Coronary Revascularization in the Past Two Decades in Japan (From the CREDO-Kyoto PCI/CABG Registries Cohort-1, -2, and -3)
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 pattern...
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creator | Shiomi, Hiroki Morimoto, Takeshi Furukawa, Yutaka Nakagawa, Yoshihisa Kadota, Kazushige Yoshikawa, Yusuke Yamaji, Kyohei Tada, Tomohisa Tazaki, Junichi Ehara, Natsuhiko Taniguchi, Ryoji Tamura, Toshihiro Iwakura, Atsushi Tada, Takeshi Watanabe, Hirotoshi Suwa, Satoru Toyofuku, Mamoru Inada, Tsukasa Kaneda, Kazuhisa Ogawa, Tatsuya Takeda, Teruki Sakai, Hiroshi Yamamoto, Takashi Tambara, Keiichi Esaki, Jiro Eizawa, Hiroshi Yamada, Miho Shinoda, Eiji Nishizawa, Junichiro Mabuchi, Hiroshi Tamura, Nobushige Shirotani, Manabu Nakayama, Shogo Uegaito, Takashi Matsuda, Mitsuo Takahashi, Mamoru Inoko, Moriaki Kanemitsu, Naoki Tamura, Takashi Ishii, Kazuhisa Nawada, Ryuzo Onodera, Tomoya Ohno, Nobuhisa Koyama, Tadaaki Tsuneyoshi, Hiroshi Sakamoto, Hiroki Aoyama, Takeshi Miki, Shinji Tanaka, Masaru Sato, Yukihito Yamazaki, Fumio Hanyu, Michiya Soga, Yoshiharu Komiya, Tatsuhiko Ando, Kenji Minatoya, Kenji Kimura, Takeshi |
description | 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. |
doi_str_mv | 10.1016/j.amjcard.2021.05.015 |
format | Article |
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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.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2021.05.015</identifier><language>eng</language><publisher>New York: Elsevier Inc</publisher><subject>Angina pectoris ; Cardiology ; Cardiovascular disease ; Cardiovascular diseases ; Clinical outcomes ; Coronary artery ; Coronary artery disease ; Coronary vessels ; Data collection ; Death ; Demography ; Health risks ; Heart diseases ; Heart surgery ; Mortality ; Patients ; Stents ; Thrombosis ; Trends ; Variables</subject><ispartof>The American journal of cardiology, 2021-08, Vol.153, p.20-29</ispartof><rights>2021 Elsevier Inc.</rights><rights>2021. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-950e4a57e2aac30e2b4c145b0441c72ffb221b850b1cee5fc0e56ed14b375e1f3</citedby><cites>FETCH-LOGICAL-c370t-950e4a57e2aac30e2b4c145b0441c72ffb221b850b1cee5fc0e56ed14b375e1f3</cites><orcidid>0000-0003-0699-4248 ; 0000-0002-8403-0164 ; 0000-0003-1388-4899 ; 0000-0001-9927-5474 ; 0000-0002-6844-739X ; 0000-0002-9443-5915 ; 0000-0003-4585-2437 ; 0000-0001-6718-6960 ; 0000-0002-5665-4076 ; 0000-0001-8082-2036 ; 0000-0001-9057-665X ; 0000-0002-3644-8750 ; 0000-0002-4329-5975 ; 0000-0003-3924-3256</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2553516716?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids></links><search><creatorcontrib>Shiomi, Hiroki</creatorcontrib><creatorcontrib>Morimoto, Takeshi</creatorcontrib><creatorcontrib>Furukawa, Yutaka</creatorcontrib><creatorcontrib>Nakagawa, Yoshihisa</creatorcontrib><creatorcontrib>Kadota, Kazushige</creatorcontrib><creatorcontrib>Yoshikawa, Yusuke</creatorcontrib><creatorcontrib>Yamaji, Kyohei</creatorcontrib><creatorcontrib>Tada, Tomohisa</creatorcontrib><creatorcontrib>Tazaki, Junichi</creatorcontrib><creatorcontrib>Ehara, Natsuhiko</creatorcontrib><creatorcontrib>Taniguchi, Ryoji</creatorcontrib><creatorcontrib>Tamura, Toshihiro</creatorcontrib><creatorcontrib>Iwakura, Atsushi</creatorcontrib><creatorcontrib>Tada, Takeshi</creatorcontrib><creatorcontrib>Watanabe, Hirotoshi</creatorcontrib><creatorcontrib>Suwa, Satoru</creatorcontrib><creatorcontrib>Toyofuku, Mamoru</creatorcontrib><creatorcontrib>Inada, Tsukasa</creatorcontrib><creatorcontrib>Kaneda, Kazuhisa</creatorcontrib><creatorcontrib>Ogawa, Tatsuya</creatorcontrib><creatorcontrib>Takeda, Teruki</creatorcontrib><creatorcontrib>Sakai, Hiroshi</creatorcontrib><creatorcontrib>Yamamoto, Takashi</creatorcontrib><creatorcontrib>Tambara, Keiichi</creatorcontrib><creatorcontrib>Esaki, Jiro</creatorcontrib><creatorcontrib>Eizawa, Hiroshi</creatorcontrib><creatorcontrib>Yamada, Miho</creatorcontrib><creatorcontrib>Shinoda, Eiji</creatorcontrib><creatorcontrib>Nishizawa, Junichiro</creatorcontrib><creatorcontrib>Mabuchi, Hiroshi</creatorcontrib><creatorcontrib>Tamura, Nobushige</creatorcontrib><creatorcontrib>Shirotani, Manabu</creatorcontrib><creatorcontrib>Nakayama, Shogo</creatorcontrib><creatorcontrib>Uegaito, Takashi</creatorcontrib><creatorcontrib>Matsuda, Mitsuo</creatorcontrib><creatorcontrib>Takahashi, Mamoru</creatorcontrib><creatorcontrib>Inoko, Moriaki</creatorcontrib><creatorcontrib>Kanemitsu, Naoki</creatorcontrib><creatorcontrib>Tamura, Takashi</creatorcontrib><creatorcontrib>Ishii, Kazuhisa</creatorcontrib><creatorcontrib>Nawada, Ryuzo</creatorcontrib><creatorcontrib>Onodera, Tomoya</creatorcontrib><creatorcontrib>Ohno, Nobuhisa</creatorcontrib><creatorcontrib>Koyama, Tadaaki</creatorcontrib><creatorcontrib>Tsuneyoshi, Hiroshi</creatorcontrib><creatorcontrib>Sakamoto, Hiroki</creatorcontrib><creatorcontrib>Aoyama, Takeshi</creatorcontrib><creatorcontrib>Miki, Shinji</creatorcontrib><creatorcontrib>Tanaka, Masaru</creatorcontrib><creatorcontrib>Sato, Yukihito</creatorcontrib><creatorcontrib>Yamazaki, Fumio</creatorcontrib><creatorcontrib>Hanyu, Michiya</creatorcontrib><creatorcontrib>Soga, Yoshiharu</creatorcontrib><creatorcontrib>Komiya, Tatsuhiko</creatorcontrib><creatorcontrib>Ando, Kenji</creatorcontrib><creatorcontrib>Minatoya, Kenji</creatorcontrib><creatorcontrib>Kimura, Takeshi</creatorcontrib><title>Coronary Revascularization in the Past Two Decades in Japan (From the CREDO-Kyoto PCI/CABG Registries Cohort-1, -2, and -3)</title><title>The American journal of cardiology</title><description>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.</description><subject>Angina pectoris</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Clinical outcomes</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Coronary vessels</subject><subject>Data collection</subject><subject>Death</subject><subject>Demography</subject><subject>Health risks</subject><subject>Heart diseases</subject><subject>Heart 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Revascularization in the Past Two Decades in Japan (From the CREDO-Kyoto PCI/CABG Registries Cohort-1, -2, and -3)</title><author>Shiomi, Hiroki ; Morimoto, Takeshi ; Furukawa, Yutaka ; Nakagawa, Yoshihisa ; Kadota, Kazushige ; Yoshikawa, Yusuke ; Yamaji, Kyohei ; Tada, Tomohisa ; Tazaki, Junichi ; Ehara, Natsuhiko ; Taniguchi, Ryoji ; Tamura, Toshihiro ; Iwakura, Atsushi ; Tada, Takeshi ; Watanabe, Hirotoshi ; Suwa, Satoru ; Toyofuku, Mamoru ; Inada, Tsukasa ; Kaneda, Kazuhisa ; Ogawa, Tatsuya ; Takeda, Teruki ; Sakai, Hiroshi ; Yamamoto, Takashi ; Tambara, Keiichi ; Esaki, Jiro ; Eizawa, Hiroshi ; Yamada, Miho ; Shinoda, Eiji ; Nishizawa, Junichiro ; Mabuchi, Hiroshi ; Tamura, Nobushige ; Shirotani, Manabu ; Nakayama, Shogo ; Uegaito, Takashi ; Matsuda, Mitsuo ; Takahashi, Mamoru ; Inoko, Moriaki ; Kanemitsu, Naoki ; Tamura, Takashi ; Ishii, Kazuhisa ; Nawada, Ryuzo ; Onodera, Tomoya ; Ohno, Nobuhisa ; Koyama, Tadaaki ; Tsuneyoshi, Hiroshi ; Sakamoto, Hiroki ; Aoyama, Takeshi ; Miki, Shinji ; Tanaka, Masaru ; Sato, Yukihito ; Yamazaki, Fumio ; Hanyu, Michiya ; Soga, Yoshiharu ; Komiya, Tatsuhiko ; Ando, Kenji ; Minatoya, Kenji ; Kimura, Takeshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-950e4a57e2aac30e2b4c145b0441c72ffb221b850b1cee5fc0e56ed14b375e1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Angina pectoris</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Clinical outcomes</topic><topic>Coronary artery</topic><topic>Coronary artery disease</topic><topic>Coronary vessels</topic><topic>Data collection</topic><topic>Death</topic><topic>Demography</topic><topic>Health risks</topic><topic>Heart diseases</topic><topic>Heart surgery</topic><topic>Mortality</topic><topic>Patients</topic><topic>Stents</topic><topic>Thrombosis</topic><topic>Trends</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shiomi, Hiroki</creatorcontrib><creatorcontrib>Morimoto, Takeshi</creatorcontrib><creatorcontrib>Furukawa, Yutaka</creatorcontrib><creatorcontrib>Nakagawa, Yoshihisa</creatorcontrib><creatorcontrib>Kadota, Kazushige</creatorcontrib><creatorcontrib>Yoshikawa, Yusuke</creatorcontrib><creatorcontrib>Yamaji, Kyohei</creatorcontrib><creatorcontrib>Tada, Tomohisa</creatorcontrib><creatorcontrib>Tazaki, Junichi</creatorcontrib><creatorcontrib>Ehara, Natsuhiko</creatorcontrib><creatorcontrib>Taniguchi, Ryoji</creatorcontrib><creatorcontrib>Tamura, Toshihiro</creatorcontrib><creatorcontrib>Iwakura, Atsushi</creatorcontrib><creatorcontrib>Tada, Takeshi</creatorcontrib><creatorcontrib>Watanabe, Hirotoshi</creatorcontrib><creatorcontrib>Suwa, Satoru</creatorcontrib><creatorcontrib>Toyofuku, Mamoru</creatorcontrib><creatorcontrib>Inada, Tsukasa</creatorcontrib><creatorcontrib>Kaneda, Kazuhisa</creatorcontrib><creatorcontrib>Ogawa, Tatsuya</creatorcontrib><creatorcontrib>Takeda, Teruki</creatorcontrib><creatorcontrib>Sakai, Hiroshi</creatorcontrib><creatorcontrib>Yamamoto, Takashi</creatorcontrib><creatorcontrib>Tambara, Keiichi</creatorcontrib><creatorcontrib>Esaki, Jiro</creatorcontrib><creatorcontrib>Eizawa, Hiroshi</creatorcontrib><creatorcontrib>Yamada, Miho</creatorcontrib><creatorcontrib>Shinoda, Eiji</creatorcontrib><creatorcontrib>Nishizawa, Junichiro</creatorcontrib><creatorcontrib>Mabuchi, Hiroshi</creatorcontrib><creatorcontrib>Tamura, Nobushige</creatorcontrib><creatorcontrib>Shirotani, Manabu</creatorcontrib><creatorcontrib>Nakayama, Shogo</creatorcontrib><creatorcontrib>Uegaito, Takashi</creatorcontrib><creatorcontrib>Matsuda, Mitsuo</creatorcontrib><creatorcontrib>Takahashi, Mamoru</creatorcontrib><creatorcontrib>Inoko, Moriaki</creatorcontrib><creatorcontrib>Kanemitsu, Naoki</creatorcontrib><creatorcontrib>Tamura, Takashi</creatorcontrib><creatorcontrib>Ishii, Kazuhisa</creatorcontrib><creatorcontrib>Nawada, Ryuzo</creatorcontrib><creatorcontrib>Onodera, Tomoya</creatorcontrib><creatorcontrib>Ohno, Nobuhisa</creatorcontrib><creatorcontrib>Koyama, Tadaaki</creatorcontrib><creatorcontrib>Tsuneyoshi, Hiroshi</creatorcontrib><creatorcontrib>Sakamoto, Hiroki</creatorcontrib><creatorcontrib>Aoyama, Takeshi</creatorcontrib><creatorcontrib>Miki, Shinji</creatorcontrib><creatorcontrib>Tanaka, Masaru</creatorcontrib><creatorcontrib>Sato, Yukihito</creatorcontrib><creatorcontrib>Yamazaki, Fumio</creatorcontrib><creatorcontrib>Hanyu, Michiya</creatorcontrib><creatorcontrib>Soga, Yoshiharu</creatorcontrib><creatorcontrib>Komiya, Tatsuhiko</creatorcontrib><creatorcontrib>Ando, Kenji</creatorcontrib><creatorcontrib>Minatoya, Kenji</creatorcontrib><creatorcontrib>Kimura, Takeshi</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central 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Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shiomi, Hiroki</au><au>Morimoto, Takeshi</au><au>Furukawa, Yutaka</au><au>Nakagawa, Yoshihisa</au><au>Kadota, Kazushige</au><au>Yoshikawa, Yusuke</au><au>Yamaji, Kyohei</au><au>Tada, Tomohisa</au><au>Tazaki, Junichi</au><au>Ehara, Natsuhiko</au><au>Taniguchi, Ryoji</au><au>Tamura, Toshihiro</au><au>Iwakura, Atsushi</au><au>Tada, Takeshi</au><au>Watanabe, Hirotoshi</au><au>Suwa, Satoru</au><au>Toyofuku, Mamoru</au><au>Inada, Tsukasa</au><au>Kaneda, Kazuhisa</au><au>Ogawa, Tatsuya</au><au>Takeda, Teruki</au><au>Sakai, Hiroshi</au><au>Yamamoto, Takashi</au><au>Tambara, Keiichi</au><au>Esaki, Jiro</au><au>Eizawa, Hiroshi</au><au>Yamada, Miho</au><au>Shinoda, Eiji</au><au>Nishizawa, Junichiro</au><au>Mabuchi, Hiroshi</au><au>Tamura, Nobushige</au><au>Shirotani, Manabu</au><au>Nakayama, Shogo</au><au>Uegaito, Takashi</au><au>Matsuda, Mitsuo</au><au>Takahashi, Mamoru</au><au>Inoko, Moriaki</au><au>Kanemitsu, Naoki</au><au>Tamura, Takashi</au><au>Ishii, Kazuhisa</au><au>Nawada, Ryuzo</au><au>Onodera, Tomoya</au><au>Ohno, Nobuhisa</au><au>Koyama, Tadaaki</au><au>Tsuneyoshi, Hiroshi</au><au>Sakamoto, Hiroki</au><au>Aoyama, Takeshi</au><au>Miki, Shinji</au><au>Tanaka, Masaru</au><au>Sato, Yukihito</au><au>Yamazaki, Fumio</au><au>Hanyu, Michiya</au><au>Soga, Yoshiharu</au><au>Komiya, Tatsuhiko</au><au>Ando, Kenji</au><au>Minatoya, Kenji</au><au>Kimura, Takeshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary Revascularization in the Past Two Decades in Japan (From the CREDO-Kyoto PCI/CABG Registries Cohort-1, -2, and -3)</atitle><jtitle>The American journal of cardiology</jtitle><date>2021-08-15</date><risdate>2021</risdate><volume>153</volume><spage>20</spage><epage>29</epage><pages>20-29</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>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.</abstract><cop>New York</cop><pub>Elsevier Inc</pub><doi>10.1016/j.amjcard.2021.05.015</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0699-4248</orcidid><orcidid>https://orcid.org/0000-0002-8403-0164</orcidid><orcidid>https://orcid.org/0000-0003-1388-4899</orcidid><orcidid>https://orcid.org/0000-0001-9927-5474</orcidid><orcidid>https://orcid.org/0000-0002-6844-739X</orcidid><orcidid>https://orcid.org/0000-0002-9443-5915</orcidid><orcidid>https://orcid.org/0000-0003-4585-2437</orcidid><orcidid>https://orcid.org/0000-0001-6718-6960</orcidid><orcidid>https://orcid.org/0000-0002-5665-4076</orcidid><orcidid>https://orcid.org/0000-0001-8082-2036</orcidid><orcidid>https://orcid.org/0000-0001-9057-665X</orcidid><orcidid>https://orcid.org/0000-0002-3644-8750</orcidid><orcidid>https://orcid.org/0000-0002-4329-5975</orcidid><orcidid>https://orcid.org/0000-0003-3924-3256</orcidid></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0002-9149 |
ispartof | The American journal of cardiology, 2021-08, Vol.153, p.20-29 |
issn | 0002-9149 1879-1913 |
language | eng |
recordid | cdi_proquest_miscellaneous_2550263982 |
source | Elsevier ScienceDirect Journals Complete; ProQuest Central UK/Ireland |
subjects | Angina pectoris Cardiology Cardiovascular disease Cardiovascular diseases Clinical outcomes Coronary artery Coronary artery disease Coronary vessels Data collection Death Demography Health risks Heart diseases Heart surgery Mortality Patients Stents Thrombosis Trends Variables |
title | Coronary Revascularization in the Past Two Decades in Japan (From the CREDO-Kyoto PCI/CABG Registries Cohort-1, -2, and -3) |
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