著者

Takahiro Nakashima Katsutaka Hashiba Migaku Kikuchi Junichi Yamaguchi Sunao Kojima Hiroyuki Hanada Toshiaki Mano Takeshi Yamamoto Akihito Tanaka Kunihiro Matsuo Naoki Nakayama Osamu Nomura Tetsuya Matoba Yoshio Tahara Hiroshi Nonogi for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.4, no.5, pp.187-193, 2022-05-10 (Released:2022-05-10)

参考文献数

30

被引用文献数

4

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Background: To achieve early reperfusion therapy for ST-elevation myocardial infarction (STEMI), proper and prompt patient transportation and activation of the catheterization laboratory are required. We investigated the efficacy of prehospital 12-lead electrocardiogram (ECG) acquisition and destination hospital notification in patients with STEMI.Methods and Results: This is a systematic review of observational studies. We searched the PubMed database from inception to March 2020. Two reviewers independently performed literature selection. The critical outcome was short-term mortality. The important outcome was door-to-balloon (D2B) time. We used the GRADE approach to assess the certainty of the evidence. For the critical outcome, 14 studies with 29,365 patients were included in the meta-analysis. Short-term mortality was significantly lower in the group with prehospital 12-lead ECG acquisition and destination hospital notification than in the control group (odds ratio 0.72; 95% confidence interval [CI] 0.61–0.85; P<0.0001). For the important outcome, 10 studies with 2,947 patients were included in the meta-analysis. D2B time was significantly shorter in the group with prehospital 12-lead ECG acquisition and destination hospital notification than in the control group (mean difference −26.24; 95% CI −33.46, −19.02; P<0.0001).Conclusions: Prehospital 12-lead ECG acquisition and destination hospital notification is associated with lower short-term mortality and shorter D2B time than no ECG acquisition or no notification among patients with suspected STEMI outside of a hospital.

著者

Migaku Kikuchi Yoshio Tahara Junichi Yamaguchi Takahiro Nakashima Osamu Nomura Akihito Tanaka Sunao Kojima Katsutaka Hashiba Naoki Nakayama Hiroyuki Hanada Toshiaki Mano Takeshi Yamamoto Kunihiro Matsuo Ichiro Takeuchi Tetsuya Matoba Hiroshi Nonogi for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0096, (Released:2023-04-20)

参考文献数

23

被引用文献数

4

著者

Naoki Nakayama Takeshi Yamamoto Migaku Kikuchi Hiroyuki Hanada Toshiaki Mano Takahiro Nakashima Katsutaka Hashiba Akihito Tanaka Kunihiro Matsuo Osamu Nomura Sunao Kojima Junichi Yamaguchi Tetsuya Matoba Yoshio Tahara Hiroshi Nonogi for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.4, no.10, pp.449-457, 2022-10-07 (Released:2022-10-07)

参考文献数

20

被引用文献数

1 5

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Background: Recent guidelines for acute coronary syndrome (ACS) recommend prehospital administration of aspirin and nitroglycerin for ACS patients. However, there is no clear evidence to support this. We investigated the benefits and harms of prehospital administration of aspirin and nitroglycerin by non-physician healthcare professionals in patients with suspected ACS.Methods and Results: We searched the PubMed database and used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence. Three retrospective studies for aspirin and 1 for nitroglycerin administered in the prehospital setting to patients with acute myocardial infarction were included. Prehospital aspirin administration was associated with significantly lower 30-day and 1-year mortality compared with aspirin administration after arrival at hospital, with odds ratios (OR) of 0.59 (95% confidence interval [CI] 0.35–0.99) and 0.47 (95% CI 0.36–0.62), respectively. Prehospital nitroglycerin administration was also associated with significantly lower 30-day and 1-year mortality compared with no prehospital administration (OR 0.34 [95% CI 0.24–0.50] and 0.38 [95% CI 0.29–0.50], respectively). The certainty of evidence was very low in both systematic reviews.Conclusions: Our systematic reviews suggest that prehospital administration of aspirin and nitroglycerin by non-physician healthcare professionals is beneficial for patients with suspected ACS, although the certainty of evidence is very low. Further investigation is needed to determine the benefit of the prehospital administration of these agents.

著者

Sunao Kojima Takeshi Yamamoto Migaku Kikuchi Hiroyuki Hanada Toshiaki Mano Takahiro Nakashima Katsutaka Hashiba Akihito Tanaka Junichi Yamaguchi Kunihiro Matsuo Naoki Nakayama Osamu Nomura Tetsuya Matoba Yoshio Tahara Hiroshi Nonogi for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.4, no.8, pp.335-344, 2022-08-10 (Released:2022-08-10)

参考文献数

24

被引用文献数

2

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Background: In Japan, oxygen is commonly administered during the acute phase of myocardial infarction (MI) to patients without oxygen saturation monitoring. In this study we assessed the effects of supplemental oxygen therapy, compared with ambient air, on mortality and cardiac events by synthesizing evidence from randomized controlled trials (RCTs) of patients with suspected or confirmed acute MI.Methods and Results: PubMed was systematically searched for full-text RCTs published in English before June 21, 2020. Two reviewers independently screened the search results and appraised the risk of bias. The estimates for each outcome were pooled using a random-effects model. In all, 2,086 studies retrieved from PubMed were screened. Finally, 7,322 patients from 9 studies derived from 4 RCTs were analyzed. In-hospital mortality in the oxygen and ambient air groups was 1.8% and 1.6%, respectively (risk ratio [RR] 0.90; 95% confidence interval [CI] 0.38–2.10]); 0.8% and 0.5% of patients, respectively, experienced recurrent MI (RR 0.44; 95% CI 0.12–1.54), 1.5% and 1.6% of patients, respectively, experienced cardiac shock (RR 1.10; 95% CI 0.77–1.59]), and 2.4% and 2.0% of patients, respectively, experienced cardiac arrest (RR 0.91; 95% CI 0.43–1.94).Conclusions: Routine supplemental oxygen administration may not be beneficial or harmful, and high-flow oxygen may be unnecessary in normoxic patients in the acute phase of MI.

著者

Katsutaka Hashiba Takahiro Nakashima Migaku Kikuchi Sunao Kojima Hiroyuki Hanada Toshiaki Mano Takeshi Yamamoto Akihito Tanaka Junichi Yamaguchi Kunihiro Matsuo Naoki Nakayama Osamu Nomura Tetsuya Matoba Yoshio Tahara Hiroshi Nonogi for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-22-0034, (Released:2022-07-13)

参考文献数

19

被引用文献数

4

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Background: In the management of patients with ST-elevation myocardial infarction (STEMI), system delays for reperfusion therapy are still a matter of concern. We investigated the impact of prehospital activation of the catheterization laboratory in the management of STEMI patients.Methods and Results: This is a systematic review of observational studies. A search was conducted of the PubMed database from inception to July 2020 to identify articles for inclusion in the study. The critical outcomes were short- and long-term mortality. The important outcome was door-to-balloon time. The GRADE approach was used to assess the certainty of the evidence. Seven studies assessed short-term mortality; 1,541 were assigned to the prehospital activation (PH) group and 1,191 were assigned to the emergency department activation (ED) group. There were 26 fewer deaths per 1,000 patients in the PH group. Three studies assessed long-term mortality; 713 patients were assigned to the PH group and 1,026 were assigned to the ED group. There were 54 fewer deaths per 1,000 patients among the PH group. Five studies assessed door-to-balloon time; 959 were assigned to the PH group and 631 to the ED group. Door-to-balloon time was 33.1 min shorter in the PH group.Conclusions: Prehospital activation of the catheterization laboratory resulted in lower mortality and shorter door-to-balloon time for patients with suspected STEMI outside of a hospital.

著者

Sunao Kojima Takeshi Yamamoto Migaku Kikuchi Hiroyuki Hanada Toshiaki Mano Takahiro Nakashima Katsutaka Hashiba Akihito Tanaka Junichi Yamaguchi Kunihiro Matsuo Naoki Nakayama Osamu Nomura Tetsuya Matoba Yoshio Tahara Hiroshi Nonogi for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-22-0031, (Released:2022-07-06)

参考文献数

24

被引用文献数

2

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Background: In Japan, oxygen is commonly administered during the acute phase of myocardial infarction (MI) to patients without oxygen saturation monitoring. In this study we assessed the effects of supplemental oxygen therapy, compared with ambient air, on mortality and cardiac events by synthesizing evidence from randomized controlled trials (RCTs) of patients with suspected or confirmed acute MI.Methods and Results: PubMed was systematically searched for full-text RCTs published in English before June 21, 2020. Two reviewers independently screened the search results and appraised the risk of bias. The estimates for each outcome were pooled using a random-effects model. In all, 2,086 studies retrieved from PubMed were screened. Finally, 7,322 patients from 9 studies derived from 4 RCTs were analyzed. In-hospital mortality in the oxygen and ambient air groups was 1.8% and 1.6%, respectively (risk ratio [RR] 0.90; 95% confidence interval [CI] 0.38–2.10]); 0.8% and 0.5% of patients, respectively, experienced recurrent MI (RR 0.44; 95% CI 0.12–1.54), 1.5% and 1.6% of patients, respectively, experienced cardiac shock (RR 1.10; 95% CI 0.77–1.59]), and 2.4% and 2.0% of patients, respectively, experienced cardiac arrest (RR 0.91; 95% CI 0.43–1.94).Conclusions: Routine supplemental oxygen administration may not be beneficial or harmful, and high-flow oxygen may be unnecessary in normoxic patients in the acute phase of MI.