非ST上昇型心筋梗塞の臨床的特徴と長期予後HIJAMIレジストリからの検討

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Background: The onset to revascularizaiton time is longer in non-ST-segment elevation acute myocaridial infarction (NSTEMI) than in ST-segment elevation acute myocardial infarction (STEMI). There are few data comparing NSTEMI with STEMI on their clnical features and progonosis in Japanese clinical settings. Methods: We conducted a multicenter registy study in Japan involving 692 patients with NSTEMI and 2,392 patients with STEMI. Results: Patients of age ≧75 years were more common in NSTEMI group than in STEMI group (41.7 vs 30.4%; p<0.001). The rate of Q wave infarction and maximum serum creatinine kinase value was significantly lower in NSTEMI group than in STEMI group (23.4 vs 77.3%; p<0.001, 1,095 vs 2,462 IU/l p<0.001, respectively). In NSTEMI group, the time from onset to revascularization was significantly prolonged (2.1 vs 1.5hrs; p<0.001). The frequency of left circumflex artery as infarct related artery, left main coronary artery lesions and three vessels disease were more common in NSTEMI group than in STEMI group (32.9 vs 8.4%; p<0.001, 3.0 vs 1.2%; p=0.001,13.4 vs 8.7%; p<0.001, respectively). The incidence of heart failure was 26.1% in NTEMI group and 12.5% in STEMI group (p<0.001). In-hospital death and total death in 4.3 years follow-up were significantly higher in NSTEMI group than in STEMI group (12.7 vs 8.6%; p = 0.002, 34.2 vs 21.1%; p<0.001, respectively). Conclusions: The in-hospital and long-term mortality were significantly high in NSTEMI than those in STEMI. We should reconsider early invasive strategy and long-term management for the patients with non-ST-segment elevation acute coronarv svndromes.
東京女子医科大学の論文

非ST上昇型心筋梗塞の臨床的特徴と長期予後HIJAMIレジストリからの検討

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