Abstract 12203: Clinical Characteristics of Patients With Acute Myocardial Infarction Who Did Not Receive Primary Percutaneous Coronary Intervention in Japan -Report From the Miyagi-AMI Registry Study
Background: In the current primary percutaneous coronary intervention (PCI) era, some patients in acute myocardial infarction (AMI) still do not undergo primary PCI in Japan. We thus aimed to elucidate the characteristics of AMI patients who did not receive primary PCI.
Methods and Results: We analyzed the patients enrolled between 2002 and 2010 in the Miyagi-AMI Registry Study, where all AMI patients in the Miyagi prefecture have been prospectively 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), 1,879 (21.7%) did not receive primary PCI and their in-hospital mortality was significantly worse compared with those who received it (21.4% vs. 6.4%, P<0.01). Multivariate analysis demonstrated that female sex was significantly associated with non-performance of primary PCI [odds ratio (95% confidence intervals); 1.40(1.22-1.61), P<0.001], along with aging [1.01(1.01-1.02), P<0.001] and heart failure on admission [2.69(2.29-3.16), P<0.001]. When dividing by age, non-performance rate of primary PCI in female showed U-shaped prevalence, whereas it simply increased with aging in male (Figure A). Importantly, female patients aged <80 years had a significantly higher non-performance rate of primary PCI compared with male patients, regardless of disease severity as evidenced by co-existing heart failure on admission (Figure B).
Conclusions: These results indicate that in the current PCI era, various factors, including aging, heart failure on admission and sex differences, are associated with non-performance of primary PCI, which remain to be resolved in order to further improve critical care of AMI.
Author Disclosures: K. Hao: None. J. Takahashi: None. K. Ito: None. Y. Cui: None. S. Miyata: None. K. Nishimiya: None. R. Tsuburaya: None. Y. Matsumoto: None. Y. Sakata: None. S. Yasuda: None. H. Shimokawa: None.
- © 2015 by American Heart Association, Inc.