Guideline adherence and long-term clinical outcomes in patients with acute myocardial infarction: a Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) substudy
Restricted accessResearch articleFirst published online December, 2020
Guideline adherence and long-term clinical outcomes in patients with acute myocardial infarction: a Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) substudy
The association between guideline adherence and long-term outcomes in patients with acute myocardial infarction in real-world clinical practice remains unclear.
Methods:
We investigated 3283 consecutive patients with acute myocardial infarction who were selected from a prospective, nation-wide, multicentre registry (J-MINUET) database covering 28 institutions in Japan between July 2012 and March 2014. Among the 2757 eligible patients, we evaluated the use of seven guideline-recommended therapies, including urgent revascularisation, door-to-balloon time of 90 minutes or less, and five discharge medications (P2Y12 inhibitors on aspirin, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, statins, lipid-lowering drugs). The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, cardiac failure and urgent revascularisation for unstable angina up to 3 years.
Results:
The overall median composite guideline adherence was 85.7%. Patients were divided into the following three groups: complete (100%) adherence group (n=862); moderate adherence (75% to <100%) group (n=911); and low adherence (0–75%) group (n=984). The rate of adverse cardiovascular events was significantly lower in the complete adherence group than in the low and moderate adherence groups (log rank P<0.0001). Multivariate Cox regression analysis showed complete guideline adherence was also significantly associated with lower adverse cardiovascular events compared with low guideline adherence (hazard ratio 0.66; 95% confidence interval 0.52–0.85; P=0.001).
Conclusion:
The use of guideline-based therapies for patients with acute myocardial infarction in contemporary clinical practice was associated with significant decreases in adverse long-term clinical outcomes.
AmsterdamEAWengerNKBrindisRG, et al. 2014 AHA/ACC Guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation2014; 130: 2354–2394.
2.
IbanezBJamesSAgewallS, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the Management of Acute Myocardial Infarction in Patients Presenting with ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J2018; 39: 119–177.
3.
KushnerFGHandMSmithSCJr, 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. Circulation2009; 120: 2271–2306.
4.
NeumannFJSousa-UvaMAhlssonA, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J2019; 40: 87–165.
5.
OzakiYKatagiriYOnumaY, et al. CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018. Cardiovasc Interv Therapeut2018; 33: 178–203.
6.
RoffiMPatronoCColletJP, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J2016; 37: 267–315.
7.
RoeMTPetersonEDNewbyLK, et al. The influence of risk status on guideline adherence for patients with non-ST-segment elevation acute coronary syndromes. Am Heart J2006; 151: 1205–1213.
8.
LewisWREllrodtAGPetersonE, et al. Trends in the use of evidence-based treatments for coronary artery disease among women and the elderly: findings from the get with the guidelines quality-improvement program. Circ Cardiovasc Quality Outcomes2009; 2: 633–641.
9.
BrilakisESHernandezAFDaiD, et al. Quality of care for acute coronary syndrome patients with known atherosclerotic disease: results from the Get With the Guidelines Program. Circulation2009; 120: 560–567.
10.
IshiharaMFujinoMOgawaH, et al. Clinical presentation, management and outcome of japanese patients with acute myocardial infarction in the troponin era – Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET). Circ J2015; 79: 1255–1262.
11.
ThygesenKAlpertJSJaffeAS, et al. Third universal definition of myocardial infarction. J Am Coll Cardiol2012; 60: 1581–1598.
12.
O’GaraPTKushnerFGAscheimDD, 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. Circulation2013; 127: e362–e425.
13.
KrumholzHMAndersonJLBachelderBL, et al. ACC/AHA 2008 Performance measures for adults with ST-elevation and non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (writing committee to develop performance measures for ST-elevation and non-ST-elevation myocardial infarction): developed in collaboration with the American Academy of Family Physicians and the American College of Emergency Physicians: endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, Society for Cardiovascular Angiography and Interventions, and Society of Hospital Medicine. Circulation2008; 118: 2596–2648.
14.
LongeneckerJCAlfaddaghAZubaidM, et al. Adherence to ACC/AHA performance measures for myocardial infarction in six Middle-Eastern countries: association with in-hospital mortality and clinical characteristics. Int J Cardiol2013; 167: 1406–1411.
15.
IshiharaMNakaoKOzakiY, et al. Long-term outcomes of non-ST-elevation myocardial infarction without creatine kinase elevation – the J-MINUET Study. Circ J2017; 81: 958–965.
16.
GibsonCMPrideYBFrederickPD, et al. Trends in reperfusion strategies, door-to-needle and door-to-balloon times, and in-hospital mortality among patients with ST-segment elevation myocardial infarction enrolled in the National Registry of Myocardial Infarction from 1990 to 2006. Am Heart J2008; 156: 1035–1044.
17.
PetersonEDRoeMTMulgundJ, et al. Association between hospital process performance and outcomes among patients with acute coronary syndromes. JAMA2006; 295: 1912–1920.
18.
ShahBRO’BrienECRoeMT, et al. The association of in-hospital guideline adherence and longitudinal postdischarge mortality in older patients with non-ST-segment elevation myocardial infarction. Am Heart J2015; 170: 273–280.e1.
19.
HudedCPKumarAJohnsonM, et al. Incremental prognostic value of guideline-directed medical therapy, transradial access, and door-to-balloon time on outcomes in ST-segment-elevation myocardial infarction. Circ Cardiovasc Interv2019; 12: e007101.
20.
SchieleFGaleCPBonnefoyE, et al. Quality indicators for acute myocardial infarction: a position paper of the Acute Cardiovascular Care Association. Eur Heart J Acute Cardiovasc Care2017; 6: 34–59.
21.
KimuraKKimuraTIshiharaM, et al. JCS 2018 Guideline on diagnosis and treatment of acute coronary syndrome. Circ J2019; 83: 1085–1196.
22.
KofoedKFKelbaekHHansenPR, et al. Early versus standard care invasive examination and treatment of patients with non-ST-segment elevation acute coronary syndrome. Circulation2018; 138: 2741–2750.
23.
NallamothuBKNormandSLWangY, et al. Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time: a retrospective study. Lancet (London, England)2015; 385: 1114–1122.
24.
RosselloXPocockSJJulianDG.Long-term use of cardiovascular drugs: challenges for research and for patient care. J Am Coll Cardiol2015; 66: 1273–1285.
25.
PagidipatiNJNavarAMPieperKS, et al. Secondary prevention of cardiovascular disease in patients with type 2 diabetes mellitus: international insights from the TECOS Trial (Trial Evaluating Cardiovascular Outcomes With Sitagliptin). Circulation2017; 136: 1193–1203.
26.
HaoYLiuJLiuJ, et al. Sex differences in in-hospital management and outcomes of patients with acute coronary syndrome. Circulation2019; 139: 1776–1785.
27.
DalyCClemensFLopez SendonJL, et al. Gender differences in the management and clinical outcome of stable angina. Circulation2006; 113: 490–498.
28.
GudnadottirGSAndersenKThrainsdottirIS, et al. Gender differences in coronary angiography, subsequent interventions, and outcomes among patients with acute coronary syndromes. Am Heart J2017; 191: 65–74.
29.
MoserDKMcKinleySDracupK, et al. Gender differences in reasons patients delay in seeking treatment for acute myocardial infarction symptoms. Patient Educ Counsel2005; 56: 45–54.
30.
WadaHMiyauchiKDaidaH.Gender differences in the clinical features and outcomes of patients with coronary artery disease. Exp Rev Cardiovasc Ther2019; 17: 127–133.
31.
Keough-RyanTMKiberdBADipchandCS, et al. Outcomes of acute coronary syndrome in a large Canadian cohort: impact of chronic renal insufficiency, cardiac interventions, and anemia. Am J Kidney Dis2005; 46: 845–855.
32.
Mechta NielsenTFrojk JuhlMFeldt-RasmussenB, et al. Adherence to medication in patients with chronic kidney disease: a systematic review of qualitative research. Clin Kid J2018; 11: 513–527.
33.
BakrisGLHartPRitzE.Beta blockers in the management of chronic kidney disease. Kidney Int2006; 70: 1905–1913.
34.
WinkelmayerWCCharytanDMLevinR, et al. Poor short-term survival and low use of cardiovascular medications in elderly dialysis patients after acute myocardial infarction. Am J Kidney Dis2006; 47: 301–308.
35.
ChertowGMNormandSLMcNeilBJ.“Renalism”: inappropriately low rates of coronary angiography in elderly individuals with renal insufficiency. J Am Soc Nephrol2004; 15: 2462–2468.
36.
SmilowitzNRGuptaNGuoY, et al. Management and outcomes of acute myocardial infarction in patients with chronic kidney disease. Int J Cardiol2017; 227: 1–7.
37.
McCulloughPA.Why is chronic kidney disease the “spoiler” for cardiovascular outcomes?J Am Coll Cardiol2003; 41: 725–728.
38.
BuenoHRosselloXPocockS, et al. Regional variations in hospital management and post-discharge mortality in patients with non-ST-segment elevation acute coronary syndrome. Clin Res Cardiol: official journal of the German Cardiac Society2018; 107: 836–844.
39.
RosselloXHuoYPocockS, et al. Global geographical variations in ST-segment elevation myocardial infarction management and post-discharge mortality. Int J Cardiol2017; 245: 27–34.
