Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Late Breaking Cohort Studies (JCS 2013)
Management and Two-Year Long-Term Clinical Outcome of Acute Coronary Syndrome in Japan
– Prevention of AtherothrombotiC Incidents Following Ischemic Coronary Attack (PACIFIC) Registry –
Hiroyuki DaidaKatsumi MiyauchiHisao OgawaHiroyoshi YokoiMasayasu MatsumotoMasafumi KitakazeTakeshi KimuraTetsuo MatsubaraYuji IkariKazuo KimuraKengo TsukaharaHideki OrigasaYoshihiro MorinoHiroyuki TsutsuiMasayuki KobayashiTakaaki Isshikion behalf of the PACIFIC investigators
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Supplementary material

2013 Volume 77 Issue 4 Pages 934-943


Background: Japanese patients have been at low risk for cardiovascular events compared with Western countries, but the data regarding current treatment status and rate of subsequent atherothrombotic events after acute coronary syndrome (ACS) are limited in Japanese patients. The objective of this study was to clarify the treatment status and long-term outcomes in Japanese ACS patients. Methods and Results: The Prevention of AtherothrombotiC Incidents Following Ischemic Coronary attack (PACIFIC) registry is a multicenter, prospective observational study of Japanese ACS patients. Consecutive patients aged ≥20 years hospitalized for ACS were enrolled from 96 hospitals and followed up for 2 years (n=3,597). ST-segment elevation myocardial infarction (STEMI) was the most frequent type of ACS (59.4%). The vast majority (93.5%) of patients underwent percutaneous coronary intervention (PCI), with a success rate of 93.9%. Frequent use of guideline-recommended pharmacological treatments was also indicated. Cumulative incidence of major adverse cardiac and cerebrovascular events (MACCE) was 6.4% (7.5% for STEMI and 4.8% for non-STEMI or unstable angina), and all-cause mortality was 6.3%. Conclusions: The PACIFIC registry has identified an incidence of MACCE of 6.4% and that of mortality at 6.3% in Japanese ACS patients at 2-year follow-up. A high proportion of patients underwent PCI, and the PCI success rate was high. Proactively performed successful PCI was considered to have contributed to favorable outcomes in these patients.  (Circ J 2013; 77: 934–943)

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