Procedural Volume and Outcomes After Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Disease-Report From the National Clinical Data (J-PCI Registry)

Aikawa, Tadao; Yamaji, Kyohei; Nagai, Toshiyuki et al.

Journal of the American Heart Association, 2020, 9(9), e015404

Permalink : https://hdl.handle.net/2115/78877

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https://doi.org/10.1161/JAHA.119.015404     195

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アクセス権
open access
URI
https://hdl.handle.net/2115/78877
タイトル
Procedural Volume and Outcomes After Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Disease-Report From the National Clinical Data (J-PCI Registry)
著者
Aikawa, Tadao ; Yamaji, Kyohei ; Nagai, Toshiyuki ; Kohsaka, Shun ; Kamiya, Kiwamu ; Omote, Kazunori ; Inohara, Taku ; Numasawa, Yohei ; Tsujita, Kenichi ; Amano, Tetsuya ; Ikari, Yuji ; Anzai, Toshihisa
e-Rad_Researcher
20795059
著者名
Aikawa, Tadao
著者名
Yamaji, Kyohei
e-Rad_Researcher
00528218
著者名
Nagai, Toshiyuki
著者名
Kohsaka, Shun
e-Rad_Researcher
60797108
著者名
Kamiya, Kiwamu
e-Rad_Researcher
10827744
著者名
Omote, Kazunori
著者名
Inohara, Taku
著者名
Numasawa, Yohei
著者名
Tsujita, Kenichi
著者名
Amano, Tetsuya
著者名
Ikari, Yuji
e-Rad_Researcher
60232089
著者名
Anzai, Toshihisa
言語
英語
キーワード
mortality
survival
percutaneous coronary intervention
revascularization
unprotected left main coronary artery disease
volume-outcome relationship
発行日
2020-05-05
出版者
John Wiley & Sons
収録物名
Journal of the American Heart Association
巻(号)
9(9)
ページ
e015404
抄録
Background There is a limited evidence base to support the volume-outcome relationship in patients undergoing percutaneous coronary intervention (PCI) for unprotected left main coronary artery disease (UPLMD). This study aimed to evaluate the relationship between institutional and operator volume and in-hospital outcomes in patients undergoing PCI for unprotected left main coronary artery disease. Methods and Results We analyzed characteristics and clinical outcomes of 24 320 patients undergoing PCI for unprotected left main coronary artery disease at 1102 hospitals by 7244 operators using data from the Japanese nationwide J-PCI Registry (National PCI Data Registry) between January 2014 and December 2017. We classified institutions and operators into quartiles based on the mean annual volume of PCI. A generalized linear mixed-effects model was used to evaluate the association between institutional and operator PCI volume and in-hospital outcomes. Among the 24 320 patients, 4027 (16.6%), 6147 (25.3%), and 14 146 (58.2%) presented with ST-segment-elevation myocardial infarction, non-ST-segment-elevation acute coronary syndrome, and stable ischemic heart disease; their crude in-hospital mortality was 15%, 3.1%, and 0.3%, respectively. Compared with patients in the lowest quartile of institutional volume (1-216 PCIs/y), the adjusted odds ratio of in-hospital death in patients in the second (217-323 PCIs/y), third (324-487 PCIs/y), and fourth (488-3015 PCIs/y) quartile of institutional volume was 0.75 (95% CI, 0.51-1.10; P=0.14), 0.87 (95% CI, 0.57-1.34; P=0.54), and 0.51 (95% CI, 0.30-0.86; P=0.01), respectively. These findings were consistent in rates of in-hospital death or any complication. Conversely, operator PCI volume was not significantly associated with in-hospital outcomes. Conclusions Institutional rather than operator-based PCI volume was associated with better in-hospital outcomes in patients undergoing PCI for unprotected left main coronary artery disease.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
権利情報
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
PISSN
2047-9980
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1161/JAHA.119.015404