Characteristics of out-of-hospital cardiac arrest patients due to acute myocardial infarction

• Project/Area Number: 16K15355
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Multi-year Fund
• Research Field: Epidemiology and preventive medicine
• Research Institution: National Cardiovascular Center Research Institute (2018); Yamagata University (2016-2017)
• Principal Investigator: Hirayama Atsushi 国立研究開発法人国立循環器病研究センター, 病院, 専門修練医 (20637350)
• Co-Investigator(Kenkyū-buntansha): 久保田 功 山形大学, 学内共同利用施設等, 理事 (30161673)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥2,912,000 (Direct Cost: ¥2,240,000、Indirect Cost: ¥672,000); Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2016: ¥1,742,000 (Direct Cost: ¥1,340,000、Indirect Cost: ¥402,000)
• Keywords: 急性心筋梗塞 / 院外心停止 / 疫学 / 急性冠症候群 / 院外心肺停止 / 地理情報システム / 予防医学 / 循環器疾患 / 循環器 / 疫学研究 / 病院外心肺停止

Outline of Final Research Achievements

We registered and analyzes all cases with acute myocardial infarction (AMI) from 2010 to 2015 in Yamagata prefecture, Japan, by using hospital-based registry and exhaustive survey of death certificate. A total of 6,978 AMI cases were registered (mean age was 75.8 ± 12.8 years; 61% were male), and the incidence rate was 0.984 per 1,000 person-years. Among these, 3,722 (54%) patients collapsed or died before arrival to hospital.
Multivariable logistic regression analysis revealed that higher age, female sex and winter-onset (December, January, February) were significantly associated with out-of-hospital cardiac arrest.

Academic Significance and Societal Importance of the Research Achievements

急性心筋梗塞患者のうち病院到着前に心肺停止状態に陥った症例は生命予後・社会復帰率が低く、病院到着後のケアと並行して病院外の対応の強化が肝要である。本研究は高齢社会の本邦において特に中～高年期の女性および冬季期間が病院到着前心肺停止のリスクとなりうることを明らかにし、心筋梗塞の初期症状及び狭心症の症状についての啓発と早期に治療可能な規模を有する医療機関への受診を促す啓発の重要性を明らかにした点で学術的・社会的に重要である。

Research Products

• [Presentation] Treatments after hospital arrival and clinical outcomes among patients with out-of-hospital cardiac arrest due to acute coronary syndrome: JAAM-OHCA study group (2019)
  • Author(s): 平山 敦士
  • Organizer: 日本循環器学会学術集会2019
• [Presentation] Sex-related difference in receiving bystander cardiopulmonary resuscitation and clinical outcome among out-of-hospital cardiac arrest patients: the JCS-ReSS study group (2019)
  • Author(s): 市原 慎也
  • Organizer: European Society of Cardiology Congress 2019
• [Presentation] 成人心肺停止蘇生後の12誘導心電図にてST上昇を伴わない症例における冠動脈造影の実施状況と社会復帰率の関係 (2019)
  • Author(s): 川越 康仁
  • Organizer: 日本集中治療学会総会2019
• [Presentation] Association of Neurological Outcome and Survival with Interventions by Public and Emergency Medical Service for Unwitnessed Out-of-Hospital Cardiac Arrest Patient; Results from the All-Japan Utstein Registry (2018)
  • Author(s): 岡本 千聡
  • Organizer: American Heart Association Scientific Meeting 2018
• [Presentation] Association between hospital arrival time and outcomes in patients with out-of-hospital cardiac arrest due to acute myocardial infarction: JAAM-OHCA study group (2018)
  • Author(s): 細田 勇人
  • Organizer: American Heart Association Scientific Meeting 2018
• [Presentation] Association of First Documented Rhythms and Etiology of Arrest with Clinical Outcomes; Report of JCS-Ress study with 23,918 Patients Out-of-hospital Cardiac Arrest (2018)
  • Author(s): 加藤 悠太
  • Organizer: American Heart Association Scientific Meeting 2018
• [Presentation] 非ST上昇型心筋梗塞院外心肺停止症例に対しての治療戦略と予後の関連：JAAM多施設共同院外心停止レジストリ (2018)
  • Author(s): 開地 亮太
  • Organizer: 日本救急医学会総会2018