Clinical Presentation, Management and Outcome of Japanese Patients with Acute Myocardial Infarction in the Troponin era – Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) –

Masaharu Ishihara, Masashi Fujino, Hisao Ogawa, Satoshi Yasuda, Teruo Noguchi, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Satoru Suwa, Kazuteru Fujimoto, Yasuharu Nakama, Takashi Morita, Wataru Shimizu, Yoshihiko Saito, Kennichi Tsujita, Kunihiko Nishimura, Yoshihiro Miyamoto

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Abstract

Background: New criteria for diagnosis of acute myocardial infarction (AMI) were proposed in 2000 as a universal definition, in which cardiac troponin (cTn) was the preferred biomarker. A large number of patients formerly classified by creatine kinase (CK) as unstable angina are now ruled-in by cTn as non-ST-elevation myocardial infarction (NSTEMI). Methods and Results: The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective and multicenter registry conducted in 28 institutions. We enrolled 3,283 consecutive patients with AMI diagnosed by cTn-based criteria who were admitted to participating institutions within 48 h of symptom onset. There were 2,262 patients (68.9%) with STEMI and 1,021 (31.1%) with NSTEMI. CK was not elevated more than twice the upper limit of normal in 458 patients (44.9%) with NSTEMI (NSTEMI-CK). Although there was no significant difference in the in-hospital mortality of STEMI and NSTEMI with CK elevation (NSTEMI+CK) patients (7.1% vs. 7.8%, P=0.57), it was significantly lower in patients with NSTEMI-CK than in those with STEMI or NSTEMI+CK (1.7%, P<0.001 for each). Conclusions: J-MINUET revealed the clinical presentation, management and outcomes of Japanese patients with AMI in the current cTn era. We should be aware of the difference between AMI diagnosed by CK-based criteria and AMI diagnosed by cTn-based criteria when using universal definitions for the diagnosis of AMI.

Original languageEnglish
Pages (from-to)1255-1262
Number of pages8
JournalCirculation Journal
Volume79
Issue number6
DOIs
Publication statusPublished - 11-05-2015

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Ishihara, M., Fujino, M., Ogawa, H., Yasuda, S., Noguchi, T., Nakao, K., Ozaki, Y., Kimura, K., Suwa, S., Fujimoto, K., Nakama, Y., Morita, T., Shimizu, W., Saito, Y., Tsujita, K., Nishimura, K., & Miyamoto, Y. (2015). Clinical Presentation, Management and Outcome of Japanese Patients with Acute Myocardial Infarction in the Troponin era – Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) –. Circulation Journal, 79(6), 1255-1262. https://doi.org/10.1253/circj.CJ-15-0217