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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Veröffentlicht in:The American journal of cardiology 2021-08, Vol.153, p.20-29
Hauptverfasser: 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
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container_title The American journal of cardiology
container_volume 153
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
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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 &lt; 0.001). There was increased use of PCI over CABG (73.5%, 81.9%, and 85.2%, ptrend &lt; 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 &lt; 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. 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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 &lt; 0.001). There was increased use of PCI over CABG (73.5%, 81.9%, and 85.2%, ptrend &lt; 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 &lt; 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, 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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 &lt; 0.001). There was increased use of PCI over CABG (73.5%, 81.9%, and 85.2%, ptrend &lt; 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 &lt; 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>
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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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