A Multi-Center Prospective Registration and Cohort Study on Prognosis and Predictors of Acute Myocardial Infarction in Japan.

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The advances in the treatment techniques have contributed to improving prognosis of acute myocardial infarction (AMI), however, clinical evidence are limited in Asia including Japan about medical practice patterns as well as other factors influencing AMI prognosis and their effect on the actual health outcome. This study aims to examine the factors influencing prognosis with special reference to QOL after AMI, and to carry out an economic evaluation of the treatment outcome.This is a multi-center prospective cohort study. Subjects are 20-to-79 year-old patients with (first or recurrent) AMI who visit one of the university hospitals in collaboration as follows : Iwate Medical University, Kitasato University, Nippon Medical University, Tokyo Medical University, Osaka City University. An online registry system provided by the University Medical Information Network (UMIN) will be used to register those patients giving written consent and willing to participate in this study. An officially approved independent personal information center will be set up in order to guarantee privacy protection all along the follow-up survey. The main outcome measures are QOL evaluated by SF-36 and EQ5D six months after discharge from hospital. Records of the incidence of serious vascular events (such as recurrent coronary events and cerebrovascular accidents) as well as of deaths that result from such events occurring within a year of discharge will be filed.Finally, 331 cases (men : 289, women : 42) participated in this study for a period of two years and subsequently were followed up for one year after discharge from hospital. Within the follow up period, 7 cases readmitted the hospital and 6 cases died. Overall follow-up rate was over 80%. The database, which was developed for the cohort study, is available for the future analysis of predictors of clinical outcomes including subjective QOL. Multivariate analyses such as Cox regression analysis will be applied for the data set.