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) -

作者：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

来源：Circulation Journal, 2015, 79(6): 1255-1262.

DOI：10.1253/circj.CJ-15-0217

• Acute myocardial infarction
• Japan
• Mortality
• Troponin

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<0.001 for each).
Conclusions: J-MINUET revealed the clinical presentation, management and outcomes of Japanese patients with AMI in the current cTn era. We should be aware of the difference between AMI diagnosed by CK-based criteria and AMI diagnosed by cTn-based criteria when using universal definitions for the diagnosis of AMI.

• 出版日期2015-6