Yoshihiko Saito, Yoshihiro Miyamoto, Kengo Tanabe, Yukio Ozaki, Junya Ako, Toshiaki Mano, Minoru Wake, Hiroshi Funayama, Teruo Inoue, Tetsuya Toubaru, Shigeru Ohshima, Atsunori Okamura, Kazuteru Fujimoto, Hisao Ogawa, Yasuhiro Morita, Ken Kozuma, Shichiro Abe, Shigeru Toyoda, Wataru Shimizu, Masaharu Ishihara, Nobuaki Kokubu, Kazuo Kimura, Kenichi Tsujita, Yoshisato Shibata, Mafumi Owa, Keijirou Saku, Yasuharu Nakama, Koichi Nakao, Masashi Sakuma, Teruo Noguchi, Satoru Suwa, Atsushi Hirohata, and Takashi Morita
Background: A Japanese prospective, nation-wide, multicenter registry (J-MINUET) showed that long-term outcomes were worse in non-ST elevation acute myocardial infarction (NSTEMI), diagnosed by increased cardiac troponin levels, compared to STEMI. This was observed in both non-STEMI with elevated creatine kinase (CK) (NSTEMI+CK) and non-STEMI without elevated CK (NSTEMI-CK). However, predictive factors for long-term outcomes in STEMI, NSTEMI+CK, and NSTEMI-CK have not been elucidated. Methods: Using the Cox proportional hazards model, we determined significant independent predictors of long-term outcomes from a total of 111 parameters evaluated in the J-MINUET study in each of our groups, including STEMI, NSTEMI+CK, and NSTEMI-CK. Then, we calculated the risk score using the regression coefficients for the determined independent predictors for the strict prediction of long-term outcomes. Results: Prognostic factors, as well as composite cardiovascular events and all-cause death, were different between STEMI, NSTEMI+CK, and NSTEMI-CK. Risk scores could effectively and powerfully predict both composite cardiovascular events and all-cause death in each group. Conclusions: The prediction of long-term outcomes using cored parameters of baseline demographics and clinical characteristics is feasible and could prove useful in establishing therapeutic strategies in patients with STEMI, NSTEMI+CK, and NSTEMI-CK.