Impact of the Japan earthquake disaster with massive Tsunami on emergency coronary intervention and in-hospital mortality in patients with acute ST-elevation myocardial infarction. Issue 3 (1st September 2014)

• Record Type: Journal Article
• Authors: Itoh, Tomonori; Nakajima, Satoshi; Tanaka, Fumitaka; Nishiyama, Osamu; Matsumoto, Tatsuya; Endo, Hiroshi; Sakai, Toshiaki; Nakamura, Motoyuki; Morino, Yoshihiro
• Is Part Of: European heart journal. Volume 3:Issue 3(2014:Sep.)
• Page Start: 195
• Page End: 203
• Publication Date: 2014-09-01
• Subjects: ST-elevation myocardial infarction -- percutaneous coronary intervention -- Japan earthquake disaster -- Tsunami -- mortality; 616.1205
• DOI: 10.1177/2048872614538388
• Languages: English
• ISSNs: 2048-8726

Abstract

Abstract: Aims: The aims of this study were to evaluate reperfusion rate, therapeutic time course and in-hospital mortality pre- and post-Japan earthquake disaster, comparing patients with ST-elevation myocardial infarction (STEMI) treated in the inland area or the Tsunami-stricken area of Iwate prefecture. Method and results: Subjects were 386 consecutive STEMI patients admitted to the four percutaneous coronary intervention (PCI) centers in Iwate prefecture in 2010 and 2011. Patients were divided into two groups: those treated in the inland or Tsunami-stricken area. We compared clinical characteristics, time course and in-hospital mortality in both years in the two groups. PCI was performed in 310 patients (80.3%). Door-to-balloon (D2B) time in the Tsunami-stricken area in 2011 was significantly shorter than in 2010 in patients treated with PCI. However, the rate of PCI performed in the Tsunami-stricken area in March–April 2011 was significantly lower than that in March–April 2010 (41.2% vs 85.7%; p =0.03). In-hospital mortality increased three-fold from 7.1% in March–April 2010 to 23.5% in March–April 2011 in the Tsunami-stricken area. Standardized mortality ratio (SMR) in March–April 2011 in the Tsunami-stricken area was significantly higher than the control SMR (SMR 4.72: 95% confidence interval (CI): 1.77–12.6: p =0.007). Conclusions: The rate of PCI decreased and in-hospital mortality increased immediately after the Japan earthquake disaster in the Tsunami-stricken area. Disorder in hospitals and in the distribution systems after the disaster impacted the clinical care and outcome of STEMI patients.