Clinical Presentation, Management and Outcome of Japanese Patients With Acute Myocardial Infarction in the Troponin Era　– Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET)

• Published in: Circulation Journal 2015/05/25, Vol.79(6), pp.1255-1262
• Main Authors: Ishihara, Masaharu, Fujino, Masashi, Ogawa, Hisao, Yasuda, Satoshi, Noguchi, Teruo, Nakao, Koichi, Ozaki, Yukio, Kimura, Kazuo, Suwa, Satoru, Fujimoto, Kazuteru, Nakama, Yasuharu, Morita, Takashi, Shimizu, Wataru, Saito, Yoshihiko, Tsujita, Kennichi, Nishimura, Kunihiko, Miyamoto, Yoshihiro, on behalf of the J-MINUET investigators
• Format: Article
• Language: English
• Subjects: Acute myocardial infarction; Aged; Angina, Unstable - blood; Angina, Unstable - diagnosis; Biomarkers; Cohort Studies; Comorbidity; Coronary Angiography - utilization; Coronary Artery Bypass - utilization; Creatine Kinase - blood; Diagnosis, Differential; Electrocardiography; Female; Heart Failure - epidemiology; Heart Failure - etiology; Hospital Mortality; Hospitalization; Humans; Japan; Japan - epidemiology; Male; Middle Aged; Mortality; Myocardial Infarction - blood; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Percutaneous Coronary Intervention - utilization; Prospective Studies; Recurrence; Registries; Smoking - epidemiology; Troponin; Troponin T - blood
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-15-0217

Background:New criteria for diagnosis of acute myocardial infarction (AMI) were proposed in 2000 as a universal definition, in which cardiac troponin (cTn) was the preferred biomarker. A large number of patients formerly classified by creatine kinase (CK) as unstable angina are now ruled-in by cTn as non-ST-elevation myocardial infarction (NSTEMI).Methods and Results:The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective and multicenter registry conducted in 28 institutions. We enrolled 3,283 consecutive patients with AMI diagnosed by cTn-based criteria who were admitted to participating institutions within 48 h of symptom onset. There were 2,262 patients (68.9%) with STEMI and 1,021 (31.1%) with NSTEMI. CK was not elevated more than twice the upper limit of normal in 458 patients (44.9%) with NSTEMI (NSTEMI-CK). Although there was no significant difference in the in-hospital mortality of STEMI and NSTEMI with CK elevation (NSTEMI+CK) patients (7.1% vs. 7.8%, P=0.57), it was significantly lower in patients with NSTEMI-CK than in those with STEMI or NSTEMI+CK (1.7%, P