Prediction of Long-Term Outcomes in ST-Elevation Myocardial Infarction and Non-ST Elevation Myocardial Infarction with and without Creatinine Kinase Elevation—Post-Hoc Analysis of the J-MINUET Study

Prediction of Long-Term Outcomes in ST-Elevation Myocardial Infarction and Non-ST Elevation Myocardial Infarction with and without Creatinine Kinase Elevation—Post-Hoc Analysis of the J-MINUET Study

Shigeru Toyoda;Masashi Sakuma;Shichiro Abe;Teruo Inoue;Koichi Nakao;Yukio Ozaki;Kazuo Kimura;Junya Ako;Teruo Noguchi;Satoru Suwa;Kazuteru Fujimoto;Yasuharu Nakama;Takashi Morita;Wataru Shimizu;Yoshihiko Saito;Atsushi Hirohata;Yasuhiro Morita;Atsunori Okamura;Toshiaki Mano;Minoru Wake;Kengo Tanabe;Yoshisato Shibata;Mafumi Owa;Kenichi Tsujita;Hiroshi Funayama;Nobuaki Kokubu;Ken Kozuma;Tetsuya Toubaru;Keijirou Saku;Shigeru Ohshima;Yoshihiro Miyamoto;Hisao Ogawa;Masaharu Ishihara;Toyoda, Shigeru;Sakuma, Masashi;Abe, Shichiro;Inoue, Teruo;Nakao, Koichi;Ozaki, Yukio;Kimura, Kazuo;Ako, Junya;Noguchi, Teruo;Suwa, Satoru;Fujimoto, Kazuteru;Nakama, Yasuharu;Morita, Takashi;Shimizu, Wataru;Saito, Yoshihiko;Hirohata, Atsushi;Morita, Yasuhiro;Okamura, Atsunori;Mano, Toshiaki;Wake, Minoru;Tanabe, Kengo;Shibata, Yoshisato;Owa, Mafumi;Tsujita, Kenichi;Funayama, Hiroshi;Kokubu, Nobuaki;Kozuma, Ken;Toubaru, Tetsuya;Saku, Keijirou;Ohshima, Shigeru;Miyamoto, Yoshihiro;Ogawa, Hisao;Ishihara, Masaharu;
journal of clinical medicine 2020 Vol. 9 pp. 2667-
206
toyoda2020journalprediction

Abstract

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.

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