Current antiplatelet therapy for Japanese patients with ST elevation acute myocardial infarction: J-AMI registry
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ORIGINAL ARTICLE
Current antiplatelet therapy for Japanese patients with ST elevation acute myocardial infarction: J-AMI registry Masato Nakamura • Masakazu Yamagishi • Takafumi Ueno • Kazuhiro Hara Sugao Ishiwata • Tomonori Itoh • Ichiro Hamanaka • Tetuszo Wakatsuki • Teruyasu Sugano • Kazuya Kawai • Takeshi Kimura
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Received: 6 September 2012 / Accepted: 29 October 2012 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2012
Abstract Antiplatelet therapy could prevent stent thrombosis, but may be associated with an increased risk of bleeding. Recent studies have revealed that bleeding complications are relatively frequent in patients with acute coronary syndromes. Our aim was to describe the current status of antiplatelet therapy for Japanese patients with acute myocardial infarction (AMI). The Japan AMI (J-AMI) registry is a prospective observational study that has enrolled 2,030 consecutive patients with stent thrombosis elevation myocardial infarction (STEMI) admitted to 213 participating Japanese institutions. For the Japanese Acute Myocardial Infarction (J-AMI) registry. M. Nakamura (&) Division of Cardiovascular Medicine, Toho University School of Medicine, Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan e-mail: [email protected] M. Yamagishi Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan T. Ueno Center of Cardiovascular Medicine, Kurume University Hospital, Kurume, Japan K. Hara Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan S. Ishiwata Division of Cardiology, Cardiovascular Center, Toranomon Hospital, Tokyo, Japan
Current antiplatelet therapy for STEMI was assessed, and the occurrence of bleeding complications (based on GUSTO bleeding criteria) and stent thrombosis was also evaluated. Additionally, the clinical course after bleeding episodes was investigated. Percutaneous coronary intervention (PCI) was done in 97.2 % of the patients, using a drug-eluting stent in 30 % and a bare metal stent in 63 % of PCI cases. A 300-mg loading dose of clopidogrel followed by its administration at 75 mg/day with aspirin was the current standard treatment for Japanese STEMI patients. In-hospital bleeding complications occurred in 1.9 %, especially in patients with severe clinical features or a history of cerebrovascular disease. Moderate to I. Hamanaka Rakuwakai Kyoto Cardiovascular Intervention Center, Rakuwakai Marutamachi Hospital, Kyoto, Japan T. Wakatsuki Department of Cardiovascular Medicine, Institute of Health Biosciences, University of Tokushima, Tokushima, Japan T. Sugano Department of Cardiology, Yokohama City University Hospital, Yokohama, Japan K. Kawai Department of Cardiology, Chikamori Hospital, Kochi, Japan T. Kimura Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
T. Itoh Division of Cardiology, Department of Internal Medicine and Memorial Heart Center, Iwate Medical University, Morioka, Japan
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