Faculty Information |
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Article types | Original article |
Language | English |
Refereed paper | Refereed |
Title | Long-term outcomes of non-ST-elevation myocardial infarction without creatine kinase elevation - the J-MINUET Study. |
Journal | Formal name:Circulation journal : official journal of the Japanese Circulation Society Abbreviation:Circ J ISSN code:1347-4820(Electronic)1346-9843(Linking) |
Domestic / Foregin | Domestic |
Volume, Number, Page | 81(7),pp.958-965 |
Papers・Author | Ishihara Masaharu, Nakao Koichi, Ozaki Yukio, Kimura Kazuo, Ako Junya, Noguchi Teruo, Fujino Masashi, Yasuda Satoshi, Suwa Satoru, Fujimoto Kazuteru, Nakama Yasuharu, Morita Takashi, Shimizu Wataru, Saito Yoshihiko, Hirohata Atsushi, Morita Yasuhiro, Inoue Teruo, Okamura Atsunori, Uematsu Masaaki, Hirata Kazuhito, Tanabe Kengo, Shibata Yoshisato, Owa Mafumi, Tsujita Kenichi, Funayama Hiroshi, Kokubu Nobuaki, Kozuma Ken, Tobaru Tetsuya, Oshima Shigeru, Nakai Michikazu, Nishimura Kunihiro, Miyamoto Yoshihiro, Ogawa Hisao |
Publication date | 2017/06 |
Papers・Description | BACKGROUND:According to troponin-based criteria of myocardial infarction (MI), patients without elevation of creatine kinase (CK), formerly classified as unstable angina (UA), are now diagnosed as non-ST-elevation MI (NSTEMI), but little is known about their outcomes.Methods and Results:Between July 2012 and March 2014, 3,283 consecutive patients with MI were enrolled. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure and urgent revascularization for UA. There were 2,262 patients with ST-elevation MI (STEMI), 563 NSTEMI with CK elevation (NSTEMI+CK) and 458 NSTEMI without CK elevation (NSTEMI-CK). From day 0, Kaplan-Meier curves for the primary endpoint began to diverge in favor of NSTEMI-CK for up to 30 days. The 30-day event rate was significantly lower in patients with NSTEMI-CK (3.3%) than in STEMI (8.6%, P<0.001) and NSTEMI+CK (9.9%, P<0.001). Later, the event curves diverged in favor of STEMI. The event rate from 31 days to 3 years was significantly lower in patients with STEMI (19.8%) than in NSTEMI+CK (33.6%, P<0.001) and NSTEMI-CK (34.2%, P<0.001). Kaplan-Meier curves from 31 days to 3 years were almost identical between NSTEMI+CK and NSTEMI-CK (P=0.91).CONCLUSIONS:Despite smaller infarct size and better short-term outcomes, long-term outcomes of NSTEMI-CK after convalescence were as poor as those for NSTEMI+CK and worse than for STEMI. |
DOI | 10.1253/circj.CJ-17-0033 |
PMID | 28320999 |