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Validation of the atherothrombotic risk score for secondary prevention in patients with acute myocardial infarction: the J-MINUET study

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Abstract

Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention (TRS2°P) is a contemporary risk scoring system for secondary prevention based on nine clinical factors. However, this scoring system has not been validated in other populations. The aim of this study was to validate the TRS2°P in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI) in a nationwide registry cohort. Among 3283 consecutive patients with AMI enrolled in the Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET), a total of 2611 patients who underwent primary PCI were included in this study. The performance of the TRS2°P to predict major adverse cardiovascular events (MACE) composed of all-cause death, non-fatal MI, and non-fatal stroke up to 3 years in the present cohort was evaluated. The TRS2°P had modest discriminative performance in this J-MINUET cohort with a c-statistic of 0.63, similar to that in the derived cohort (TRA2°P-TIMI50, c-statistic 0.67). A strong graded relationship between the TRS2°P and 3-year cardiovascular event rates was also observed in the J-MINUET cohort. Age ≥ 75 years, Killip ≥ 2, prior stroke, peripheral artery disease, anemia, and non-ST-elevation myocardial infarction were identified as independent factors for the incidence of MACE. The TRS2°P modestly predicted secondary cardiovascular events among patients with AMI treated by primary PCI in a nationwide cohort of Japan. Further studies are needed to develop a novel risk score better predicting secondary cardiovascular events.

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Acknowledgements

The authors thank all of the enrolled patients, participating cardiologists, medical professionals, and other staff who contributed to this study.

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan

    Takuya Hashimoto, Yoshiyasu Minami & Junya Ako

  2. Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan

    Koichi Nakao

  3. Department of Cardiology, Fujita Health University Okazaki Hospital, Okazaki, Japan

    Yukio Ozaki

  4. Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Japan

    Kazuo Kimura

  5. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan

    Teruo Noguchi & Hisao Ogawa

  6. Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan

    Satoru Suwa

  7. Department of Cardiology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

    Kazuteru Fujimoto

  8. Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan

    Yasuharu Nakama

  9. Division of Cardiology, Osaka General Medical Center, Osaka, Japan

    Takashi Morita

  10. Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan

    Wataru Shimizu

  11. First Department of Internal Medicine, Nara Medical University, Kashihara, Japan

    Yoshihiko Saito

  12. Department of Cardiovascular Medicine, The Sakakibara Heart Institute of Okayama, Okayama, Japan

    Atsushi Hirohata

  13. Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan

    Yasuhiro Morita

  14. Department of Cardiovascular Medicine, Dokkyo Medical University, Tochigi, Japan

    Teruo Inoue

  15. Department of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan

    Atsunori Okamura

  16. Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan

    Toshiaki Mano

  17. Department of Cardiology, Okinawa Chubu Hospital, Uruma, Japan

    Kazuhito Hirata

  18. Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan

    Kengo Tanabe

  19. Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki, Japan

    Yoshisato Shibata

  20. Department of Cardiovascular Medicine, Suwa Red Cross Hospital, Suwa, Japan

    Mafumi Owa

  21. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Kenichi Tsujita

  22. Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University, Saitama, Japan

    Hiroshi Funayama

  23. Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Sapporo, Japan

    Nobuaki Kokubu

  24. Department of Cardiology, Teikyo University, Tokyo, Japan

    Ken Kozuma

  25. Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan

    Shiro Uemura

  26. Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan

    Tetsuya Tobaru

  27. Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan

    Keijiro Saku

  28. Department of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan

    Shigeru Oshima

  29. Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan

    Kunihiro Nishimura & Yoshihiro Miyamoto

  30. Division of Coronary Artery Disease, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan

    Masaharu Ishihara

Authors
  1. Takuya Hashimoto
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  2. Yoshiyasu Minami
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  4. Koichi Nakao
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  5. Yukio Ozaki
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  6. Kazuo Kimura
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  7. Teruo Noguchi
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  8. Satoru Suwa
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  9. Kazuteru Fujimoto
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  11. Takashi Morita
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  14. Atsushi Hirohata
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  15. Yasuhiro Morita
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  16. Teruo Inoue
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  18. Toshiaki Mano
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  22. Mafumi Owa
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  24. Hiroshi Funayama
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  25. Nobuaki Kokubu
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  26. Ken Kozuma
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  31. Kunihiro Nishimura
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  32. Yoshihiro Miyamoto
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  33. Hisao Ogawa
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  34. Masaharu Ishihara
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Hashimoto, T., Minami, Y., Ako, J. et al. Validation of the atherothrombotic risk score for secondary prevention in patients with acute myocardial infarction: the J-MINUET study. Heart Vessels 36, 1506–1513 (2021). https://doi.org/10.1007/s00380-021-01840-z

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