Guideline adherence and long-term clinical outcomes in patients with acute myocardial infarction: a Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) substudy.
Adrenergic beta-Antagonists
/ therapeutic use
Aged
Aged, 80 and over
Aspirin
/ therapeutic use
Coronary Angiography
/ methods
Electrocardiography
Female
Follow-Up Studies
Guideline Adherence
Hospital Mortality
/ trends
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ therapeutic use
Japan
/ epidemiology
Male
Middle Aged
Morbidity
/ trends
Myocardial Infarction
/ diagnosis
Platelet Aggregation Inhibitors
/ therapeutic use
Prognosis
Prospective Studies
Registries
Survival Rate
/ trends
Time Factors
Acute myocardial infarction
guideline adherence
long-term clinical outcomes
Journal
European heart journal. Acute cardiovascular care
ISSN: 2048-8734
Titre abrégé: Eur Heart J Acute Cardiovasc Care
Pays: England
ID NLM: 101591369
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
pubmed:
25
1
2020
medline:
1
6
2021
entrez:
25
1
2020
Statut:
ppublish
Résumé
The association between guideline adherence and long-term outcomes in patients with acute myocardial infarction in real-world clinical practice remains unclear. We investigated 3283 consecutive patients with acute myocardial infarction who were selected from a prospective, nation-wide, multicentre registry (J-MINUET) database covering 28 institutions in Japan between July 2012 and March 2014. Among the 2757 eligible patients, we evaluated the use of seven guideline-recommended therapies, including urgent revascularisation, door-to-balloon time of 90 minutes or less, and five discharge medications (P2Y12 inhibitors on aspirin, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins, lipid-lowering drugs). The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, cardiac failure and urgent revascularisation for unstable angina up to 3 years. The overall median composite guideline adherence was 85.7%. Patients were divided into the following three groups: complete (100%) adherence group ( The use of guideline-based therapies for patients with acute myocardial infarction in contemporary clinical practice was associated with significant decreases in adverse long-term clinical outcomes. UMIN Unique trial Number: UMIN000010037.
Sections du résumé
BACKGROUND
BACKGROUND
The association between guideline adherence and long-term outcomes in patients with acute myocardial infarction in real-world clinical practice remains unclear.
METHODS
METHODS
We investigated 3283 consecutive patients with acute myocardial infarction who were selected from a prospective, nation-wide, multicentre registry (J-MINUET) database covering 28 institutions in Japan between July 2012 and March 2014. Among the 2757 eligible patients, we evaluated the use of seven guideline-recommended therapies, including urgent revascularisation, door-to-balloon time of 90 minutes or less, and five discharge medications (P2Y12 inhibitors on aspirin, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins, lipid-lowering drugs). The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, cardiac failure and urgent revascularisation for unstable angina up to 3 years.
RESULTS
RESULTS
The overall median composite guideline adherence was 85.7%. Patients were divided into the following three groups: complete (100%) adherence group (
CONCLUSION
CONCLUSIONS
The use of guideline-based therapies for patients with acute myocardial infarction in contemporary clinical practice was associated with significant decreases in adverse long-term clinical outcomes.
TRIAL REGISTRATION
BACKGROUND
UMIN Unique trial Number: UMIN000010037.
Identifiants
pubmed: 31976749
doi: 10.1177/2048872620902024
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Platelet Aggregation Inhibitors
0
Aspirin
R16CO5Y76E
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
939-947Investigateurs
Tadaya Sato
(T)
Hiroyuki Kyono
(H)
Tetsuya Tobaru
(T)
Takahito Sone
(T)
Yasuhiro Sone
(Y)
Masashi Fujino
(M)
Kunihiko Nishimura
(K)
Junichi Kotani
(J)
Hiroyuki Okura
(H)
Masaaki Uematsu
(M)
Shirou Uemura
(S)
Seiji Hokimoto
(S)