scholarly journals Trends in Coronary Risk Factors Among Patients with Acute Myocardial Infarction Over the Last Decade: The Yamagata AMI Registry

2010 ◽  
Vol 17 (9) ◽  
pp. 989-998 ◽  
Author(s):  
Satoshi Nishiyama ◽  
Tetsu Watanabe ◽  
Takanori Arimoto ◽  
Hiroki Takahashi ◽  
Tetsuro Shishido ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Risk Factors ◽  
Coronary Risk

Abstract 13121: Different Presentation Mode of Acute Myocardial Infarction is Associated With Antecedent Therapy With Nitrates and β-blockers

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sunao Kojima ◽  
Hisao Ogawa ◽  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Channel Blockers ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Converting Enzyme Inhibitors ◽  
Coronary Syndrome ◽  
Mode Of Presentation ◽  
Β Blockers

Introduction: Brief episodes of ischemia increases cardiac tolerance to a subsequent major ischemic insult. Prehospital medication may affect the mode of presentation in acute myocardial infarction (AMI) and pharmacologically precondition the heart toward ischemic episodes. Hypothesis: We assessed the hypothesis that antecedent therapy confers cardioprotection in patients suffering an AMI. Methods: The Japanese Acute Coronary Syndrome Study (JACSS) is a retrospective and multicenter observational study that is being conducted at 35 medical institutions in Japan. The JACSS database includes information on consecutive 1,204 patients who were hospitalized within 48 hours after the onset of AMI. Results: A total of 1,010 ST-elevation myocardial infarction (STEMI) and 194 non STEMI (NSTEMI) patients were included and the differences of the mode of presentation, prehospital medication and coronary risk factors were investigated in the present study. Coronary risk factors such as sex, hypertension, diabetes mellitus, hypercholesterolemia, smoking, obesity and previous coronary artery disease were comparable between STEMI and NSTEMI groups. Prehospital medication with aspirin, nitrates, β-blockers and calcium-channel blockers but not with angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and statins were associated with the onset as NSTEMI. A stepwise regression analysis including coronary risk factors and prehospital medication revealed that chronic therapy with nitrates and β-blockers reduced the onset as STEMI compared with that as NSTEMI (table) Conclusions: Antecedent therapy with nitrates and β-blockers was associated with reduced severity of myocardial injury in response to an acute coronary event. Our findings may help to explain the missing link between a shift away from STEMI in favor of NSTEMI and a combined capability of nitrates and β-blockers to act as pharmacological inducers of ischemic preconditioning.

P3615The number of coronary risk factors and mortality in patients with acute myocardial infarction from Japanese nation-wide real-world database

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Mori ◽  
K Nishihara ◽  
S Honda ◽  
S Kojima ◽  
M Takegami ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Real World ◽  
Japanese Patients ◽  
Advanced Age ◽  
Coronary Risk Factors ◽  
Inverse Association ◽  
Coronary Risk

Abstract Background Hypertension, diabetes, dyslipidemia and smoking are so-called coronary risk factors for coronary heart disease, which were established by extensive epidemiological research. However, in Japanese patients with acute myocardial infarction (AMI), the impact of number of coronary risk factors on in-hospital morality has not been elucidated. Methods The Japan Acute Myocardial Infarction Registry (JAMIR) is a nationwide real-world database integrated form 10 regional registries. We examined the association between number of coronary risk factors and in-hospital mortality from this JAMIR registry. Results The data were obtained from total of 20462 AMI patients (mean age, 68.8±13.3 years old; 15281 men, 5181 women). Figure 1 shows the prevalence of each coronary risk factors stratified by sex and decade. The prevalence of hypertension became higher with the advanced age while the prevalence of smoking became lower with the advanced age. Prevalence of diabetes and dyslipidemia were highest in middle age. Majority (76.9%) of the patients with AMI had at least 1 of these coronary risk factors and, 23.1% had none of them. Overall, except women under 50, number of coronary risk factor was relatively less in older age (Figure 2). In-hospital mortality by sex and decades was shown in figure 3. In-hospital mortality rates were 10.7%, 10.5%, 7.2%, 5.0% and 4.5% with 0, 1, 2, 3 and 4 risk factors, respectively (Figure 4A). After adjusting age and sex, there was an inverse association between the number of coronary risk factors and in-hospital mortality (adjusted odds ratio [1.68; 95% CI, 1.20–2.35] among individuals with 0 vs. 4 risk factors, Figure 4B). Conclusion In the present study of Japanese patients with AMI, who received modern medical treatment, in-hospital mortality was inversely related to the number of coronary risk factors. Acknowledgement/Funding Grant-in-Aid for Scientific Research

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