TY - JOUR
T1 - In-Hospital Outcomes After Percutaneous Coronary Intervention for Acute Coronary Syndrome With Cardiogenic Shock (from a Japanese Nationwide Registry [J-PCI Registry])
AU - Kubo, Shunsuke
AU - Yamaji, Kyohei
AU - Inohara, Taku
AU - Kohsaka, Shun
AU - Tanaka, Hiroyuki
AU - Ishii, Hideki
AU - Uemura, Shiro
AU - Amano, Tetsuya
AU - Nakamura, Masato
AU - Kadota, Kazushige
N1 - Funding Information:
Disclosures: Dr. Inohara has a research grant from Boston Scientific . Dr. Kohsaka reports investigator-initiated grant funding from Bayer and Daiichi Sankyo , and personal fees from Bayer and Bristol-Myers Squibb. Dr. Ishii receives lecture fees from Astellas Pharma, AstraZeneca, Bayer, Daiichi Sankyo, and MSD. Dr. Amano receives lecture fees from Astellas Pharma, AstraZeneca, Bayer, Daiichi Sankyo, and Bristol-Myers Squibb. Dr. Nakamura receives remuneration for lecture from Daiichi Sankyo, Sanofi, Bayer, Nippon Boehringer Ingelheim, Bristol-Myers Squibb, Terumo, Japan Lifeline, Abbott, Boston Scientific, Medtronic, and Nipro, and investigator-initiated grant funding from Sanofi and Daiichi Sankyo, Tokyo. The remaining authors have no disclosures to report.
Funding Information:
Funding: This research was supported by AMED ( Japan Agency for Medical Research and Development Tokyo ) under Grant Number 17ek0210097h0001 .
Funding Information:
Funding: This research was supported by AMED (Japan Agency for Medical Research and Development Tokyo) under Grant Number 17ek0210097h0001.Dr. Inohara has a research grant from Boston Scientific. Dr. Kohsaka reports investigator-initiated grant funding from Bayer and Daiichi Sankyo, and personal fees from Bayer and Bristol-Myers Squibb. Dr. Ishii receives lecture fees from Astellas Pharma, AstraZeneca, Bayer, Daiichi Sankyo, and MSD. Dr. Amano receives lecture fees from Astellas Pharma, AstraZeneca, Bayer, Daiichi Sankyo, and Bristol-Myers Squibb. Dr. Nakamura receives remuneration for lecture from Daiichi Sankyo, Sanofi, Bayer, Nippon Boehringer Ingelheim, Bristol-Myers Squibb, Terumo, Japan Lifeline, Abbott, Boston Scientific, Medtronic, and Nipro, and investigator-initiated grant funding from Sanofi and Daiichi Sankyo. The remaining authors have no disclosures to report. The authors appreciate the contributions of all the investigators, staff who managed the J-PCI registry, and members of the CVIT and its secretariat. Members of the CVIT scientific committee: Kazushige Kadota (Kurashiki Central Hospital), Nobuo Shiode (Akane Foundation Tsuchiya General Hospital), Nobuhiro Tanaka (Tokyo Medical University), Tetsuya Amano (Aichi Medical University), Shiro Uemura (Kawasaki Medical School), Takashi Akasaka (Wakayama Medical University), Yoshihiro Morino (Iwate Medical University), Kenshi Fujii (Sakurabashi Watanabe Hospital), Hiroshi Hikichi (Saga University), Members of the registry subcommittee: Tetsuya Amano (Aichi Medical University), Kenshi Fujii (Sakurabashi Watanabe Hospital), Shun Kohsaka (Keio University), Hideki Ishii (Nagoya University), Kengo Tanabe (Mitsui Memorial Hospital), Yukio Ozaki (Fujita Health University), Satoru Sumitsuji (Osaka University), Osamu Iida (Kansai Rosai Hospital), Hidehiko Hara (Toho University Ohashi Medical Center), Hiroaki Takashima (Aichi Medical University), Shinichi Shirai (Kokura Memorial Hospital), Mamoru Nanasato (Nagoya Daini Red Cross Hospital), Taku Inohara (Keio University), Yasunori Ueda (Osaka National Hospital), Yohei Numasawa (Japanese Red Cross Ashikaga Hospital), Shigetaka Noma (Saiseikai Utsunomiya Hospital).
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/5/15
Y1 - 2019/5/15
N2 - In-hospital complications and their predictors in acute coronary syndrome (ACS) patients with cardiogenic shock (CS) have not been fully investigated, particularly in those who underwent invasive revascularization procedures. This study investigated the in-hospital outcomes, along with the volume-outcome relationship of ACS patients with CS, using a contemporary large-scale nationwide percutaneous coronary intervention (PCI) registry in Japan. We analyzed PCI procedural data on ACS patients treated between 2014 and 2016 in a nationwide Japanese PCI registry. Predictors of in-hospital death and major bleeding complications requiring transfusion were identified via multivariable logistic regression analysis. The association of bleeding complications with in-hospital death was also analyzed. This study enrolled 253,355 patients who underwent PCI for ACS, of whom 17,549 (6.9%) were with CS. The rates of in-hospital mortality and access/nonaccess site bleeding complications in CS patients were 13.2%, 1.2%, and 1.3%, respectively. Age, gender, and baseline kidney condition, along with presentation status (e.g., cardiopulmonary arrest and/or acute heart failure) or the number and location of diseased vessels (e.g., left main lesion), were associated with in-hospital mortality and bleeding complications. Of note, the in-hospital mortalities decreased in parallel with the increasing institutional PCI volumes. In-hospital mortality also differed by the presence of concomitant bleeding complications (43.1% and 48.3% with access or nonaccess site bleeding, and 12.9% and 12.7% without, respectively). In conclusion, in-hospital mortality was 13.2% in ACS patients with CS who underwent contemporary PCI. Other than traditional predictors of PCI complications, lower institutional PCI volumes, and concurrent bleeding were associated with higher in-hospital mortality.
AB - In-hospital complications and their predictors in acute coronary syndrome (ACS) patients with cardiogenic shock (CS) have not been fully investigated, particularly in those who underwent invasive revascularization procedures. This study investigated the in-hospital outcomes, along with the volume-outcome relationship of ACS patients with CS, using a contemporary large-scale nationwide percutaneous coronary intervention (PCI) registry in Japan. We analyzed PCI procedural data on ACS patients treated between 2014 and 2016 in a nationwide Japanese PCI registry. Predictors of in-hospital death and major bleeding complications requiring transfusion were identified via multivariable logistic regression analysis. The association of bleeding complications with in-hospital death was also analyzed. This study enrolled 253,355 patients who underwent PCI for ACS, of whom 17,549 (6.9%) were with CS. The rates of in-hospital mortality and access/nonaccess site bleeding complications in CS patients were 13.2%, 1.2%, and 1.3%, respectively. Age, gender, and baseline kidney condition, along with presentation status (e.g., cardiopulmonary arrest and/or acute heart failure) or the number and location of diseased vessels (e.g., left main lesion), were associated with in-hospital mortality and bleeding complications. Of note, the in-hospital mortalities decreased in parallel with the increasing institutional PCI volumes. In-hospital mortality also differed by the presence of concomitant bleeding complications (43.1% and 48.3% with access or nonaccess site bleeding, and 12.9% and 12.7% without, respectively). In conclusion, in-hospital mortality was 13.2% in ACS patients with CS who underwent contemporary PCI. Other than traditional predictors of PCI complications, lower institutional PCI volumes, and concurrent bleeding were associated with higher in-hospital mortality.
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U2 - 10.1016/j.amjcard.2019.02.015
DO - 10.1016/j.amjcard.2019.02.015
M3 - Article
C2 - 30846213
AN - SCOPUS:85062284652
VL - 123
SP - 1595
EP - 1601
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 10
ER -