Comparison of Incidence, Mortality and Treatment of Acute Myocardial Infarction in Hospitals in Japan and China
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概要
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Acute myocardial infarction (AMI) is one of the most intractable diseases and is increasing rapidly in Japan and China. Two hospitals in Japan and China, the Critical Care Center of Kurume University Hospital and the Chinese Beijing 309 Hospital in China (abbreviated to Beijing 309 Hospital) were compared. The incidence, mortality and treatment of AMI were investigated in both hospitals from 1989 to 1991. The incidence of AMI for all patients admitted during the three years was 5% in Kurume University Hospital and 4.7% in Beijing 309 Hospital, which are similar rates. The average age of the patients in Beijing 309 Hospital was younger (58±13) than in Kurume University Hospital (64±11). The mortality rate in Kurume University Hospital was slightly lower than the rate in Beijing 309 Hospital (8.1% vs 8.9%). Thrombolytic therapy was actively performed in both hospitals. In Kurume University Hospital, urokinase (UK: 71.4%) or recombinant tissue plasminogen activator (rt-PA: 28.6%) was administered by intravenous (85.7%) and intracoronary percutaneous transluminal coronary recanalization (PTCR: 14.3%) injection. In Beijing 309 Hospital, UK (32.7%) or snake poison enzyme (SPE: 62.3%) was administered by intravenous (85.8%) or intra-aortic (14.2%) injection. Rt-PA was only used in Japan and SPE was only used in China, but both had very strong fibrinolytic effects and resulted in high success rates of coronary reperfusion. The incidence of direct coronary intervention with percutaneous transluminal coronary angioplasty (PTCA) and intra-aortic balloon pumping (IABP) for cardiogenic shock was much higher at Kurume University Hospital than at Beijing 309 Hospital. Though there were no differences in the use of coronary dilators, antiarrhythmics, analgesics and catecholamines in the two hospitals, Chinese herbal medicine was used in the Beijing 309 Hospital. In conclusion, the incidence of AMI was similar at both hospitals and the mortality rate was slightly lower at Kurume University Hospital than at Beijing 309 Hospital. Coupling the advanced technology applied in Japan and the Chinese herbal medicines used in China may advance the treatment of AMI.