Unstable angina and non-ST elevation acute coronary syndrome: epidemiology and current management in Japan (Japan Multicenter Investigation for Cardiovascular Disease-D (JMIC-D) Committee).
BACKGROUND
A multicenter study was conducted to assess the current medical management of unstable angina (UA) and non-ST-elevation acute coronary syndrome in Japan.


RESULTS
This study presents the results of a nationwide questionnaire survey of 770 sites and a case report investigation performed at 20 sites. The questionnaire survey revealed that the number of acute myocardial infarction (AMI) patients treated annually was 1.56-fold greater than the number of UA patients. Non-ST-elevation AMI accounted for 17% of all patients with AMI. Analysis of case reports for 885 UA patients showed extensive use of invasive treatment. In the UA patients, the cumulative incidence of a composite endpoint (all-cause mortality, AMI, and urgent coronary revascularization) was 2% at 1 month and 9% at 6 months. Stratified analysis with respect to the composite endpoint through 6 months showed a significantly lower incidence in patients treated with a calcium-channel blocker than in patients not treated with a calcium-channel blocker.


CONCLUSIONS
In Japan, fewer patients are hospitalized annually for treatment of UA than for AMI. The largest percentage of UA patients had Braunwald class III disease. Non-ST-elevation AMI is managed in Japan according to the principle of early invasive treatment, resembling the treatment for ST-elevation AMI. The outcome of treatment is better for Japanese UA patients than for Japanese AMI patients.
Yui
Yoshiki
Y
Department of Cardiovascular Medicine, Kyoto University Hospital, Kyoto, Japan. yoshiki@kuhp.kyoto-u.ac.jp
Hirayama
Atsushi
A
Nonogi
Hiroshi
H
Kimura
Kazuo
K
Kodama
Kazuhisa
K
Hosoda
Saichi
S
Kawai
Chuichi
C
D054058:Acute Coronary Syndrome / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D000789:Angina, Unstable / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D009204:Myocardial Revascularization; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D002121:Calcium Channel Blockers