Abstract 12836: Characteristics of Patients with Acute Myocardial Infarction who Did not Receive Primary Percutaneous Coronary Intervention in Japan -A Report from the Miyagi-AMI Registry Study
Background: Primary percutaneous coronary intervention (PCI) has significantly improved the prognosis of patients with acute myocardial infarction (AMI). Although primary PCI with stents has been widely performed since mid-1990s in Japan, some AMI patients do not undergo the treatment for various reasons. We thus aimed to elucidate the characteristics of AMI patients who did not receive primary PCI.
Methods and Results: The Miyagi-AMI Registry Study is a prospective study where all AMI patients in the Miyagi prefecture (population ~2.35 million) have been registered for 34 years since 1979. Among a total of 8,640 patients with AMI (M/F 6205/2435, mean age 68.9±13.0 [SD] years) registered between 2002 and 2010, 1,879 patients (21.7%) did not receive primary PCI and their in-hospital mortality was significantly higher than those who underwent the treatment (21.4% vs. 6.4%, P≤0.01). Non-performance rate of primary PCI was significantly higher in female than in male patients (28.7% vs. 19.2%, P≤0.01). Multivariate analysis also demonstrated that female gender was significantly associated with non-performance of primary PCI [OR (95% CI); 1.20 (1.04-1.39), P≤0.001], age [OR (95% CI); 1.01 (1.01-1.02), P≤0.001] and co-existing heart failure on admission [OR (95% CI); 2.69 (2.29-3.16), P≤0.001]. When dividing by age, the non-performance rate of primary PCI in female patients showed U-shaped prevalence, whereas it simply increased with age in male patients (Figure). Moreover, the female patients in the 4 younger groups had a significantly higher non-performance rate of primary PCI than in the male patients (Figure).
Conclusions: These results indicate that AMI patients who did not undergo primary PCI had worse in-hospital mortality and were characterized by more female gender (especially in younger age) and more prevalence of heart failure on admission, suggesting the need of emergency care for those populations.
- © 2013 by American Heart Association, Inc.