Impact of Coronary Dominance on In-Hospital Outcomes after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome

Toshiki Kuno, Yohei Numasawa, Hiroaki Miyata, Toshiyuki Takahashi, Koichiro Sueyoshi, Takahiro Ohki, Koji Negishi, Akio Kawamura, Shun Kosaka, Keiichi Fukuda

Research output: Contribution to journalArticle

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Abstract

Objective:This study evaluated the manner in which coronary dominance affects in-hospital outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).Background:Previous studies have shown that left dominant coronary anatomies are associated with worse prognoses in patients with coronary artery disease.Methods:Data were analyzed from 4873 ACS patients undergoing PCI between September 2008 and April 2013 at 14 hospitals participating in the Japanese Cardiovascular Database Registry. The patients were grouped based on diagnostic coronary angiograms performed prior to PCI; those with right- or co-dominant anatomy (RD group) and those with left-dominant anatomy (LD group).Results:The average patient age was 67.6±11.8 years and both patient groups had similar ages, coronary risk factors, comorbidities, and prior histories. The numbers of patients presenting with symptoms of heart failure, cardiogenic shock, or cardiopulmonary arrest were significantly higher in the LD group than in the RD group (heart failure: 650 RD patients [14.7%] vs. 87 LD patients [18.8%], P = 0.025; cardiogenic shock: 322 RD patients [7.3%] vs. 48 LD patients [10.3%], P = 0.021; and cardiopulmonary arrest: 197 RD patients [4.5%] vs. 36 LD patients [7.8%], P = 0.003). In-hospital mortality was significantly higher among LD patients than among RD patients (182 RD patients [4.1%] vs. 36 LD patients [7.8%], P = 0.001). Multivariate logistic regression analysis revealed that LD anatomy was an independent predictor for in-hospital mortality (odds ratio, 1.75; 95% confidence interval, 1.06-2.89; P = 0.030).Conclusion:Among ACS patients who underwent PCI, LD patients had significantly worse in-hospital outcomes compared with RD patients, and LD anatomy was an independent predictor of in-hospital mortality.

Original languageEnglish
Article numbere72672
JournalPLoS One
Volume8
Issue number8
DOIs
Publication statusPublished - 2013 Aug 26

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Percutaneous Coronary Intervention
Acute Coronary Syndrome
Anatomy
Regression analysis
Hospital Mortality
Logistics
cardiac arrest
Cardiogenic Shock
heart failure
Heart Arrest
Heart Failure

ASJC Scopus subject areas

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

Cite this

Impact of Coronary Dominance on In-Hospital Outcomes after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome. / Kuno, Toshiki; Numasawa, Yohei; Miyata, Hiroaki; Takahashi, Toshiyuki; Sueyoshi, Koichiro; Ohki, Takahiro; Negishi, Koji; Kawamura, Akio; Kosaka, Shun; Fukuda, Keiichi.

In: PLoS One, Vol. 8, No. 8, e72672, 26.08.2013.

Research output: Contribution to journalArticle

Kuno, Toshiki ; Numasawa, Yohei ; Miyata, Hiroaki ; Takahashi, Toshiyuki ; Sueyoshi, Koichiro ; Ohki, Takahiro ; Negishi, Koji ; Kawamura, Akio ; Kosaka, Shun ; Fukuda, Keiichi. / Impact of Coronary Dominance on In-Hospital Outcomes after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome. In: PLoS One. 2013 ; Vol. 8, No. 8.
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abstract = "Objective:This study evaluated the manner in which coronary dominance affects in-hospital outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).Background:Previous studies have shown that left dominant coronary anatomies are associated with worse prognoses in patients with coronary artery disease.Methods:Data were analyzed from 4873 ACS patients undergoing PCI between September 2008 and April 2013 at 14 hospitals participating in the Japanese Cardiovascular Database Registry. The patients were grouped based on diagnostic coronary angiograms performed prior to PCI; those with right- or co-dominant anatomy (RD group) and those with left-dominant anatomy (LD group).Results:The average patient age was 67.6±11.8 years and both patient groups had similar ages, coronary risk factors, comorbidities, and prior histories. The numbers of patients presenting with symptoms of heart failure, cardiogenic shock, or cardiopulmonary arrest were significantly higher in the LD group than in the RD group (heart failure: 650 RD patients [14.7{\%}] vs. 87 LD patients [18.8{\%}], P = 0.025; cardiogenic shock: 322 RD patients [7.3{\%}] vs. 48 LD patients [10.3{\%}], P = 0.021; and cardiopulmonary arrest: 197 RD patients [4.5{\%}] vs. 36 LD patients [7.8{\%}], P = 0.003). In-hospital mortality was significantly higher among LD patients than among RD patients (182 RD patients [4.1{\%}] vs. 36 LD patients [7.8{\%}], P = 0.001). Multivariate logistic regression analysis revealed that LD anatomy was an independent predictor for in-hospital mortality (odds ratio, 1.75; 95{\%} confidence interval, 1.06-2.89; P = 0.030).Conclusion:Among ACS patients who underwent PCI, LD patients had significantly worse in-hospital outcomes compared with RD patients, and LD anatomy was an independent predictor of in-hospital mortality.",
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AU - Kuno, Toshiki

AU - Numasawa, Yohei

AU - Miyata, Hiroaki

AU - Takahashi, Toshiyuki

AU - Sueyoshi, Koichiro

AU - Ohki, Takahiro

AU - Negishi, Koji

AU - Kawamura, Akio

AU - Kosaka, Shun

AU - Fukuda, Keiichi

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N2 - Objective:This study evaluated the manner in which coronary dominance affects in-hospital outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).Background:Previous studies have shown that left dominant coronary anatomies are associated with worse prognoses in patients with coronary artery disease.Methods:Data were analyzed from 4873 ACS patients undergoing PCI between September 2008 and April 2013 at 14 hospitals participating in the Japanese Cardiovascular Database Registry. The patients were grouped based on diagnostic coronary angiograms performed prior to PCI; those with right- or co-dominant anatomy (RD group) and those with left-dominant anatomy (LD group).Results:The average patient age was 67.6±11.8 years and both patient groups had similar ages, coronary risk factors, comorbidities, and prior histories. The numbers of patients presenting with symptoms of heart failure, cardiogenic shock, or cardiopulmonary arrest were significantly higher in the LD group than in the RD group (heart failure: 650 RD patients [14.7%] vs. 87 LD patients [18.8%], P = 0.025; cardiogenic shock: 322 RD patients [7.3%] vs. 48 LD patients [10.3%], P = 0.021; and cardiopulmonary arrest: 197 RD patients [4.5%] vs. 36 LD patients [7.8%], P = 0.003). In-hospital mortality was significantly higher among LD patients than among RD patients (182 RD patients [4.1%] vs. 36 LD patients [7.8%], P = 0.001). Multivariate logistic regression analysis revealed that LD anatomy was an independent predictor for in-hospital mortality (odds ratio, 1.75; 95% confidence interval, 1.06-2.89; P = 0.030).Conclusion:Among ACS patients who underwent PCI, LD patients had significantly worse in-hospital outcomes compared with RD patients, and LD anatomy was an independent predictor of in-hospital mortality.

AB - Objective:This study evaluated the manner in which coronary dominance affects in-hospital outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).Background:Previous studies have shown that left dominant coronary anatomies are associated with worse prognoses in patients with coronary artery disease.Methods:Data were analyzed from 4873 ACS patients undergoing PCI between September 2008 and April 2013 at 14 hospitals participating in the Japanese Cardiovascular Database Registry. The patients were grouped based on diagnostic coronary angiograms performed prior to PCI; those with right- or co-dominant anatomy (RD group) and those with left-dominant anatomy (LD group).Results:The average patient age was 67.6±11.8 years and both patient groups had similar ages, coronary risk factors, comorbidities, and prior histories. The numbers of patients presenting with symptoms of heart failure, cardiogenic shock, or cardiopulmonary arrest were significantly higher in the LD group than in the RD group (heart failure: 650 RD patients [14.7%] vs. 87 LD patients [18.8%], P = 0.025; cardiogenic shock: 322 RD patients [7.3%] vs. 48 LD patients [10.3%], P = 0.021; and cardiopulmonary arrest: 197 RD patients [4.5%] vs. 36 LD patients [7.8%], P = 0.003). In-hospital mortality was significantly higher among LD patients than among RD patients (182 RD patients [4.1%] vs. 36 LD patients [7.8%], P = 0.001). Multivariate logistic regression analysis revealed that LD anatomy was an independent predictor for in-hospital mortality (odds ratio, 1.75; 95% confidence interval, 1.06-2.89; P = 0.030).Conclusion:Among ACS patients who underwent PCI, LD patients had significantly worse in-hospital outcomes compared with RD patients, and LD anatomy was an independent predictor of in-hospital mortality.

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