title: Management and two-year long-term clinical outcome of acute coronary syndrome in Japan: prevention of atherothrombotic incidents following ischemic coronary attack (PACIFIC) registry.
abstract: BACKGROUND
  Japanese patients have been at low risk for cardiovascular events compared with Western countries, but the data regarding current treatment status and rate of subsequent atherothrombotic events after acute coronary syndrome (ACS) are limited in Japanese patients. The objective of this study was to clarify the treatment status and long-term outcomes in Japanese ACS patients.
  
  
  RESULTS
  The Prevention of AtherothrombotiC Incidents Following Ischemic Coronary attack (PACIFIC) registry is a multicenter, prospective observational study of Japanese ACS patients. Consecutive patients aged ≥20 years hospitalized for ACS were enrolled from 96 hospitals and followed up for 2 years (n=3,597). ST-segment elevation myocardial infarction (STEMI) was the most frequent type of ACS (59.4%). The vast majority (93.5%) of patients underwent percutaneous coronary intervention (PCI), with a success rate of 93.9%. Frequent use of guideline-recommended pharmacological treatments was also indicated. Cumulative incidence of major adverse cardiac and cerebrovascular events (MACCE) was 6.4% (7.5% for STEMI and 4.8% for non-STEMI or unstable angina), and all-cause mortality was 6.3%.
  
  
  CONCLUSIONS
  The PACIFIC registry has identified an incidence of MACCE of 6.4% and that of mortality at 6.3% in Japanese ACS patients at 2-year follow-up. A high proportion of patients underwent PCI, and the PCI success rate was high. Proactively performed successful PCI was considered to have contributed to favorable outcomes in these patients.
authors.affiliation: Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan. daida@juntendo.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kitakaze
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Matsubara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Kengo
authors.initials: K
authors.lastname: Tsukahara
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Morino
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsutsui
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Takaaki
authors.initials: T
authors.lastname: Isshiki
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D012042:Registries; D013927:Thrombosis / Q000209:etiology