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Current treatment of ST elevation acute myocardial infarction in Japan: door-to-balloon time and total ischemic time from the J-AMI registry

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An Erratum to this article was published on 15 June 2013

Abstract

The door-to-balloon time and total ischemic time are important predictors of the outcome in patients with ST elevation myocardial infarction (STEMI) receiving primary angioplasty, but the current situation in Japan is unknown. The Japan Acute Myocardial Infarction registry is a prospective observational study of 2,030 consecutive STEMI patients admitted to 213 Japanese institutions. The time from symptom onset to hospital arrival, door-to-balloon time, and in-hospital outcome were assessed. Data were compared between patients treated during regular hours or after hours. Percutaneous coronary angioplasty was done in 97.2 % of the patients, using drug-eluting stents in 30 % and bare metal stents in 63 % of the treated cases. The median symptom onset-to-door time (25th and 75th percentiles) was 135 min (64–305 min), median door-to-balloon time was 42 min (28–66 min), and mean procedural time was 98 ± 51 min. The on-call catheterization team performed 48.5 % of the procedures. There was no significant difference of door-to-balloon time between the patients treated after hours and those treated during regular hours. The cardiac mortality rate was 3.2 %, and it increased with longer door-to-balloon times (P = 0.03). The relationship between total ischemic time and cardiac mortality showed 2 peaks, with a trough at 5 h. Median door-to-balloon time was <90 min and was not longer in after hours cases. These findings suggest that Japanese institutions can provide primary angioplasty within an acceptable time frame.

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Acknowledgments

This study was supported by Sanofi-Aventis, and was coordinated by the Japanese Society of Cardiovascular Intervention and Therapeutics. The authors were solely responsible for the design and conduct of this study, for all analyses, for drafting and editing the manuscript, and for the final contents.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Ohashi Medical Center, Toho University, Tokyo, Japan

    Masato Nakamura

  2. Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan

    Masakazu Yamagishi

  3. Center of Cardiovascular Medicine, Kurume University Hospital, Kurume, Japan

    Takafumi Ueno

  4. Division of Cardiovascular Medicine, Mitsui Memorial Hospital, Tokyo, Japan

    Kazuhiro Hara

  5. Division of Cardiology, Cardiovascular Center, Toranomon Hospital, Tokyo, Japan

    Sugao Ishiwata

  6. Division of Cardiology, Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Morioka, Japan

    Tomonori Itoh

  7. Rakuwakai Marutamachi Hospital, Rakuwakai Kyoto Cardiovascular Intervention Center, Kyoto, Japan

    Ichiro Hamanaka

  8. Department of Cardiovascular Medicine, Institute of Health Biosciences, University of Tokushima, Tokushima, Japan

    Tetuszo Wakatsuki

  9. Department of Cardiology, Yokohama City University Hospital, Yokohama, Japan

    Teruyasu Sugano

  10. Department of Cardiovascular Medicine, Chikamori Hospital, Kochi, Japan

    Kazuya Kawai

  11. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Takeshi Kimura

  12. Department of Cardiovascular Medicine, Ohashi Medical Center, Toho University School of Medicine, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan

    Masato Nakamura

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  1. Masato Nakamura
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  2. Masakazu Yamagishi
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  3. Takafumi Ueno
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  4. Kazuhiro Hara
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  8. Tetuszo Wakatsuki
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  9. Teruyasu Sugano
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  10. Kazuya Kawai
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  11. Takeshi Kimura
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Correspondence to Masato Nakamura.

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For the Japanese Acute Myocardial Infarction (J-AMI) registry.

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Nakamura, M., Yamagishi, M., Ueno, T. et al. Current treatment of ST elevation acute myocardial infarction in Japan: door-to-balloon time and total ischemic time from the J-AMI registry. Cardiovasc Interv and Ther 28, 30–36 (2013). https://doi.org/10.1007/s12928-012-0128-x

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  • DOI: https://doi.org/10.1007/s12928-012-0128-x

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