January 1, 2002Circulation JournalOpen Access

Fifteen-Year Trend in the Treatment and Outcome of Acute Myocardial Infarction in Japan

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Why the study?

Does the evolution of reperfusion therapy strategies over a 15-year period improve clinical outcomes in patients with acute myocardial infarction?

Population

1,437 patients with acute myocardial infarction who underwent emergency coronary angiography within 24h of…

Comparison

Evolution of reperfusion therapy over time… vs Historical comparison across three time periods.

Design

Cohort

Follow-up

1 year

Authors

MIMasaharu IshiharaInterventional Cardiology IIIchiro InoueWako University TKTakuji KawagoeInterventional Cardiology

Discussion

Member takes

Implication

Warrants continued reperfusion optimization in AMI; extends Level 3 observations but leaves causal effects of stenting open.

Structured PICO

Does the evolution of reperfusion therapy strategies over a 15-year period improve clinical outcomes in patients with acute myocardial infarction?

Population

1,437 patients with acute myocardial infarction (AMI) who underwent emergency coronary angiography within 24h of the onset of chest pain at a single center in Japan between 1985 and 1999. Divided into 3 chronological groups: group 1 (1985-89, n=439), group 2 (1990-94, n=453), and group 3 (1995-99, n=545).

Intervention

Evolution of reperfusion therapy over time, shifting from predominantly conventional balloon angioplasty and thrombolysis (1985-1994) to predominantly coronary stenting (1995-1999).

Comparator

Historical comparison across three time periods (Group 1: 1985-1989, Group 2: 1990-1994, Group 3: 1995-1999).

Outcome

Achievement of TIMI grade 3 flow, incidence of reinfarction, and in-hospital mortality.hard clinical

The shift toward coronary stenting as the primary reperfusion strategy for acute myocardial infarction over a 15-year period was associated with higher rates of successful reperfusion and a 50% reduction in in-hospital mortality.

Limitations

Improvements in adjunctive therapy (e.g., intra-aortic balloon pumping, aspirin) were not assessed and may confound the results

Cite This Study

Ishihara et al. (2002) studied this question.

synapsesocial.com/papers/6a76faf4137c7dcc81bd868e https://doi.org/10.1253/circj.66.178

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Fifteen-Year Trend in the Treatment and Outcome of Acute Myocardial Infarction in Japan

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Fifteen-Year Trend in the Treatment and Outcome of Acute Myocardial Infarction in Japan

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider