ACUTE MYOCARDIAL INFARCTION IN FUKUSHIMA AREA OF JAPAN

[Original Article]

ACUTE MYOCARDIAL INFARCTION IN FUKUSHIMA AREA
OF JAPAN

MINORU MITSUGI¹⁾, MIKIHIRO KIJIMA²⁾, YOSHITANE SEINO²⁾,
YUKIHIKO ABE³⁾, AKIHISA FUJINO⁴⁾, AKIRA HIROSAKA⁵⁾,
SHINICHI HISA⁶⁾, TAKAAKI KUBO⁷⁾, TADAMI MAEYAMA⁸⁾,
NAOTO OHARA⁹⁾, MASAHIRO ONO¹⁰⁾, TAKAYUKI OWADA¹¹⁾,
TOMIYOSHI SAITO¹²⁾, MORIO IGARASHI¹²⁾, MASAHIKO SATO¹³⁾,
SHIGEFUMI SUZUKI¹⁴⁾, KAZUAKI TAMAGAWA¹⁵⁾, TATSUNORI TSUDA¹⁶⁾,
AKIHIRO TSUDA¹⁶⁾, MASAYUKI WATANABE¹⁷⁾, MITSURU YUI¹⁸⁾,
NOBUO KOMATSU¹⁸⁾, KAZUHIKO NAKAZATO¹⁾ and YUKIO MARUYAMA¹⁾

¹⁾Department of Internal Medicine I, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan, Departments of Cardiovascular Medicine, ²⁾Hoshi General Hospital, Koriyama, 963-8501, Japan, ³⁾Oharara Medical Center, Fukushima, 960-0102, Japan, ⁴⁾Yonezawa Municipal Hospital, Yonezawa, 992-0032, Japan, ⁵⁾Ohta Nishinouchi Hospital, Koriyama, 963-8558, Japan, ⁶⁾Masu Memorial Hospital, Nihonmatsu, 964-0867, Japan, ⁷⁾Takeda General Hospital, Aizuwakamatsu, 965-8585, Japan, ⁸⁾Iwaki Municipal Jyoban Hospital, Iwaki, 972-8322, Japan, ⁹⁾Aizu West Hospital, Aizuwakamatsu, 969-6193, Japan, ¹⁰⁾General South Tohoku Hospital, Koriyama, 963-8563, Japan, ¹¹⁾Fukushima South Circulatory Hospital, Fukushima, 960-8163, Japan, ¹²⁾Department of Internal Medicine II, Shirakawa Kosei General Hospital, Shirakawa, 961-0907, Japan, Departments of Cardiovascular Medicine, ¹³⁾Public Soma General Hospital, Soma, 976-8686, Japan, ¹⁴⁾Fukushima Rosai Hospital, Iwaki, 973-8403, Japan, ¹⁵⁾Fukushima Prefectural Aizu General Hospital, Aizuwakamatsu, 965-8555, Japan, ¹⁶⁾Sukagawa Hospital, Sukagawa, 962-0022, Japan, ¹⁷⁾Saiseikai Fukushima General Hospital, Fukushima, 960-1101, Japan, ¹⁸⁾Iwaki Kyoritsu General Hospital, Iwaki, 973-8555, Japan

(Received October 3, 2007, accepted February 15, 2008)

Abstract: Although acute myocardial infarction (AMI) is the most serious coronary disease, the background of its onset and the mortality are not fully understood, especially in Japan. From June 1999 to May 2005, we mailed an annual questionnaire to eighteen hospitals in which emergency cardiac catheterization and percutaneous coronary intervention (PCI) were available in the Fukushima area of Japan. A total of 1,590 patients were included. The onset time of AMI had two peaks, i.e., from 9 : 00 AM to 10 : 00 AM and 9 : 00 PM to 10 : 00 PM. As for reperfusion therapy, four groups were analyzed, the non-reperfusion therapy group (Group N, n=233), thrombolysis alone group (Group T, n=80), PCI without thrombolysis group (Group P, n=1106), and PCI with thrombolysis group (Group TP, n=151). The in-hospital mortality rate was significantly reduced in Group P (8.4%) compared with that in Group N (33.0%, p<0.01) and Group T (18.8%, p<0.01). However, the in-hospital mortality in Group P did not differ from that in Group TP (9.9%). The in-hospital mortality was analyzed by the logistic regression analysis among age, arrival time after onset, peak creatine kinase (CK) values, coronary risk factors, reperfusion therapy, PCI, and thrombolysis. There were significant differences in age (p<0.01), peak CK values (p<0.01), hypertension (p<0.05), and diabetes mellitus (p<0.01). These results suggest that the onset of AMI may be partly related to human biorhythms, and that PCI would be effective in reducing the in-hospital mortality.

Key words: acute myocardial infarction, circadian rhythm, reperfusion therapy, percutaneous coronary intervention

三次　実，木島幹博，清野義胤，阿部之彦，藤野彰久，廣坂　朗，比佐新一，久保貴昭，前山忠美，大原直人，小野正博，大和田尊之，斎藤富善，五十嵐盛雄，佐藤雅彦，鈴木重文，玉川和亮，津田達徳，津田晃洋，渡辺正之，油井　満，小松宣夫，中里和彦，丸山幸夫

Corresponding author: Minoru Mitsugi
E-mail: wrchf592@yahoo.co.jp
http://www.fmu.ac.jp/home/lib/F-igaku/
http://www.sasappa.co.jp/online/