抄録
Background: Only a few nationwide studies have focused on the post-discharge treatment and outcomes of acute coronary syndrome (ACS) by general practitioners. Methods and Results: This prospective cohort study was conducted between February 2007 and March 2011. In total, 178 facilities across the country participated in this study, which included 545 patients with ACS who received acute care in cardiovascular centers and were then referred to general practitioners for further care. Clinical follow-up data, of up to 5 years, were obtained. As for patient characteristics, 403 of the 545 patients (73.9%) were men. The mean age of all subjects was 66 ± 11 years. Approximately two-thirds of patients had hypertension and dyslipidemia, and one-third had diabetes mellitus. Only 3.5% of patients had renal dysfunction. In the cardiovascular centers, reperfusion therapy was administered as acute care to 516 of the 545 patients (94.7%). Frequent use of guideline-directed medical therapy was indicated during the in-hospital and post-discharge periods. During the 5-year follow-up period, the cumulative incidence of clinical events was 24.0%, and all-cause mortality was 5.3%. The number of affected vessels was the strongest independent predictor of cardiovascular events. Conclusions: The MIC-K study identified an incidence of clinical events of 24.0%, and that of mortality of 5.3% in patients with ACS who were managed by general practitioners following their discharge from cardiovascular centers. The high rate of reperfusion therapy administered in cardiovascular centers and a low complication rate may have contributed to the favorable outcomes in these patients.
