Current management of acute myocardial infarction: Experience from the Korea Acute Myocardial Infarction Registry

Sim, Doo Sun; Jeong, Myung Ho; Kang, Jung Chaee

doi:10.1016/j.jjcc.2010.04.002

Cited by 34 publications

(23 citation statements)

References 73 publications

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“…14,15) Also, in the KAMIR, 12-month mortality was similar in both STE-MI and NSTEMI patients. 16) How about the prognosis in NSTEMI patients with TO of the culprit artery? Should NSTEMI patients with TO in the IRA be considered STEMIequivalents?…”

Section: Discussionmentioning

confidence: 99%

Impact of Total Occlusion of an Infarct-Related Artery on Long-Term Mortality in Acute Non-ST-Elevation Myocardial Infarction Patients Who Underwent Early Percutaneous Coronary Intervention

et al. 2012

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SummarySome patients with non-ST-elevation myocardial infarction (NSTEMI) have a total occlusive infarct-related artery. However, the long-term prognosis of these patients is uncertain, particularly for those who underwent an early invasive strategy.The aim of this study was to determine the clinical impact of total occlusion (TO) of an infarct-related artery (IRA) in these patients.A total of 2,094 patients with NSTEMI who underwent an early invasive strategy with percutaneous coronary intervention (PCI) in the Korea Acute MI Registry (KAMIR) were analyzed (TO group; 665 patients, and non-TO group; 1,429 patients).In-hospital and one-year clinical outcomes were compared between the two groups. The left circumflex (42.9%) and right coronary artery (31.9%) were the major IRA in the TO group, while the left anterior descending artery was more common as an IRA in the non-TO group (44.1%). In-hospital complications including death and cardiogenic shock occurred frequently in the TO group. Also, the rates of one-month and 12-month adverse cardiac outcomes were higher in the TO group. In the Cox-proportional hazard model, TO in IRA predicted 12-month all-cause death.In conclusion, NSTEMI patients with TO in IRA showed worse short-and long-term clinical outcomes compared with those of non-TO patients. (Int Heart J 2012; 53: 160-164) Key words: Non-ST-elevation myocardial infarction, Total occlusion, Percutaneous coronary intervention A mong patients with acute myocardial infarction (AMI), non-ST-elevation MI (NSTEMI) is a heterogenous group in aspects of diagnosis, treatment, and timing of percutaneous coronary intervention (PCI). It is difficult to decide the optimal timing of PCI in patients with NSTEMI because of various clinical settings. However, an early invasive strategy with PCI gives better clinical and angiographic results in high risk patients with NSTEMI than conservative management or late PCI. 1,2) Generally, more than 50% of patients diagnosed as STE-MI are known to have total occlusion (TO) of an infarct-related artery (IRA).2) However, it is difficult to predict TO in patients with NSTEMI. One study regarding this issue revealed that the probability of TO in patients with NSTEMI was proportional to the time from symptoms to the diagnostic coronary angiogram.3) This finding is perhaps associated with a progression of nonocclusion to occlusion in IRA with time. In 2 recent studies, the proportion of TO of culprit artery in patients with NSTEMI was about one quarter, and TO was associated with larger infarcts and worse clinical outcomes. 4,5) Therefore, we assessed the clinical characteristics, angiographic findings, and long-term clinical outcomes in patients with NSTEMI having TO of the culprit artery in the largescaled Korea AMI Registry (KAMIR), which should provide valuable information about this issue. MethodsStudy design and populations: A total of 2,094 patients in the KAMIR from November 2005 to January 2008 were included in the present study. The KAMIR is a prospective, observational, multicente...

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Section: Discussionmentioning

confidence: 99%

Impact of Total Occlusion of an Infarct-Related Artery on Long-Term Mortality in Acute Non-ST-Elevation Myocardial Infarction Patients Who Underwent Early Percutaneous Coronary Intervention

et al. 2012

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“…9,10 In brief, the Korea Acute Myocardial Infarction Registry and the Korea Working Group on Myocardial Infarction registry were established in November 2005, with support from the Korean Society of Cardiology, for prospective, open, observational, multicenter studies of AMI, including assessment of clinical outcomes. Fifty-five cardiac centers in Korea participated in establishing the database.…”

Section: Methodsmentioning

confidence: 99%

Influence of Second- and Third-Degree Heart Block on 30-Day Outcome Following Acute Myocardial Infarction in the Drug-Eluting Stent Era

Kim

Seo

et al. 2014

The American Journal of Cardiology

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“…The registry included 52 community and university hospitals capable of primary PCI with one-year clinical follow up. Data was collected at each site by a well-trained study coordinator based on a standardized protocol 6-8)…”

Section: Methodsmentioning

confidence: 99%

Prognostic Impact of Baseline High-Sensitivity C-Reactive Protein in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Based on Body Mass Index

et al. 2012

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Background and ObjectivesSerum high sensitivity C-reactive protein (hs-CRP) is a marker of inflammation and may lead to the development of atherosclerosis, adversely affecting mortality. The aim of this study was to evaluate the relationship between baseline hs-CRP level and 12-month clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) according to their body mass index (BMI) status.Subjects and MethodsUsing data from the Korea Acute Myocardial Infarction Registry from November 2005 to September 2008, a total of 8174 consecutive AMI patients were studied. Cox proportional hazard model revealed that higher baseline levels of hs-CRP was associated with 12-month all-cause mortality (p=0.045). To further understand this association, patients were divided into 3 groups based on their body mass index: 1) overweight/obese, 2) normal weight, and 3) underweight patients. Then each group was stratified into quartiles based on their hs-CRP.ResultsIn overweight/obese patients, Cox model showed significant association of hs-CRP with 12-month mortality when adjusted for age and gender (p<0.001), however, after adjustment with multiple covariates, mortality was highest in the 4th quartile {HR 2.382, (1.079-5.259), p=0.032} though statistically insignificant (p=0.172). We observed no significant association of serum hs-CRP with 12-month mortality in normal weight (p=0.681) and underweight (p=0.760) patients.ConclusionHigher baseline hs-CRP level (≥4.08 mg/dL) in overweight/obese AMI patients showed significant association with 12-month all-cause mortality independent of other prognostic markers.

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Current management of acute myocardial infarction: Experience from the Korea Acute Myocardial Infarction Registry

Cited by 34 publications

References 73 publications

Impact of Total Occlusion of an Infarct-Related Artery on Long-Term Mortality in Acute Non-ST-Elevation Myocardial Infarction Patients Who Underwent Early Percutaneous Coronary Intervention

Impact of Total Occlusion of an Infarct-Related Artery on Long-Term Mortality in Acute Non-ST-Elevation Myocardial Infarction Patients Who Underwent Early Percutaneous Coronary Intervention

Influence of Second- and Third-Degree Heart Block on 30-Day Outcome Following Acute Myocardial Infarction in the Drug-Eluting Stent Era

Prognostic Impact of Baseline High-Sensitivity C-Reactive Protein in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention Based on Body Mass Index

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