TY - JOUR
T1 - Off-hours presentation does not affect in-hospital mortality of Japanese patients with acute myocardial infarction
T2 - J-MINUET substudy
AU - on behalf of J-MINUET Investigators
AU - Ogita, Manabu
AU - Suwa, Satoru
AU - Ebina, Hideki
AU - Nakao, Koichi
AU - Ozaki, Yukio
AU - Kimura, Kazuo
AU - Ako, Junya
AU - Noguchi, Teruo
AU - Yasuda, Satoshi
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 - Hokimoto, Seiji
AU - Funayama, Hiroshi
AU - Kokubu, Nobuaki
AU - Kozuma, Ken
AU - Uemura, Shiro
AU - Toubaru, Tetsuya
AU - Saku, Keijiro
AU - Oshima, Shigeru
AU - Nishimura, Kunihiro
AU - Miyamoto, Yoshihiro
AU - Ishihara, Masaharu
N1 - Funding Information:
This study was supported by the Intramural Research Fund, grant number 23-4-5, for Cardiovascular Diseases of the National Cerebral and Cardiovascular Center.
PY - 2017/12
Y1 - 2017/12
N2 - Background The association between patients with acute myocardial infarction (AMI) who present during off-hours and clinical outcomes has not been fully elucidated. Methods We investigated 3283 consecutive patients with AMI who were selected from a prospective, nationwide, multicenter registry (J-MINUET) database comprising 28 institutions in Japan between July 2012 and March 2014 to determine the current impact of off-hours presentation on in-hospital mortality among Japanese patients with AMI. Results Among the patients, 52% presented in off-hours. Baseline characteristics were comparable, although those who presented during off-hours were younger and had a higher incidence of ST-elevation myocardial infarction and advanced Killip Class. The time from symptom onset to presentation time was shorter in off-hour patients (120 min, interquartile range 60 to 256 vs. 215 min, interquartile range 90 to 610, p < 0.0001). In contrast, 85% of patients underwent primary percutaneous coronary intervention (PCI) and door to balloon time was comparable between the groups (74 min, interquartile range 52 to 113 vs. 75 min, interquartile range 52 to 126, p = 0.34). The rates of in-hospital mortality were comparable (6.2% vs 6.8%, p = 0.39). Multivariate logistic regression analysis revealed that off-hours presentation was not significantly associated with in-hospital mortality [odds ratio (OR) 0.94; 95% CI, 0.68–1.30, p = 0.70]. Conclusion The clinical impact of presenting during off-hours or regular hours on AMI patients in Japan is comparable in contemporary practice. Trial registration UMIN Unique trial Number: UMIN000010037.
AB - Background The association between patients with acute myocardial infarction (AMI) who present during off-hours and clinical outcomes has not been fully elucidated. Methods We investigated 3283 consecutive patients with AMI who were selected from a prospective, nationwide, multicenter registry (J-MINUET) database comprising 28 institutions in Japan between July 2012 and March 2014 to determine the current impact of off-hours presentation on in-hospital mortality among Japanese patients with AMI. Results Among the patients, 52% presented in off-hours. Baseline characteristics were comparable, although those who presented during off-hours were younger and had a higher incidence of ST-elevation myocardial infarction and advanced Killip Class. The time from symptom onset to presentation time was shorter in off-hour patients (120 min, interquartile range 60 to 256 vs. 215 min, interquartile range 90 to 610, p < 0.0001). In contrast, 85% of patients underwent primary percutaneous coronary intervention (PCI) and door to balloon time was comparable between the groups (74 min, interquartile range 52 to 113 vs. 75 min, interquartile range 52 to 126, p = 0.34). The rates of in-hospital mortality were comparable (6.2% vs 6.8%, p = 0.39). Multivariate logistic regression analysis revealed that off-hours presentation was not significantly associated with in-hospital mortality [odds ratio (OR) 0.94; 95% CI, 0.68–1.30, p = 0.70]. Conclusion The clinical impact of presenting during off-hours or regular hours on AMI patients in Japan is comparable in contemporary practice. Trial registration UMIN Unique trial Number: UMIN000010037.
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U2 - 10.1016/j.jjcc.2017.05.006
DO - 10.1016/j.jjcc.2017.05.006
M3 - Article
C2 - 28684209
AN - SCOPUS:85023748855
VL - 70
SP - 553
EP - 558
JO - Journal of Cardiology
JF - Journal of Cardiology
SN - 0914-5087
IS - 6
ER -