Background:Characteristics and treatment outcomes of acute myocardial infarction (AMI) patients have been studied; however, those of recent myocardial infarction (RMI) patients remain unclear. This study aimed to clarify characteristics, treatment strategy, and in-hospital outcomes of RMI patients in the Tokyo CCU network database.

Methods and Results:In total, 1,853 RMI and 12,494 AMI patients from the Tokyo CCU network database during 2013–2016 were compared. Both RMI and AMI were redefined by onset times of 2–28 days and ≤24 h, respectively. The RMI group had a higher average age (70.4±12.9 vs. 68.0±13.4 years, P<0.001), more women (27.6% vs. 23.6%, P<0.001), lower proportion of patients with chest pain as the chief complaint (75.2% vs. 83.6%, P<0.001), higher prevalence of diabetes mellitus (35.9% vs. 31.0%, P<0.001), and higher mechanical complication incidence (3.0% vs. 1.5%, P<0.001) than did the AMI group. Thirty-day mortality was comparable (5.3% vs. 5.8%, P=0.360); major causes of death were cardiogenic shock and mechanical complications in the AMI and RMI groups, respectively. Death from mechanical complications (not onset time) in the AMI group plateaued almost 1 week after hospitalization, whereas it continued to increase in the RMI group.

Conclusions:Both RMI and AMI patients have distinctive clinical features, sequelae, and causes of death. Although treatment of RMI patients adhered to guidelines, it was insufficient, and death from mechanical complications continues to increase.

背景：研究了急性心肌梗死（AMI）患者的特征和治疗结果；然而，近期心肌梗死 (RMI) 患者的情况仍不清楚。本研究旨在阐明东京 CCU 网络数据库中 RMI 患者的特征、治疗策略和住院结果。

方法和结果：总共比较了 2013-2016 年东京 CCU 网络数据库中的 1,853 名 RMI 和 12,494 名 AMI 患者。RMI 和 AMI 分别被重新定义为 2-28 天和≤24 小时的发病时间。RMI组平均年龄较高（70.4±12.9 vs. 68.0±13.4岁，P<0.001），女性较多（27.6% vs. 23.6%，P<0.001），以胸痛为主诉的患者比例较低（75.2% vs. 83.6%，P<0.001），糖尿病患病率更高（35.9% vs. 31.0%，P<0.001），机械并发症发生率更高（3.0% vs. 1.5%，P<0.001） AMI 组。30 天死亡率相当（5.3% 对 5.8%，P=0.360）；AMI 和 RMI 组的主要死亡原因分别是心源性休克和机械并发症。

结论： RMI 和 AMI 患者都有独特的临床特征、后遗症和死亡原因。RMI患者的治疗虽然遵循了指南，但还不够，机械并发症导致的死亡继续增加。