An overview of percutaneous coronary intervention in dialysis patients: Insights from a Japanese nationwide registry

on behalf of the J-PCI Registry Investigators

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: This study sought to provide an overview of percutaneous coronary intervention (PCI) in dialysis patients from a Japanese nationwide registry. Background: Little is known about dialysis patients undergoing PCI because few are enrolled in clinical trials. Methods: We analyzed 624,900 PCI cases including 41,384 dialysis patients (6.6%) from 1,017 Japanese hospitals between 2014 and 2016. We investigated differences in characteristics and in-hospital outcomes between dialysis and nondialysis patients, and assessed factors associated with an increased risk of adverse outcomes. Results: Dialysis patients had more comorbidities than nondialysis patients and higher rates of complications including in-hospital mortality (3.3% vs. 1.5%, respectively, in the acute coronary syndrome [ACS] cohort, 0.2% vs. 0.1% in the non-ACS cohort) and bleeding complications requiring blood transfusion (1.1% vs. 0.4% in ACS, 0.5% vs. 0.2% in non-ACS). Dialysis was significantly associated with an increased risk of in-hospital mortality (odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.24–1.62 in ACS, OR: 2.25, 95% CI: 1.66–3.05 in non-ACS) and bleeding (OR: 1.60, 95% CI: 1.30–1.96 in ACS, OR: 1.55, 95% CI: 1.27–1.88 in non-ACS). For dialysis patients, age, acute heart failure, and cardiogenic shock were associated with an increased risk of in-hospital mortality in the ACS cohort, whereas age, female gender, and history of heart failure were associated with higher in-hospital mortality in the non-ACS cohort. Conclusions: PCI was widely performed for dialysis patients with either ACS or non-ACS in Japan. Dialysis patients had a greater risk of adverse outcomes than nondialysis patients after PCI.

Original languageEnglish
JournalCatheterization and Cardiovascular Interventions
DOIs
Publication statusAccepted/In press - 2018 Jan 1

Fingerprint

Percutaneous Coronary Intervention
Registries
Dialysis
Acute Coronary Syndrome
Hospital Mortality
Odds Ratio
Confidence Intervals
Heart Failure
Hemorrhage
Cardiogenic Shock
Blood Transfusion
Comorbidity
Japan
Clinical Trials

Keywords

  • chronic kidney disease
  • coronary artery disease
  • end-stage renal disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

An overview of percutaneous coronary intervention in dialysis patients : Insights from a Japanese nationwide registry. / on behalf of the J-PCI Registry Investigators.

In: Catheterization and Cardiovascular Interventions, 01.01.2018.

Research output: Contribution to journalArticle

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title = "An overview of percutaneous coronary intervention in dialysis patients: Insights from a Japanese nationwide registry",
abstract = "Objectives: This study sought to provide an overview of percutaneous coronary intervention (PCI) in dialysis patients from a Japanese nationwide registry. Background: Little is known about dialysis patients undergoing PCI because few are enrolled in clinical trials. Methods: We analyzed 624,900 PCI cases including 41,384 dialysis patients (6.6{\%}) from 1,017 Japanese hospitals between 2014 and 2016. We investigated differences in characteristics and in-hospital outcomes between dialysis and nondialysis patients, and assessed factors associated with an increased risk of adverse outcomes. Results: Dialysis patients had more comorbidities than nondialysis patients and higher rates of complications including in-hospital mortality (3.3{\%} vs. 1.5{\%}, respectively, in the acute coronary syndrome [ACS] cohort, 0.2{\%} vs. 0.1{\%} in the non-ACS cohort) and bleeding complications requiring blood transfusion (1.1{\%} vs. 0.4{\%} in ACS, 0.5{\%} vs. 0.2{\%} in non-ACS). Dialysis was significantly associated with an increased risk of in-hospital mortality (odds ratio [OR]: 1.42, 95{\%} confidence interval [CI]: 1.24–1.62 in ACS, OR: 2.25, 95{\%} CI: 1.66–3.05 in non-ACS) and bleeding (OR: 1.60, 95{\%} CI: 1.30–1.96 in ACS, OR: 1.55, 95{\%} CI: 1.27–1.88 in non-ACS). For dialysis patients, age, acute heart failure, and cardiogenic shock were associated with an increased risk of in-hospital mortality in the ACS cohort, whereas age, female gender, and history of heart failure were associated with higher in-hospital mortality in the non-ACS cohort. Conclusions: PCI was widely performed for dialysis patients with either ACS or non-ACS in Japan. Dialysis patients had a greater risk of adverse outcomes than nondialysis patients after PCI.",
keywords = "chronic kidney disease, coronary artery disease, end-stage renal disease",
author = "{on behalf of the J-PCI Registry Investigators} and Yohei Numasawa and Taku Inohara and Hideki Ishii and Kyohei Yamaji and Keita Hirano and Shun Kosaka and Mitsuaki Sawano and Toshiki Kuno and Masaki Kodaira and Shiro Uemura and Kazushige Kadota and Tetsuya Amano and Masato Nakamura",
year = "2018",
month = "1",
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language = "English",
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T1 - An overview of percutaneous coronary intervention in dialysis patients

T2 - Insights from a Japanese nationwide registry

AU - on behalf of the J-PCI Registry Investigators

AU - Numasawa, Yohei

AU - Inohara, Taku

AU - Ishii, Hideki

AU - Yamaji, Kyohei

AU - Hirano, Keita

AU - Kosaka, Shun

AU - Sawano, Mitsuaki

AU - Kuno, Toshiki

AU - Kodaira, Masaki

AU - Uemura, Shiro

AU - Kadota, Kazushige

AU - Amano, Tetsuya

AU - Nakamura, Masato

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: This study sought to provide an overview of percutaneous coronary intervention (PCI) in dialysis patients from a Japanese nationwide registry. Background: Little is known about dialysis patients undergoing PCI because few are enrolled in clinical trials. Methods: We analyzed 624,900 PCI cases including 41,384 dialysis patients (6.6%) from 1,017 Japanese hospitals between 2014 and 2016. We investigated differences in characteristics and in-hospital outcomes between dialysis and nondialysis patients, and assessed factors associated with an increased risk of adverse outcomes. Results: Dialysis patients had more comorbidities than nondialysis patients and higher rates of complications including in-hospital mortality (3.3% vs. 1.5%, respectively, in the acute coronary syndrome [ACS] cohort, 0.2% vs. 0.1% in the non-ACS cohort) and bleeding complications requiring blood transfusion (1.1% vs. 0.4% in ACS, 0.5% vs. 0.2% in non-ACS). Dialysis was significantly associated with an increased risk of in-hospital mortality (odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.24–1.62 in ACS, OR: 2.25, 95% CI: 1.66–3.05 in non-ACS) and bleeding (OR: 1.60, 95% CI: 1.30–1.96 in ACS, OR: 1.55, 95% CI: 1.27–1.88 in non-ACS). For dialysis patients, age, acute heart failure, and cardiogenic shock were associated with an increased risk of in-hospital mortality in the ACS cohort, whereas age, female gender, and history of heart failure were associated with higher in-hospital mortality in the non-ACS cohort. Conclusions: PCI was widely performed for dialysis patients with either ACS or non-ACS in Japan. Dialysis patients had a greater risk of adverse outcomes than nondialysis patients after PCI.

AB - Objectives: This study sought to provide an overview of percutaneous coronary intervention (PCI) in dialysis patients from a Japanese nationwide registry. Background: Little is known about dialysis patients undergoing PCI because few are enrolled in clinical trials. Methods: We analyzed 624,900 PCI cases including 41,384 dialysis patients (6.6%) from 1,017 Japanese hospitals between 2014 and 2016. We investigated differences in characteristics and in-hospital outcomes between dialysis and nondialysis patients, and assessed factors associated with an increased risk of adverse outcomes. Results: Dialysis patients had more comorbidities than nondialysis patients and higher rates of complications including in-hospital mortality (3.3% vs. 1.5%, respectively, in the acute coronary syndrome [ACS] cohort, 0.2% vs. 0.1% in the non-ACS cohort) and bleeding complications requiring blood transfusion (1.1% vs. 0.4% in ACS, 0.5% vs. 0.2% in non-ACS). Dialysis was significantly associated with an increased risk of in-hospital mortality (odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.24–1.62 in ACS, OR: 2.25, 95% CI: 1.66–3.05 in non-ACS) and bleeding (OR: 1.60, 95% CI: 1.30–1.96 in ACS, OR: 1.55, 95% CI: 1.27–1.88 in non-ACS). For dialysis patients, age, acute heart failure, and cardiogenic shock were associated with an increased risk of in-hospital mortality in the ACS cohort, whereas age, female gender, and history of heart failure were associated with higher in-hospital mortality in the non-ACS cohort. Conclusions: PCI was widely performed for dialysis patients with either ACS or non-ACS in Japan. Dialysis patients had a greater risk of adverse outcomes than nondialysis patients after PCI.

KW - chronic kidney disease

KW - coronary artery disease

KW - end-stage renal disease

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