Clinical Outcomes of Isolated Diastolic Dysfunction in Comparison to Systolic Dysfunction

Abstract

Methods and Results: A total of 22,551 AMI patients registered were divided into the 2 groups, according to the hospitalization inside (U, urban; n517 institutes) or outside (R, rural; n526 institutes) of Sendai City. In 1979, the incidence of AMI (/100,000 persons/year) was lower (R7.3 vs. U12.9) and the in-hospital mortality was higher (R32.8 vs. U12.1%) in the rural than in the urban district (P!0.01). Although the incidence of AMI in the rural district was progressively increased and exceeded that in the urban district by 2008 (R51.4 vs. U36.6, P!0.01), in-hospital mortality was decreased to the similar levels (R9.1 vs. U10.1%). In the last 10 years, the rate of ambulance use (R72 vs. U65%, P!0.0001) and primary percutaneous coronary intervention (R79 vs. U76%, P!0.01) was rather higher in the rural than in the urban district. Conclusions: The increasing incidence of AMI with decreasing in-hospital mortality emerges a more effective strategy to improve the management of post-infarction heart failure, especially in the rural district.