Disparity in the process and outcome of the treatment for acute myocardial infarction in Japan: CAMPAIGN Study in the National Hospital Network.
BACKGROUND
A nationwide survey of the process and outcome of treatment for acute myocardial infarction (AMI) has not been conducted in Japan.


RESULTS
In the present study 2,007 patients with AMI admitted to 22 national hospitals were registered between July 1999 and January 2002 for CAMPAIGN Study 1; an additional 206 and 238 cases were registered between October and December 2002 (CAMPAIGN 2) and between October and December 2003 (CAMPAIGN 3), respectively. In CAMPAIGN 1, the length of stay varied from 15 to 35 days among hospitals (mean: 24.8 days), and was mainly determined by the schedule of follow-up examinations rather than clinical course. Of the prescriptions at discharge, beta-blockers and angiotensin-converting enzyme inhibitors varied widely; the use of beta-blockers was very low (25%). Nitrates were frequently used (68%) although there is no evidence for secondary prevention. In CAMPAIGNs 2 and 3, the use of beta-blockers increased (36%, 47%) and that of nitrates decreased (24%, 21%).


CONCLUSIONS
CAMPAIGN Study 1 revealed considerable variation in the treatment of AMI during the acute phase among the hospitals. The use of beta-blocker and nitrates as discharge medication was inappropriate. CAMPAIGNs 2 and 3 showed some improvement in the problems revealed by CAMPAIGN 1.
Kusuoka
Hideo
H
Osaka National Hospital, Japan. Kusuoka@onh.go.jp
Koretsune
Yukihiro
Y
Chino
Masao
M
Nishiyama
Keiji
K
Shiraki
Teruo
T
Nakamura
Kazuhiko
K
Inoue
Michitoshi
M
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D009566:Nitrates / Q000627:therapeutic use; D012042:Registries; D015996:Survival Rate; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D009566:Nitrates