Why the study?
How do primary PCI rates and mortality for AMI patients compare between Japan and other countries?
How do primary PCI rates and mortality for AMI patients compare between Japan and other countries?
Japan has significantly higher rates of primary PCI for AMI, even in low-volume hospitals, compared to other regions worldwide, while maintaining comparable mortality rates.
High primary PCI rates in low-volume Japanese hospitals were associated with similar AMI mortality; leaves open optimal volume thresholds elsewhere.
BACKGROUND: Primary percutaneous coronary intervention (PCI) is at present the most effective procedure for reducing the mortality rate of patients with acute myocardial infarction (AMI). However, there is a great difference between Japan and other countries in the rate of primary PCI. METHODS AND RESULTS: Registration period, number of patients with AMI, rates of primary PCI or thrombolysis and in-hospital or 30-day mortality rates were analyzed in 3 Japanese, 4 European, 4 American and 2 world-wide databases of AMI. The primary PCI rate is higher (75-94%) in Japan than in the other countries (5.5-49.6%), particularly in low-volume hospitals, and the mortality rates at these centers were similar to those in high-volume hospitals (approximately 4-10%). The primary PCI rate has recently been rising (25-50%) worldwide and most PCI procedures are performed in large-volume centers, except in Japan. CONCLUSIONS: Comparison of the AMI databases suggest there is a relationship between the primary PCI rate and annual PCI caseload in each country. It is interesting that in Japan even low-volume PCI hospitals have comparable numbers of primary PCI cases.
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Ui et al. (2004) studied this question.
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