Hypothesis of long-term outcome after coronary revascularization in japanese patients compared to multiethnic groups in the US

Taku Inohara, Shun Kosaka, Masashi Goto, Yutaka Furukawa, Masanori Fukushima, Ryuzo Sakata, MacArthur Elayda, James M. Wilson, Takeshi Kimura

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Abstract

Background Ethnicity has a significant impact on coronary artery disease (CAD). This study investigated the long-term outcomes of Japanese patients undergoing revascularization compared with US patients belonging to multiple ethnic groups. Methods and Results We evaluated clinical outcomes, based on ethnicity, of patients included in the Coronary Revascularization Demonstrating Outcome (CREDO-Kyoto) and the Texas (US) Heart Institute Research Database (THIRDBase) registries. For the analysis, we included 8871 patients from the CREDO-Kyoto registry (median follow-up period [FU], 3.5 years; interquartile range [IQR], 2.6-4.3) and 6717 patients from the THIRDBase registry (FU, 5.2 years; IQR, 3.8-6.5) who underwent percutaneous coronary intervention or bypass surgery. Cox proportional hazard models were constructed to compare the adjusted long-term outcomes for each ethnic group. A total of 8871 Japanese, 5170 Caucasians, 648 African-Americans, 817 Hispanics, and 82 Asian-Americans were identified. When adjusted, Japanese patients had significantly better outcomes than US patients, classified by ethnicity (Caucasians: hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.35-1.79; Hispanics: HR, 1.53; 95% CI, 1.22-1.93; African-Americans: HR, 2.03; 95% CI, 1.62-2.56), except for Asian-Americans (HR, 0.84; 95% CI. 0.38-1.89) who had outcomes similar to Japanese patients. Conclusion Our findings indicate better survival outcomes in re-vascularized Japanese CAD patients compared to major ethnic groups in the US, including Caucasian, Hispanic, and African-American CAD patients. The characteristics and outcomes of Japanese CAD patients were similar to those of Asian-Americans, despite the sample size limitations in the US dataset.

Original languageEnglish
Article numbere0128252
JournalPLoS One
Volume10
Issue number5
DOIs
Publication statusPublished - 2015 May 29

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ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Inohara, T., Kosaka, S., Goto, M., Furukawa, Y., Fukushima, M., Sakata, R., Elayda, M., Wilson, J. M., & Kimura, T. (2015). Hypothesis of long-term outcome after coronary revascularization in japanese patients compared to multiethnic groups in the US. PLoS One, 10(5), [e0128252]. https://doi.org/10.1371/journal.pone.0128252