Korean Circ J.  2017 Nov;47(6):811-822. 10.4070/kcj.2017.0027.

Differences in the Korea Acute Myocardial Infarction Registry Compared with Western Registries

• Sim DS
• Jeong MH

• KMID: 2396473
• DOI: http://doi.org/10.4070/kcj.2017.0027

Abstract

The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry that reflects current therapeutic approaches and acute myocardial infarction (AMI) management in Korea. The results of the KAMIR demonstrated different risk factors and responses to medical and interventional treatments. The results indicated that the incidence of ST-elevation myocardial infarction (STEMI) was relatively high, and that the prevalence of dyslipidemia was relatively low with higher triglyceride and lower high-density lipoprotein cholesterol levels. Percutaneous coronary intervention (PCI) rates were high for both STEMI and non-ST-elevation myocardial infarction (NSTEMI) with higher use of drug-eluting stents (DESs). DES were effective and safe without increased risk of stent thrombosis in Korean AMI patients. Triple antiplatelet therapy, consisting of aspirin, clopidogrel, and cilostazol, was effective in preventing adverse clinical outcomes after PCI. Statin therapy was effective in Korean AMI patients, including those with very low levels of low-density lipoprotein cholesterol and those with cardiogenic shock. The KAMIR score had a greater predictive value than Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) scores for long-term mortality in AMI patients. Based on these results, the KAMIR will be instrumental for establishing new therapeutic strategies and effective methods for secondary prevention of AMI and guidelines for Asian patients.

Keyword

Myocardial infarction; Risk factors; Hydroxymethylglutaryl-CoA reductase inhibitors; Percutaneous coronary intervention

MeSH Terms

Asian Continental Ancestry Group
Aspirin
Cholesterol
Drug-Eluting Stents
Dyslipidemias
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Incidence
Korea*
Lipoproteins
Mortality
Myocardial Infarction*
Percutaneous Coronary Intervention
Prevalence
Registries*
Risk Factors
Secondary Prevention
Shock, Cardiogenic
Stents
Thrombosis
Triglycerides
Aspirin
Cholesterol
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipoproteins

Figure

• 

  Figure 1 (A) Annual incidence rates of STEMI and NSTEMI from 2006 to 2013. (B) Annual in-hospital mortality rates of STEMI and NSTEMI from 2006 to 2013. NSTEMI = non-ST-elevation myocardial infarction; STEMI = ST-elevation myocardial infarction.

• 

  Figure 2 (A) A new risk score for predicting 1-year death from AMI. (B) Receiver operator characteristic curves for 1-year mortality in patients with AMI. AMI = acute myocardial infarction; GRACE = Global Registry of Acute Coronary Events; LVEF = left ventricular ejection fraction; PCI = percutaneous coronary intervention.

Reference

1. Kook HY, Jeong MH, Oh S, et al. Current trend of acute myocardial infarction in Korea (from the Korea Acute Myocardial Infarction Registry from 2006 to 2013). Am J Cardiol. 2014; 114:1817–1822.

2. Kim JH, Chae SC, Oh DJ, et al. Multicenter cohort study of acute myocardial infarction in Korea: interim analysis of the Korea Acute Myocardial Infarction Registry-National Institutes of Health Registry. Circ J. 2016; 80:1427–1436.

3. Park KH, Jeong MH, Ahn Y, et al. Comparison of short-term clinical outcomes between ticagrelor versus clopidogrel in patients with acute myocardial infarction undergoing successful revascularization; from Korea Acute Myocardial Infarction Registry-National Institute of Health. Int J Cardiol. 2016; 215:193–200.

4. Yang JH, Hahn JY, Song YB, et al. Angiotensin receptor blocker in patients with ST segment elevation myocardial infarction with preserved left ventricular systolic function: prospective cohort study. BMJ. 2014; 349:g6650.

5. Kim KH, Kim CH, Jeong MH, et al. Differential benefit of statin in secondary prevention of acute myocardial infarction according to the level of triglyceride and high density lipoprotein cholesterol. Korean Circ J. 2016; 46:324–334.

6. Hong YJ, Jeong MH, Ahn Y, Kang JC. The efficacy and safety of drug-eluting stents in patients with acute myocardial infarction: results from Korea Acute Myocardial Infarction (KAMIR). Int J Cardiol. 2013; 163:1–4.

7. Jeong YA, Jeong MH, Jeong HC, et al. Impact of smoking on clinical outcomes in female patients with acute myocardial infarction. Korean Circ J. 2015; 45:22–27.

8. Kim JS, Kim W, Woo JS, et al. The predictive role of serum triglyceride to high-density lipoprotein cholesterol ratio according to renal function in patients with acute myocardial infarction. PLoS One. 2016; 11:e0165484.

9. Ji MS, Jeong MH, Ahn YK, et al. Impact of low level of high-density lipoprotein-cholesterol sampled in overnight fasting state on the clinical outcomes in patients with acute myocardial infarction (difference between ST-segment and non-ST-segment-elevation myocardial infarction). J Cardiol. 2015; 65:63–70.

10. Cho KH, Jeong MH, Park KW, et al. Comparison of the effects of two low-density lipoprotein cholesterol goals for secondary prevention after acute myocardial infarction in real-world practice: ≥ 50% reduction from baseline versus <70 mg/dL. Int J Cardiol. 2015; 187:478–485.

11. Cho JY, Jeong MH, Ahn Y, et al. Impact of high admission blood pressure without history of hypertension on clinical outcomes of patients with acute myocardial infarction: from Korea Acute Myocardial Infarction Registry. Int J Cardiol. 2014; 172:e54–e58.

12. Lee SA, Cho SJ, Jeong MH, et al. Hypoglycemia at admission in patients with acute myocardial infarction predicts a higher 30-day mortality in patients with poorly controlled type 2 diabetes than in well-controlled patients. Diabetes Care. 2014; 37:2366–2373.

13. Yoo SH, Kook HY, Hong YJ, Kim JH, Ahn Y, Jeong MH. Influence of undernutrition at admission on clinical outcomes in patients with acute myocardial infarction. J Cardiol. 2017; 69:555–560.

14. Sim DS, Jeong MH, Ahn Y, et al. Pharmacoinvasive strategy versus primary percutaneous coronary intervention in patients with ST-segment-elevation myocardial infarction: a propensity score-matched analysis. Circ Cardiovasc Interv. 2016; 9:e003508.

15. Kim HK, Jeong MH, Ahn Y, et al. Relationship between time to treatment and mortality among patients undergoing primary percutaneous coronary intervention according to Korea Acute Myocardial Infarction Registry. J Cardiol. 2017; 69:377–382.

16. Sim DS, Jeong MH, Ahn Y, et al. Safety and benefit of early elective percutaneous coronary intervention after successful thrombolytic therapy for acute myocardial infarction. Am J Cardiol. 2009; 103:1333–1338.

17. Danchin N, Coste P, Ferrières J, et al. Comparison of thrombolysis followed by broad use of percutaneous coronary intervention with primary percutaneous coronary intervention for ST-segment-elevation acute myocardial infarction: data from the french registry on acute ST-elevation myocardial infarction (FAST-MI). Circulation. 2008; 118:268–276.

18. Armstrong PW, Gershlick AH, Goldstein P, et al. Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction. N Engl J Med. 2013; 368:1379–1387.

19. Kushner FG, Hand M, Smith SC Jr, et al. 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2009; 54:2205–2241.

20. Van de Werf F, Bax J, Betriu A, et al. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology. Eur Heart J. 2008; 29:2909–2945.

21. Sim DS, Jeong MH, Ahn Y, et al. Benefit of percutaneous coronary intervention in early latecomers with acute ST-segment elevation myocardial infarction. Am J Cardiol. 2012; 110:1275–1281.

22. Riezebos RK, Verheugt FW. Timing of angiography in non-ST elevation myocardial infarction. Heart. 2013; 99:1867–1873.

23. Sim DS, Jeong MH, Ahn Y, et al. Clinical impact of immediate invasive strategy in patients with non-ST-segment elevation myocardial infarction. Int J Cardiol. 2016; 221:937–943.

24. Hachinohe D, Jeong MH, Saito S, et al. Management of non-ST-segment elevation acute myocardial infarction in patients with chronic kidney disease (from the Korea Acute Myocardial Infarction Registry). Am J Cardiol. 2011; 108:206–213.

25. Piao ZH, Jeong MH, Jin L, et al. Clinical impact of early intervention in octogenarians with non-ST-elevation myocardial infarction. Int J Cardiol. 2014; 172:462–464.

26. Sim DS, Ahn Y, Jeong MH, et al. Clinical outcome of unprotected left main coronary artery disease in patients with acute myocardial infarction. Int Heart J. 2013; 54:185–191.

27. Kim MC, Jeong MH, Ahn Y, et al. What is optimal revascularization strategy in patients with multivessel coronary artery disease in non-ST-elevation myocardial infarction? Multivessel or culprit-only revascularization. Int J Cardiol. 2011; 153:148–153.

28. Kim MC, Jeong MH, Park KH, et al. Three-year clinical outcomes of staged, ad hoc and culprit-only percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction and multivessel disease. Int J Cardiol. 2014; 176:505–507.

29. Sim DS, Jeong MH, Ahn Y, et al. Effectiveness of drug-eluting stents versus bare-metal stents in large coronary arteries in patients with acute myocardial infarction. J Korean Med Sci. 2011; 26:521–527.

30. Ahmed K, Jeong MH, Chakraborty R, et al. Comparison of zotarolimus- and everolimus-eluting stents in patients with ST-elevation myocardial infarction and chronic kidney disease undergoing primary percutaneous coronary intervention. J Cardiol. 2014; 64:273–278.

31. Piao ZH, Jeong MH, Li Y, et al. Comparison of second-generation drug-eluting versus bare-metal stents in octogenarian patients with ST-segment elevation myocardial infarction. Int J Cardiol. 2014; 177:1081–1084.

32. Ji MS, Jeong MH, Ahn YK, et al. Comparison of resolute zotarolimus-eluting stents versus everolimus-eluting stents in patients with metabolic syndrome and acute myocardial infarction: propensity score-matched analysis. Int J Cardiol. 2015; 199:53–62.

33. Ahmed K, Jeong MH, Chakraborty R, et al. Role of intravascular ultrasound in patients with acute myocardial infarction undergoing percutaneous coronary intervention. Am J Cardiol. 2011; 108:8–14.

34. Vlaar PJ, Svilaas T, van der Horst IC, et al. Cardiac death and reinfarction after 1 year in the thrombus aspiration during percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1-year follow-up study. Lancet. 2008; 371:1915–1920.

35. Fröbert O, Lagerqvist B, Olivecrona GK, et al. Thrombus aspiration during ST-segment elevation myocardial infarction. N Engl J Med. 2013; 369:1587–1597.

36. Lagerqvist B, Fröbert O, Olivecrona GK, et al. Outcomes 1 year after thrombus aspiration for myocardial infarction. N Engl J Med. 2014; 371:1111–1120.

37. Hachinohe D, Jeong MH, Saito S, et al. Clinical impact of thrombus aspiration during primary percutaneous coronary intervention: results from Korea Acute Myocardial Infarction Registry. J Cardiol. 2012; 59:249–257.

38. Sim DS, Jeong MH, Ahn Y, et al. Manual thrombus aspiration during primary percutaneous coronary intervention: Impact of total ischemic time. J Cardiol. 2017; 69:428–435.

39. Chen KY, Rha SW, Li YJ, et al. Triple versus dual antiplatelet therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Circulation. 2009; 119:3207–3214.

40. Park KH, Jeong MH, Lee KH, et al. Comparison of peri-procedural platelet inhibition with prasugrel versus adjunctive cilostazol to dual anti-platelet therapy in patients with ST segment elevation myocardial infarction. J Cardiol. 2014; 63:99–105.

41. American College of Emergency Physicians. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; 61:e78–e140.

42. Yang JH, Hahn JY, Song YB, et al. Association of beta-blocker therapy at discharge with clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. JACC Cardiovasc Interv. 2014; 7:592–601.

43. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Steg PG, James SK, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012; 33:2569–2619.

44. O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127:e362–e425.

45. Jeong HC, Jeong MH, Ahn Y, et al. Comparative assessment of angiotensin II type 1 receptor blockers in the treatment of acute myocardial infarction: surmountable vs. insurmountable antagonist. Int J Cardiol. 2014; 170:291–297.

46. Park H, Kim HK, Jeong MH, et al. Clinical impacts of inhibition of renin-angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention. J Cardiol. 2017; 69:216–221.

47. Cannon CP, Braunwald E, McCabe CH, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med. 2004; 350:1495–1504.

48. Schwartz GG, Olsson AG, Ezekowitz MD, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA. 2001; 285:1711–1718.

49. Lee KH, Jeong MH, Kim HM, et al. Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol. J Am Coll Cardiol. 2011; 58:1664–1671.

50. Sim DS, Jeong MH, Cho KH, et al. Effect of early statin treatment in patients with cardiogenic shock complicating acute myocardial infarction. Korean Circ J. 2013; 43:100–109.

51. Piao ZH, Jeong MH, Li Y, et al. Benefit of statin therapy in patients with coronary spasm-induced acute myocardial infarction. J Cardiol. 2016; 68:7–12.

52. Ji MS, Jeong MH, Ahn YK, et al. Clinical outcome of statin plus ezetimibe versus high-intensity statin therapy in patients with acute myocardial infarction propensity-score matching analysis. Int J Cardiol. 2016; 225:50–59.

53. Kim HK, Jeong MH, Ahn Y, et al. A new risk score system for the assessment of clinical outcomes in patients with non-ST-segment elevation myocardial infarction. Int J Cardiol. 2010; 145:450–454.

54. Kim HK, Jeong MH, Ahn Y, et al. Hospital discharge risk score system for the assessment of clinical outcomes in patients with acute myocardial infarction (Korea Acute Myocardial Infarction Registry [KAMIR] score). Am J Cardiol. 2011; 107:965–971.e1.

55. Jeong YW, Jeong MH, Kim SS, et al. CHA2DS2-VASc scoring system as an initial method for screening high-risk patients in acute myocardial infarction. Int J Cardiol. 2014; 174:777–780.

56. Kim HK, Jeong MH, Seo HW, et al. Clinical impacts of high-sensitivity C-reactive protein reduction for secondary prevention in Asian patients with one-year survivor after acute myocardial infarction. Int J Cardiol. 2015; 193:20–22.

57. Lee JH, Bae MH, Yang DH, et al. Prognostic value of the age, creatinine, and ejection fraction score for 1-year mortality in 30-day survivors who underwent percutaneous coronary intervention after acute myocardial infarction. Am J Cardiol. 2015; 115:1167–1173.

58. Park DW, Clare RM, Schulte PJ, et al. Extent, location, and clinical significance of non-infarct-related coronary artery disease among patients with ST-elevation myocardial infarction. JAMA. 2014; 312:2019–2027.