PCI). However, the efficacy of primary PCI, intravenous thrombolysis (IV-T), intracoronary thrombolysis (IC-T) and rescue PCI has not been compared in the clinical situation. In the present study, 3,258 cases of AMI in 1992-2000 from the data base of the Miyagi Study Group for AMI were analyzed. These patients were hospitalized within 6h of the onset of symptoms. IV-T and IC-T were initially performed in 120 and 441 patients, respectively, and 41 and 199 rescue PCI procedures, respectively, were needed. Primary PCI was performed in 1,822 cases, and no reperfusion therapy was done in 875 patients. The crude 30-day in-hospital mortality was 12.7% for IV-T, 3.7% for IC-T, 4.8% for primary PCI, 7.9% for rescue PCI, and 14.1% in patients who did not undergo reperfusion therapy. The covariate-adjusted odds ratio (95% confidence interval) was 0.38 (0.28-0.52) for primary PCI, 0.30 (0.15-0.60) for IC-T, 1.04 (0.51-2.10) for IV-T and 0.77 (0.46-1.30) for rescue PCI. The present data verify that primary PCI is superior to other reperfusion strategies in the real clinical situation and justifies the current unique strategy of reperfusion therapy for AMI used in Japan.

Original languageEnglish
Pages (from-to)209-214
Number of pages6
JournalCirculation Journal
Volume67
Issue number3
DOIs
Publication statusPublished - 2003 Mar 1

Keywords

  • Acute myocardial infarction
  • In-hospital mortality
  • Primary percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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