PREVENTION OF ACUTE MI BY AGGRESSIVE APPROACH TO TREAT UNSTABLE ANGINA



Yasunori Ueda, M.D., Ph.D., Osaka National Hospital, Osaka, Japan

Although the incidence of in-hospital death from acute myocardial infarction (MI) is about 5%, about 40% of the patients who suffer acute MI die before hospitalization. Indeed, 6,000 of 69,000 hospitalized acute MI patients die and 34,000 acute MI patients die before hospitalization every year in Japan. Therefore, the prevention of acute MI is very important.

Acute MI is known to occur within a day after coronary plaque disruption in a half of the patients, while it takes days to weeks in the rest half. A half of the hospitalized acute MI patients are known to have experienced chest pain days to weeks before the onset of MI. This symptom of unstable angina is often disregarded by the patients because it is often a mild chest pain or heartburn of short duration.

If we can treat all of those unstable angina patients, we can prevent them from suffering MI and we can reduce the number of MI patients into half. This effect can be translated into the medical cost reduction of 70,000,000,000 yen per year.

All we have to do to achieve this aim is to make those unstable angina patients go to hospital and to diagnose and treat them properly. In order to make them go to hospital, “STOP MI campaign” is now under preparation by The Japanese Circulation Society. Although it may take a long time to eliminate the occurrence of MI from this world, we can and we should make it half immediately.