{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T16:48:20Z","timestamp":1782060500082,"version":"3.54.5"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Population Health and Outcomes"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Adherence to the clinical performance measures has been advocated in ST-segment\u2013elevation acute myocardial infarction (STEMI) care worldwide. We aimed to examine the association between adherence to these performance measures and long-term clinical outcomes in patients with STEMI undergoing percutaneous coronary intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>The CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) AMI Registry Wave-2 was a multicenter registry conducted at 22 centers in Japan between 2011 and 2013, enrolling consecutive acute myocardial infarction patients who underwent coronary revascularization. The exposures were adherence to 9 guideline-based performance measures for STEMI care, including early reperfusion, evidence-based medical therapy, and cardiac rehabilitation. The primary outcome measure was all-cause death. The secondary outcome measures included cardiovascular death, myocardial infarction, stroke, heart failure hospitalization, major bleeding, and repeat coronary revascularization. Outcomes were assessed over a median follow-up of 6.0 years (interquartile range, 5.1\u20136.8). Adjusted hazard ratios with 95% CIs were estimated using Cox proportional hazards models, adjusting for baseline characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Among 2892 patients with STEMI who underwent percutaneous coronary intervention within 24 hours after symptom onset and survived to discharge (mean age, 67\u00b113 years; 23% women), patients were categorized according to the number of fulfilled performance measures (PMs=9: N=551, PMs=8: N=985, PMs=7: N=794, and PMs\u22646: N=562). As the adherence categories decreased from PMs=9 to PMs\u22646, the cumulative 5-year incidence of all-cause death increased from 8.9% to 23.6%. Relative to PMs=9, the adjusted hazard ratio (95% CI) for all-cause death was 1.14 (0.83\u20131.57) in PMs=8, 1.36 (0.99\u20131.87) in PMs=7, and 1.96 (1.43\u20132.69) in PMs\u22646, respectively. These inverse associations were observed between adherence to performance measures and most clinical outcomes except for repeat coronary revascularization (adjusted hazard ratio, 1.00 [95% CI, 0.82\u20131.21] in PMs=8, 0.89 [0.72\u20131.09] in PMs=7, and 0.91 [0.72\u20131.15] in PMs\u22646, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Defect-free care adherent to the performance measures was associated with improved long-term clinical outcomes, including lower mortality, among patients with STEMI undergoing percutaneous coronary intervention, whereas no association was observed for repeat coronary revascularization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.125.013012","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T09:00:18Z","timestamp":1775811618000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Clinical Outcomes With Defect-Free Care Adherent to the Performance Measures in Patients with STEMI Undergoing PCI in Japan"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7234-023X","authenticated-orcid":true,"given":"Hiroki","family":"Shiomi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine (H.S., K.O.), Kyoto University Graduate School of Medicine, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6844-739X","authenticated-orcid":true,"given":"Takeshi","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan (T.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1644-3442","authenticated-orcid":true,"given":"Manabu","family":"Ogita","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan (M.O., S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1666-551X","authenticated-orcid":true,"given":"Tomohisa","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Osaka Red Cross Hospital, Japan (T. Tada)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0637-2521","authenticated-orcid":true,"given":"Yuki","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery (Y.K.), Kyoto University Graduate School of Medicine, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4585-2437","authenticated-orcid":true,"given":"Yutaka","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Japan (Y.F., N.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9411-9314","authenticated-orcid":true,"given":"Yoshihisa","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shiga University of Medical Science Hospital, Otsu, Japan (Y.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2845-9561","authenticated-orcid":true,"given":"Kazushige","family":"Kadota","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kurashiki Central Hospital, Japan (K.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9212-3953","authenticated-orcid":true,"given":"Natsuhiko","family":"Ehara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Japan (Y.F., N.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0373-4443","authenticated-orcid":true,"given":"Ryoji","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Japan (R.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8655-0203","authenticated-orcid":true,"given":"Toshihiro","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tenri Hospital, Japan (T. Tamura)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7614-0937","authenticated-orcid":true,"given":"Satoru","family":"Suwa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan (M.O., S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-4248","authenticated-orcid":true,"given":"Kenji","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan (K.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4163-980X","authenticated-orcid":true,"given":"Koh","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (H.S., K.O.), Kyoto University Graduate School of Medicine, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5665-4076","authenticated-orcid":true,"given":"Takeshi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hirakata Kohsai Hospital, Japan (T.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.11.003"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.044107"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1208200"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61932-2"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.06.032"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872616643053"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjacc\/zuaa037"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.118.004983"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.16.1912"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.22.2694"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx008"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.116.003336"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021417"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0259268"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.685313"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rec.2021.06.003"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3257"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872620911853"},{"key":"e_1_3_3_21_2","first-page":"349","article-title":"Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group.","volume":"2","year":"1988","unstructured":"Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet. 1988;2:349\u2013360.","journal-title":"Lancet"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)90865-X"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61350-5"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.032615"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.066720"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.10.026"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-012-0137-9"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)01592-2"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2512686"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2404204"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcad007"}],"container-title":["Circulation: Population Health and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.125.013012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T16:24:03Z","timestamp":1782059043000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.125.013012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1161\/CIRCOUTCOMES.125.013012"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.125.013012","relation":{},"ISSN":["3068-563X"],"issn-type":[{"value":"3068-563X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}