title: Regional Clinical Alliance Path and Cardiac Rehabilitation After Hospital Discharge for Acute Myocardial Infarction Patients in Japan　- A Nationwide Survey.
abstract: BACKGROUND
  The regional clinical alliance path (RCAP) after discharge from an acute-phase hospital is emerging as a tool for bridging acute-phase treatment and chronic-phase disease management. However, the optimal application of RCAP for acute myocardial infarction (AMI) remains unknown in Japan, and therefore a nationwide survey of hospitals was conducted.
  
  
  RESULTS
  In 2009, questionnaires were sent to 1,240 cardiology training hospitals authorized by the Japanese Circulation Society. The response rate was 62.9% (780/1,240). Of the 780 responding hospitals, 708 treated AMI, and in these hospitals the number of AMI patients and percutaneous coronary intervention (PCI) procedures performed were, respectively, 59±52 and 200±206 per year. The implementation rate of emergency PCI was high (91%), but that of outpatient cardiac rehabilitation (OPCR) was very low (18%). The implementation rate of RCAP after AMI was significantly lower (10%) than after stroke (57%). Cardiac rehabilitation (CR) was adopted as part of RCAP in only 19% (13/70) of currently operating RCAP programs.
  
  
  CONCLUSIONS
  This first Japanese nationwide survey of RCAP after AMI showed that in contrast to the broad dissemination of acute-phase invasive treatment for AMI, there was infrequent implementation of OPCR, RCAP after AMI, and RCAP including CR. It will be necessary to broaden the use of RCAP after AMI, including OPCR. (Circ J 2016; 80: 1750-1755).
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Arakawa
authors.forename: Leon
authors.initials: L
authors.lastname: Kumasaka
authors.forename: Michio
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nagayama
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Adachi
authors.forename: Kozue
authors.initials: K
authors.lastname: Ikeda
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Takao
authors.initials: T
authors.lastname: Tashiro
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Momomura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Goto
mesh_terms: D000072038:Cardiac Rehabilitation; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D010351:Patient Discharge; D011795:Surveys and Questionnaires