Yasuda Yu, Ishiguchi Hironori, Yamaguchi Madoka, Murakami Kei, Kinoshita Natsu, Kato Takayoshi, Yoshida Masaaki, Imoto Koji, Sonoyama Kazuhiko, Kawabata Tetsuya, Okamura Takayuki, Endo Akihiro, Kobayashi Shigeki, Yano Masafumi, Oda Tsuyoshi, Tanabe Kazuaki
Division of Cardiology, Shimane University Faculty of Medicine Izumo Japan.
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine Ube Japan.
Circ Rep. 2023 Apr 20;5(5):198-209. doi: 10.1253/circrep.CR-23-0029. eCollection 2023 May 10.
Data on the incidence of mid-term prognostic events in patients who developed acute coronary syndrome (ACS) in the late 2010s are scarce. We retrospectively included and collected data for 889 patients with ACS (ST-elevation myocardial infarction [STEMI]/non-ST-elevation ACS [NSTE-ACS]) discharged alive from 2 tertiary hospitals in Izumo City, in rural Japan, between August 2009 and July 2018. Patients were divided into 3 time groups (T1: August 2009-July 2012; T2: August 2012-July 2015; T3: August 2015-July 2018). The cumulative incidence of major adverse cardiovascular events (MACE; comprising all-cause death, recurrent ACS, and stroke), major bleeding, and heart failure hospitalization within 2 years of discharge was compared among the 3 groups. The incidence of freedom from MACE was significantly higher in the T3 group than in the T1 and T2 groups (93 [95% confidence interval {CI} 90-96%] vs. 86% [95% CI 83-90] and 89% [95% CI 90-96], respectively; P=0.03). There was a tendency for a higher incidence of STEMI among patients in T3 (P=0.057). The incidence of NSTE-ACS was comparable among the 3 groups (P=0.31), as was the incidence of major bleeding and hospitalization for heart failure. The incidence of mid-term MACE in patients who developed ACS during the late 2010 s (2015-2018) was lower than that in prior periods (2009-2015).
关于2010年代后期发生急性冠状动脉综合征（ACS）患者中期预后事件发生率的数据稀缺。我们回顾性纳入并收集了2009年8月至2018年7月期间从日本农村出云市的2家三级医院存活出院的889例ACS患者（ST段抬高型心肌梗死[STEMI]/非ST段抬高型ACS[NSTE-ACS]）的数据。患者被分为3个时间段组（T1：2009年8月至2012年7月；T2：2012年8月至2015年7月；T3：2015年8月至2018年7月）。比较了3组患者出院后2年内主要不良心血管事件（MACE；包括全因死亡、复发性ACS和中风）、大出血和心力衰竭住院的累积发生率。T3组无MACE的发生率显著高于T1组和T2组（分别为93[95%置信区间{CI}90 - 96%] vs. 86%[95%CI 83 - 90]和89%[95%CI 90 - 96]；P = 0.03）。T3组患者中STEMI的发生率有升高趋势（P = 0.057）。3组之间NSTE-ACS的发生率相当（P = 0.31），大出血和心力衰竭住院的发生率也是如此。2010年代后期（2015 - 2018年）发生ACS患者的中期MACE发生率低于先前时期（2009 - 2015年）。
