Purpose: Atherothrombotic disease is a major and increasing health problem in Japan. Effective secondary prevention of atherothrombotic events after acute coronary syndrome (ACS) is required, but clinical evidence regarding the current state of preventive treatment and the rate of subsequent atherothrombotic events after ACS in Japan is limited. Up-to-date Japanese epidemiological real world data are required to construct optimal evidence-based Japanese guidelines for the management of patients with ACS.
Methods: The PACIFIC (Prevention of AtherothrombotiC Incidents Following Ischemic Coronary attack) Registry is an ongoing, observational study of a large cohort of Japanese patients hospitalised with any manifestation of ACS (ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction or unstable angina [UA]). Up to 4,000 patients from approximately 100 sites nationwide will be enrolled and the primary study endpoint is the incidence of any major atherothrombotic event (cardiovascular, cerebrovascular or peripheral) between the initial ACS event and 2 years of follow-up. Secondary endpoints include fatal myocardial infarction (MI), fatal stroke, other cardiovascular death, non-cardiovascular death, non-fatal MI/UA, non-fatal stroke and acute peripheral arterial occlusion. Hospitalisation for vascular interventions will also be recorded, as will haemorrhage requiring hospitalisation or blood transfusion. The use of preventive treatment will also be reported and different patient subgroups (diabetes mellitus, hypertension, dyslipidaemia and metabolic syndrome) will be analysed. It is expected that the study will be completed in early to mid 2011.
Conclusions: The PACIFIC Registry will give insights as to the Japanese epidemiology of ACS: recurrence of atherothrombotic events in the same or other vascular territories.