Clinical InvestigationAcute Ischemic Heart DiseaseA large-scale prospective cohort study on the current status of therapeutic modalities for acute myocardial infarction in Japan: Rationale and initial results of the HIJAMI Registry
Section snippets
Study design
The HIJAMI study, the prospective cohort study for Japanese patients with AMI, is being conducted at 17 collaborating institutions in Japan. The present study enrolled all patients who underwent a medical examination within 48 hours after the onset of their myocardial infarction. Acute myocardial infarction was defined when meeting 2 or more of the following conditions11: (1) typical chest pain, (2) an increase in creatine kinase to twice the normal level or greater, and (3) a persisting
Participating medical institutions
Among the 17 participating medical institutions (Table I), 16 have a catheter laboratory and are ready on a 24-hour basis to conduct CAG and PCI. Furthermore, 12 medical institutions are ready to conduct coronary artery bypass grafting (CABG). Between January 1999 and June 2001, 3021 consecutive patients with AMI were registered.
Patient characteristics
The median age of the 3021 patients registered was 69 [59, 77] years. The present study included 851 elderly patients ≥76 years (28.2%) and 2136 (70.7%) men. The number
Discussion
In Japan, because there was an absence of therapeutic guidelines for Japanese patients with AMI, they have been treated based on data obtained from Western countries. This fact involves several issues. One is that the Western subjects of these clinical trials do not necessarily represent the patients treated in clinical practice because they were selected patients who met given criteria.13 Another issue is that the pathogenesis of Japanese patients with AMI is manifested by a greater prevalence
References (31)
- et al.
Analysis of the relative costs and effectiveness of primary angioplasty versus tissue-type plasminogen activator: the Primary Angioplasty in Myocardial Infarction (PAMI) trial
J Am Coll Cardiol
(1997) - et al.
1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
J Am Coll Cardiol
(1999) - et al.
ACC/AHA guidelines for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction
J Am Coll Cardiol
(2000) - et al.
Racial heterogeneity in coronary artery vasomotor reactivity: differences between Japanese and Caucasian patients
J Am Coll Cardiol
(1999) - et al.
Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients
Am J Cardiol
(1967) - et al.
Trends in the incidence of coronary heart disease and stroke and the prevalence of cardiovascular risk factors among Japanese men from 1963 to 1994
Am J Med
(2002) - et al.
Dietary saturated and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries Study
Prev Med
(1995) - et al.
Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Incidence of myocardial infarction and death from coronary heart disease
Am J Cardiol
(1977) - et al.
Temporal trends in the treatment of over 1.5 million patients with myocardial infarction in the US from 1990 through 1999: the National Registry of Myocardial Infarction 1, 2 and 3
J Am Coll Cardiol
(2000) - et al.
Baseline characteristics, management practices, and in-hospital outcomes of patients hospitalized with acute coronary syndromes in the Global Registry of Acute Coronary Events (GRACE)
Am J Cardiol
(2002)
Identification and treatment of complications of myocardial infarction
Mayo Clin Proc
Effects of aspirin and trapidil on cardiovascular events after acute myocardial infarction. Japanese Antiplatelets Myocardial Infarction Study (JAMIS) Investigators
Am J Cardiol
An updated meta-analysis of calcium-channel blockers in the prevention of restenosis after coronary angioplasty
Am Heart J
2002 heart and stroke statistical update
An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction
N Engl J Med
Cited by (47)
Absence of coronary angioscopy-derived in-stent thrombi is associated with major bleeding events in acute myocardial infarction
2021, AtherosclerosisCitation Excerpt :According to epidemiological studies based on regional or hospital data, the number of ST-elevation myocardial infarction (STEMI) patients has increased by four times within the past 30 years in Japan [1]. The prognosis of these patients remains poor, and the 30-day in-hospital mortality rate of acute myocardial infarction (MI) patients has been reported to be approximately 7%–9% [2]. Appropriate administration of antiplatelet therapy to STEMI patients is essential to prevent stent thromboses and a poor prognosis.
Relationships between blood pressure lowering therapy and cardiovascular events in hypertensive patients with coronary artery disease and type 2 diabetes mellitus: The HIJ-CREATE sub-study
2019, Diabetes Research and Clinical PracticeCitation Excerpt :In addition, modest glycemic control may not increase the incidence of adverse events in such a high-risk population. The roles of diabetes and hypertension as risk factors for cardiovascular events are well established [17–19]. A meta-analysis involving more than 1 million individuals without pre-existing cardiovascular disease indicated that deaths from cardiovascular disease increase progressively and linearly with blood pressure [20].
Acute coronary syndrome in the Asia-Pacific region
2016, International Journal of CardiologyCitation Excerpt :Based on personal experience and supportive data, the authors discussed the current status of ACS management in the Asia-Pacific region; identifying key factors and actions that will potentially impact on, or improve, outcomes in this region. Registry-based mortality data across APAC countries was considered in terms of disease status and invasive versus non-invasive intervention (Table 1 and Supplementary Table 1) [21–55]. According to the multinational Global Registry of Acute Coronary Events (GRACE), which studied 43,810 patients from 1999–2005 in 14 countries excluding Africa and Asia [22] large differences exist in management practice both by hospital type and geographic location despite comparable use of antiplatelets and anticoagulants [22].
An international comparison of patients undergoing percutaneous coronary intervention: A collaborative study of the National Cardiovascular Data Registry (NCDR) and Japan Cardiovascular Database-Keio interhospital Cardiovascular Studies (JCD-KiCS)
2015, American Heart JournalCitation Excerpt :Interestingly, better outcomes were observed in elective patients in the United States, whereas an opposite pattern was observed in Japanese patients, with a better outcome for STEMI patients rather than elective patients. It has been previously reported that the risk profile is worse for Japanese patients in both the STEMI and elective groups, largely owing to the higher age, higher prevalence of multivessel disease, and higher proportion of patients presenting with cardiogenic shock.16,17 Of note, there may be some overlap in the risk distributions of the individuals with and without the events.