Management and Two-Year Long-Term Clinical Outcome of Acute Coronary Syndrome in Japan - Prevention of AtherothrombotiC Incidents Following Ischemic Coronary Attack (PACIFIC) Registry
Management and Two-Year Long-Term Clinical Outcome of Acute Coronary Syndrome in Japan - Prevention of AtherothrombotiC Incidents Following Ischemic Coronary Attack (PACIFIC) Registry
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DOI：
10.1253/circj.cj-13-0174
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发表时间：
2013-04-01
影响因子：
3.3
通讯作者：
Isshiki, Takaaki
中科院分区：
文献类型：
--
作者：
Daida, Hiroyuki;Miyauchi, Katsumi;Isshiki, Takaaki
背景：与西方国家相比，日本患者心血管事件的风险较低，但有关日本患者当前治疗状态和急性冠脉综合征（ACS）后随后动脉粥样硬化血栓事件发生率的数据有限。本研究的目的是阐明日本 ACS 患者的治疗状况和长期结果。方法和结果：缺血性冠状动脉发作后动脉粥样硬化事件的预防 (PACIFIC) 登记是一项针对日本 ACS 患者的多中心、前瞻性观察性研究。连续招募了 96 家医院年龄≥20 岁因 ACS 住院的患者并随访 2 年（n=3,597）。 ST 段抬高型心肌梗死 (STEMI) 是最常见的 ACS 类型 (59.4%)。绝大多数（93.5%）患者接受了经皮冠状动脉介入治疗（PCI），成功率为93.9%。还指出经常使用指南推荐的药物治疗。主要不良心脑血管事件 (MACCE) 的累积发生率为 6.4%（STEMI 为 7.5%，非 STEMI 或不稳定型心绞痛为 4.8%），全因死亡率为 6.3%。结论：PACIFIC 登记处发现日本 ACS 患者在 2 年随访中 MACCE 发生率为 6.4%，死亡率为 6.3%。接受PCI的患者比例高，PCI成功率高。积极主动地进行成功的 PCI 被认为有助于这些患者获得良好的预后。 （Circ J 2013；77：934-943）
Background: Japanese patients have been at low risk for cardiovascular events compared with Western countries, but the data regarding current treatment status and rate of subsequent atherothrombotic events after acute coronary syndrome (ACS) are limited in Japanese patients. The objective of this study was to clarify the treatment status and long-term outcomes in Japanese ACS patients.Methods and Results: The Prevention of AtherothrombotiC Incidents Following Ischemic Coronary attack (PACIFIC) registry is a multicenter, prospective observational study of Japanese ACS patients. Consecutive patients aged >= 20 years hospitalized for ACS were enrolled from 96 hospitals and followed up for 2 years (n=3,597). ST-segment elevation myocardial infarction (STEMI) was the most frequent type of ACS (59.4%). The vast majority (93.5%) of patients underwent percutaneous coronary intervention (PCI), with a success rate of 93.9%. Frequent use of guideline-recommended pharmacological treatments was also indicated. Cumulative incidence of major adverse cardiac and cerebrovascular events (MACCE) was 6.4% (7.5% for STEMI and 4.8% for non-STEMI or unstable angina), and all-cause mortality was 6.3%.Conclusions: The PACIFIC registry has identified an incidence of MACCE of 6.4% and that of mortality at 6.3% in Japanese ACS patients at 2-year follow-up. A high proportion of patients underwent PCI, and the PCI success rate was high. Proactively performed successful PCI was considered to have contributed to favorable outcomes in these patients. (Circ J 2013; 77: 934-943)