title: Thirty years trend in acute myocardial infarction during coronary angiography at a tertiary emergency center in Japan.
abstract: BACKGROUND
  Coronary thrombolytic therapy was first introduced for patients with acute myocardial infarction (AMI) during the early 1980s in Japan. Several modalities have been developed and primary percutaneous intervention with stent is the current preferred strategy for patients with AMI.
  
  
  RESULTS
  From May 1981 to December 2010, 2782 patients with AMI underwent coronary angiography within 24h after the onset of symptoms at Hiroshima City Hospital. Patients were divided into 6 groups in chronological order. Thrombolysis was most frequently performed in the early 1980s. Balloon angioplasty became the most frequent choice in the late 1980s and angioplasty with stents in the late 1990s. Final thrombolysis in myocardial infarction-3 flow was obtained in only 39% in the early 1980s, which progressively increased to 93% in the late 2000s. In-hospital mortality was >10% in the 1980s, which decreased by half in the late 1990s. Post-infarction angina occurred in 30% in the early 1980s. It rapidly decreased, occurring in <1% in the 2000s. Reinfarction occurred in 8.8% in the late 1980s which decreased to <3% in the 2000s. The incidence of congestive heart failure remained unchanged ranging approximately from 5% to 10% until the early 2000s, which decreased to 2.8% in the late 2000s.
  
  
  CONCLUSIONS
  Over the past 30 years, modality of reperfusion therapy has changed from thrombolysis to balloon angioplasty and further to angioplasty with stents. As the reperfusion rate increased, in-hospital outcomes after AMI have improved.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan. ishifami@fb3.so-net.ne.jp
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Hikaru
authors.initials: H
authors.lastname: Sato
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D017052:Hospital Mortality; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods* / Q000639:trends*; D015607:Stents; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome