Nationwide real-world database of 20,462 patients enrolled in the Japanese Acute Myocardial Infarction Registry (JAMIR): Impact of emergency coronary intervention in a super-aging population.
Nationwide real-world database of 20,462 patients enrolled in the Japanese Acute Myocardial Infarction Registry (JAMIR): Impact of emergency coronary intervention in a super-aging population.
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DOI：
10.1016/j.ijcha.2018.06.003
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发表时间：
2018-09
期刊：
影响因子：
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通讯作者：
JAMIR Investigators
中科院分区：
文献类型：
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作者：
Kojima S;Nishihira K;Takegami M;Nakao YM;Honda S;Takahashi J;Takayama M;Shimokawa H;Sumiyoshi T;Ogawa H;Kimura K;Yasuda S;JAMIR Investigators
心血管疾病，包括急性心肌梗死（AMI），是日本人的主要死亡原因，日本人的预期寿命是世界上最长的。在过去的50年里，日本的老年人比例增加了4倍，从1960年的5.7%增加到2010年的23.1%。为了探索老龄化社会中AMI的医疗实践和紧急护理，日本急性心肌梗死登记处（JAMIR）被建立为全国性的真实世界数据库。JAMIR对2011年1月至2013年12月期间住院的20，462例AMI患者（平均年龄68.8 ± 13.3岁; 15，281例男性[74.7%]）进行了回顾性分析。救护车使用率和急诊PCI率分别为78.9%和87.9%。中位入院至球囊扩张时间为80分钟（四分位距，53-143分钟）。总体住院死亡率为8.3%，包括6.6%的心源性死亡。JAMIR纳入了4837例年龄≥80岁的患者（23.6%）。在该年龄组中，接受PCI的患者（79.9%）的住院死亡率显著低于未接受PCI的患者（11.1% vs.36.9%，P < 0.001）。大型JAMIR数据库中有24%的AMI患者年龄≥80岁，可以提供有关老龄化社会医疗保健的有用信息。观察到的合理住院结局可能证明年龄≥80岁的AMI患者考虑PCI是合理的。
Cardiovascular diseases, including acute myocardial infarction (AMI), are leading causes of death among the Japanese, who have the longest life expectancy in the world. Over the past 50 years in Japan, the percentage of elderly individuals has increased 4-fold, from 5.7% in 1960 to 23.1% in 2010. To explore medical practices and emergency care for AMI in this aging society, the Japan Acute Myocardial Infarction Registry (JAMIR) was established as a nationwide real-world database. JAMIR conducted retrospective analysis of 20,462 AMI patients (mean age, 68.8 ± 13.3 years; 15,281 men [74.7%]) hospitalized between January 2011 and December 2013. The rates of ambulance use and emergency PCI were 78.9% and 87.9%, respectively. The median door-to-balloon time was 80 min (interquartile range, 53–143 min). Overall in-hospital mortality was 8.3%, including 6.6% due to cardiac death. JAMIR included 4837 patients aged ≥80 years (23.6%). In this age group, patients who underwent PCI (79.9%) had significantly lower in-hospital mortality than those who did not (11.1% vs. 36.9%, P < 0.001). The large JAMIR database, with 24% of AMI patients aged ≥80 years, could provide useful information about medical care in an aging society. The reasonable in-hospital outcomes observed may justify consideration of PCI for patients with AMI aged ≥80 years.