Recent Update of Korea Acute Myocardial Infarction Registry (KAMIR)

Abstract

Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry and reflects the current therapeutic approaches and management for acute myocardial infarction (AMI) in Korea. The results of KAMIR demonstrated different risk factors and different responses to medical and interventional therapies. The prevalence of hypertension, diabetes mellitus and dyslipidemia has increased, but smoking has decreased remarkably. Different pattern of dyslipidemia was demonstrated. The KAMIR score was better than TIMI and GRACE scores in the prediction of long-term mortality in AMI patients. Triple antiplatelet therapy, consisting of aspirin, clopidogrel and cilostazol, was effective in preventing adverse clinical outcomes after percutaneous coronary intervention (PCI). Prasugrel and ticagrelor could not reduce ischemic events, but increased bleeding risk in Korean patients. Therefore, we may recommend low dose prasugrel and ticagrelor compared with Western patients. Statin therapy was effective in Korean AMI patients, including those with very low levels of low density cholesterol and spasm-induced AMI. Statin and ezetimibe was effective in high-risk AMI patients, such as diabetes, old age and systolic heart failure. PCI and its success rates of ST-elevation myocardial infarction (STEMI) are 96.7% and 99.4%, and those of non-ST-elevation myocardial infarction (NSTEMI) 82.7% and 99.5%, respectively. Drug-eluting stents were effective and safe in AMI patients with no increased risk of stent thrombosis in Korean patients. KAMIR will provide new therapeutic strategies and effective methods for secondary prevention of AMI and new guidelines for Asian patients.