Long-term outcomes of non-ST-elevation myocardial infarction without creatine kinase elevation

The J-MINUET study

J-MINUET investigators

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: According to troponin-based criteria of myocardial infarction (MI), patients without elevation of creatine kinase (CK), formerly classified as unstable angina (UA), are now diagnosed as non-ST-elevation MI (NSTEMI), but little is known about their outcomes. Methods and Results: Between July 2012 and March 2014, 3,283 consecutive patients with MI were enrolled. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure and urgent revascularization for UA. There were 2,262 patients with ST-elevation MI (STEMI), 563 NSTEMI with CK elevation (NSTEMI+CK) and 458 NSTEMI without CK elevation (NSTEMI-CK). From day 0, Kaplan-Meier curves for the primary endpoint began to diverge in favor of NSTEMI-CK for up to 30 days. The 30-day event rate was significantly lower in patients with NSTEMI-CK (3.3%) than in STEMI (8.6%, P<0.001) and NSTEMI+CK (9.9%, P<0.001). Later, the event curves diverged in favor of STEMI. The event rate from 31 days to 3 years was significantly lower in patients with STEMI (19.8%) than in NSTEMI+CK (33.6%, P<0.001) and NSTEMI-CK (34.2%, P<0.001). Kaplan-Meier curves from 31 days to 3 years were almost identical between NSTEMI+CK and NSTEMI-CK (P=0.91). Conclusions: Despite smaller infarct size and better short-term outcomes, long-term outcomes of NSTEMI-CK after convalescence were as poor as those for NSTEMI+CK and worse than for STEMI.

Original languageEnglish
Pages (from-to)958-965
Number of pages8
JournalCirculation Journal
Volume81
Issue number7
DOIs
Publication statusPublished - 01-01-2017

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Creatine Kinase
Myocardial Infarction
Unstable Angina
Non-ST Elevated Myocardial Infarction
Troponin
Cause of Death
Heart Failure
Stroke

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{e89f2755b55d49d68a0c690c075ddda9,
title = "Long-term outcomes of non-ST-elevation myocardial infarction without creatine kinase elevation: The J-MINUET study",
abstract = "Background: According to troponin-based criteria of myocardial infarction (MI), patients without elevation of creatine kinase (CK), formerly classified as unstable angina (UA), are now diagnosed as non-ST-elevation MI (NSTEMI), but little is known about their outcomes. Methods and Results: Between July 2012 and March 2014, 3,283 consecutive patients with MI were enrolled. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure and urgent revascularization for UA. There were 2,262 patients with ST-elevation MI (STEMI), 563 NSTEMI with CK elevation (NSTEMI+CK) and 458 NSTEMI without CK elevation (NSTEMI-CK). From day 0, Kaplan-Meier curves for the primary endpoint began to diverge in favor of NSTEMI-CK for up to 30 days. The 30-day event rate was significantly lower in patients with NSTEMI-CK (3.3{\%}) than in STEMI (8.6{\%}, P<0.001) and NSTEMI+CK (9.9{\%}, P<0.001). Later, the event curves diverged in favor of STEMI. The event rate from 31 days to 3 years was significantly lower in patients with STEMI (19.8{\%}) than in NSTEMI+CK (33.6{\%}, P<0.001) and NSTEMI-CK (34.2{\%}, P<0.001). Kaplan-Meier curves from 31 days to 3 years were almost identical between NSTEMI+CK and NSTEMI-CK (P=0.91). Conclusions: Despite smaller infarct size and better short-term outcomes, long-term outcomes of NSTEMI-CK after convalescence were as poor as those for NSTEMI+CK and worse than for STEMI.",
author = "{J-MINUET investigators} and Masaharu Ishihara and Koichi Nakao and Yukio Ozaki and Kazuo Kimura and Junya Ako and Teruo Noguchi and Masashi Fujino and Satoshi Yasuda and Satoru Suwa and Kazuteru Fujimoto and Yasuharu Nakama and Takashi Morita and Wataru Shimizu and Yoshihiko Saito and Atsushi Hirohata and Yasuhiro Morita and Teruo Inoue and Atsunori Okamura and Masaaki Uematsu and Kazuhito Hirata and Kengo Tanabe and Yoshisato Shibata and Mafumi Owa and Kenichi Tsujita and Hiroshi Funayama and Nobuaki Kokubu and Ken Kozuma and Tetsuya Tobaru and Shigeru Oshima and Michikazu Nakai and Kunihiro Nishimura and Yoshihiro Miyamoto and Hisao Ogawa",
year = "2017",
month = "1",
day = "1",
doi = "10.1253/circj.CJ-17-0033",
language = "English",
volume = "81",
pages = "958--965",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "7",

}

Long-term outcomes of non-ST-elevation myocardial infarction without creatine kinase elevation : The J-MINUET study. / J-MINUET investigators.

In: Circulation Journal, Vol. 81, No. 7, 01.01.2017, p. 958-965.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term outcomes of non-ST-elevation myocardial infarction without creatine kinase elevation

T2 - The J-MINUET study

AU - J-MINUET investigators

AU - Ishihara, Masaharu

AU - Nakao, Koichi

AU - Ozaki, Yukio

AU - Kimura, Kazuo

AU - Ako, Junya

AU - Noguchi, Teruo

AU - Fujino, Masashi

AU - Yasuda, Satoshi

AU - Suwa, Satoru

AU - Fujimoto, Kazuteru

AU - Nakama, Yasuharu

AU - Morita, Takashi

AU - Shimizu, Wataru

AU - Saito, Yoshihiko

AU - Hirohata, Atsushi

AU - Morita, Yasuhiro

AU - Inoue, Teruo

AU - Okamura, Atsunori

AU - Uematsu, Masaaki

AU - Hirata, Kazuhito

AU - Tanabe, Kengo

AU - Shibata, Yoshisato

AU - Owa, Mafumi

AU - Tsujita, Kenichi

AU - Funayama, Hiroshi

AU - Kokubu, Nobuaki

AU - Kozuma, Ken

AU - Tobaru, Tetsuya

AU - Oshima, Shigeru

AU - Nakai, Michikazu

AU - Nishimura, Kunihiro

AU - Miyamoto, Yoshihiro

AU - Ogawa, Hisao

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: According to troponin-based criteria of myocardial infarction (MI), patients without elevation of creatine kinase (CK), formerly classified as unstable angina (UA), are now diagnosed as non-ST-elevation MI (NSTEMI), but little is known about their outcomes. Methods and Results: Between July 2012 and March 2014, 3,283 consecutive patients with MI were enrolled. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure and urgent revascularization for UA. There were 2,262 patients with ST-elevation MI (STEMI), 563 NSTEMI with CK elevation (NSTEMI+CK) and 458 NSTEMI without CK elevation (NSTEMI-CK). From day 0, Kaplan-Meier curves for the primary endpoint began to diverge in favor of NSTEMI-CK for up to 30 days. The 30-day event rate was significantly lower in patients with NSTEMI-CK (3.3%) than in STEMI (8.6%, P<0.001) and NSTEMI+CK (9.9%, P<0.001). Later, the event curves diverged in favor of STEMI. The event rate from 31 days to 3 years was significantly lower in patients with STEMI (19.8%) than in NSTEMI+CK (33.6%, P<0.001) and NSTEMI-CK (34.2%, P<0.001). Kaplan-Meier curves from 31 days to 3 years were almost identical between NSTEMI+CK and NSTEMI-CK (P=0.91). Conclusions: Despite smaller infarct size and better short-term outcomes, long-term outcomes of NSTEMI-CK after convalescence were as poor as those for NSTEMI+CK and worse than for STEMI.

AB - Background: According to troponin-based criteria of myocardial infarction (MI), patients without elevation of creatine kinase (CK), formerly classified as unstable angina (UA), are now diagnosed as non-ST-elevation MI (NSTEMI), but little is known about their outcomes. Methods and Results: Between July 2012 and March 2014, 3,283 consecutive patients with MI were enrolled. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure and urgent revascularization for UA. There were 2,262 patients with ST-elevation MI (STEMI), 563 NSTEMI with CK elevation (NSTEMI+CK) and 458 NSTEMI without CK elevation (NSTEMI-CK). From day 0, Kaplan-Meier curves for the primary endpoint began to diverge in favor of NSTEMI-CK for up to 30 days. The 30-day event rate was significantly lower in patients with NSTEMI-CK (3.3%) than in STEMI (8.6%, P<0.001) and NSTEMI+CK (9.9%, P<0.001). Later, the event curves diverged in favor of STEMI. The event rate from 31 days to 3 years was significantly lower in patients with STEMI (19.8%) than in NSTEMI+CK (33.6%, P<0.001) and NSTEMI-CK (34.2%, P<0.001). Kaplan-Meier curves from 31 days to 3 years were almost identical between NSTEMI+CK and NSTEMI-CK (P=0.91). Conclusions: Despite smaller infarct size and better short-term outcomes, long-term outcomes of NSTEMI-CK after convalescence were as poor as those for NSTEMI+CK and worse than for STEMI.

UR - http://www.scopus.com/inward/record.url?scp=85021405887&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021405887&partnerID=8YFLogxK

U2 - 10.1253/circj.CJ-17-0033

DO - 10.1253/circj.CJ-17-0033

M3 - Article

VL - 81

SP - 958

EP - 965

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 7

ER -