In-Hospital Outcomes After Percutaneous Coronary Intervention for Acute Coronary Syndrome With Cardiogenic Shock (from a Japanese Nationwide Registry [J-PCI Registry])

Shunsuke Kubo, Kyohei Yamaji, Taku Inohara, Shun Kosaka, Hiroyuki Tanaka, Hideki Ishii, Shiro Uemura, Tetsuya Amano, Masato Nakamura, Kazushige Kadota

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalAmerican Journal of Cardiology
DOIs
Publication statusPublished - 2019 Jan 1

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Cardiogenic Shock
Percutaneous Coronary Intervention
Acute Coronary Syndrome
Registries
Hospital Mortality
Hemorrhage
Heart Arrest
Japan
Heart Failure
Logistic Models
Regression Analysis
Kidney

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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In-Hospital Outcomes After Percutaneous Coronary Intervention for Acute Coronary Syndrome With Cardiogenic Shock (from a Japanese Nationwide Registry [J-PCI Registry]). / Kubo, Shunsuke; Yamaji, Kyohei; Inohara, Taku; Kosaka, Shun; Tanaka, Hiroyuki; Ishii, Hideki; Uemura, Shiro; Amano, Tetsuya; Nakamura, Masato; Kadota, Kazushige.

In: American Journal of Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

Kubo, Shunsuke ; Yamaji, Kyohei ; Inohara, Taku ; Kosaka, Shun ; Tanaka, Hiroyuki ; Ishii, Hideki ; Uemura, Shiro ; Amano, Tetsuya ; Nakamura, Masato ; Kadota, Kazushige. / In-Hospital Outcomes After Percutaneous Coronary Intervention for Acute Coronary Syndrome With Cardiogenic Shock (from a Japanese Nationwide Registry [J-PCI Registry]). In: American Journal of Cardiology. 2019.
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abstract = "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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