論文

国際誌
2021年8月15日

Coronary Revascularization in the Past Two Decades in Japan (From the CREDO-Kyoto PCI/CABG Registries Cohort-1, -2, and -3).

The American journal of cardiology
  • Hiroki Shiomi
  • ,
  • Takeshi Morimoto
  • ,
  • Yutaka Furukawa
  • ,
  • Yoshihisa Nakagawa
  • ,
  • Kazushige Kadota
  • ,
  • Yusuke Yoshikawa
  • ,
  • Kyohei Yamaji
  • ,
  • Tomohisa Tada
  • ,
  • Junichi Tazaki
  • ,
  • Natsuhiko Ehara
  • ,
  • Ryoji Taniguchi
  • ,
  • Toshihiro Tamura
  • ,
  • Atsushi Iwakura
  • ,
  • Takeshi Tada
  • ,
  • Hirotoshi Watanabe
  • ,
  • Satoru Suwa
  • ,
  • Mamoru Toyofuku
  • ,
  • Tsukasa Inada
  • ,
  • Kazuhisa Kaneda
  • ,
  • Tatsuya Ogawa
  • ,
  • Teruki Takeda
  • ,
  • Hiroshi Sakai
  • ,
  • Takashi Yamamoto
  • ,
  • Keiichi Tambara
  • ,
  • Jiro Esaki
  • ,
  • Hiroshi Eizawa
  • ,
  • Miho Yamada
  • ,
  • Eiji Shinoda
  • ,
  • Junichiro Nishizawa
  • ,
  • Hiroshi Mabuchi
  • ,
  • Nobushige Tamura
  • ,
  • Manabu Shirotani
  • ,
  • Shogo Nakayama
  • ,
  • Takashi Uegaito
  • ,
  • Mitsuo Matsuda
  • ,
  • Mamoru Takahashi
  • ,
  • Moriaki Inoko
  • ,
  • Naoki Kanemitsu
  • ,
  • Takashi Tamura
  • ,
  • Kazuhisa Ishii
  • ,
  • Ryuzo Nawada
  • ,
  • Tomoya Onodera
  • ,
  • Nobuhisa Ohno
  • ,
  • Tadaaki Koyama
  • ,
  • Hiroshi Tsuneyoshi
  • ,
  • Hiroki Sakamoto
  • ,
  • Takeshi Aoyama
  • ,
  • Shinji Miki
  • ,
  • Masaru Tanaka
  • ,
  • Yukihito Sato
  • ,
  • Fumio Yamazaki
  • ,
  • Michiya Hanyu
  • ,
  • Yoshiharu Soga
  • ,
  • Tatsuhiko Komiya
  • ,
  • Kenji Ando
  • ,
  • Kenji Minatoya
  • ,
  • Takeshi Kimura

153
開始ページ
20
終了ページ
29
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.amjcard.2021.05.015

The treatment of coronary artery disease has substantially changed over the past two decades. However, it is unknown whether and how much these changes have contributed to the improvement of long-term outcomes after coronary revascularization. We assessed trends in the demographics, practice patterns and long-term outcomes in 24,951 patients who underwent their first percutaneous coronary intervention (PCI) (n = 20,106), or isolated coronary artery bypass grafting (CABG) (n = 4,845) using the data in a series of the CREDO-Kyoto PCI/CABG Registries (Cohort-1 [2000 to 2002]: n = 7,435, Cohort-2 [2005 to 2007]: n = 8,435, and Cohort-3 [2011 to 2013]: n = 9,081). From Cohort-1 to Cohort-3, the patients got progressively older across subsequent cohorts (67.0 ± 10.0, 68.4 ± 9.9, and 69.8 ± 10.2 years, ptrend < 0.001). There was increased use of PCI over CABG (73.5%, 81.9%, and 85.2%, ptrend < 0.001) and increased prevalence of evidence-based medications use over time. The cumulative 3-year incidence of all-cause death was similar across the 3 cohorts (9.0%, 9.0%, and 9.3%, p = 0.74), while cardiovascular death decreased over time (5.7%, 5.1%, and 4.8%, p = 0.03). The adjusted risk for all-cause death and for cardiovascular death progressively decreased from Cohort-1 to Cohort-2 (HR:0.89, 95%CI:0.80 to 0.99, p = 0.03, and HR:0.80, 95%CI:0.70 to 0.92, p = 0.002, respectively), and from Cohort-2 to Cohort-3 (HR:0.86, 95%CI:0.78 to 0.95, p = 0.004, and HR:0.77, 95%CI:0.67-0.89, p < 0.001, respectively). The risks for stroke and repeated coronary revascularization also improved over time. In conclusions, we found a progressive and substantial reduction of adjusted risk for all-cause death, cardiovascular death, stroke, and repeated coronary revascularization over the past two decades in Japan.

リンク情報
DOI
https://doi.org/10.1016/j.amjcard.2021.05.015
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34238444
ID情報
  • DOI : 10.1016/j.amjcard.2021.05.015
  • PubMed ID : 34238444

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