Incidence and Determinants of Complications in Rotational Atherectomy: Insights from the National Clinical Data (J-PCI Registry)

Kenichi Sakakura, Taku Inohara, Shun Kosaka, Tetsuya Amano, Shiro Uemura, Hideki Ishii, Kazushige Kadota, Masato Nakamura, Hiroshi Funayama, Hideo Fujita, Shin Ichi Momomura

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background-The usage of rotational atherectomy (RA) is growing in the current percutaneous coronary intervention (PCI) because of the expansion of PCI indication to more complex lesions. However, the complications after RA have been linked to procedure-related morbidity and mortality. The purpose of this study was to investigate the incidence and determinants of complications in RA using a large nationwide registration system in Japan (J-PCI). Methods and Results-The primary composite outcome of this study was defined as the occurrence of in-hospital death, cardiac tamponade, and emergent surgery after RA. A total of 13 335 RA cases (3.2% of registered PCI cases) were analyzed. The composite outcome was observed in 175 cases (1.31%) and included 80 in-hospital deaths (0.60%), 86 tamponades (0.64%), and 24 emergent surgeries (0.18%). The clinical variables associated with occurrence of the composite outcome were age (odds ratio [OR] 1.03 per unit increment, 95% confidence interval [CI] 1.02-1.05), impaired kidney function (OR 1.59, 95% CI 1.15-2.19), previous myocardial infarction (OR 1.69, 95% CI 1.21-2.35), emergent PCI (OR 4.02, 95% CI 1.66-8.27), and triple-vessel disease (versus single-vessel disease: OR 2.17, 95% CI 1.43-3.28). Notably, institutional volume of RA cases was inversely associated with the composite outcomes (high-versus low-volume institution: OR 0.56, 95% CI 0.36-0.89). Conclusions-The reported incidence of important procedure-related complication rate was 1.3%, with each component ranging between 0.2% and 0.6% in J-PCI. Its determinants were both patient related (age, impaired kidney function, and previous myocardial infarction) and procedure related (emergent procedures, number of diseased vessels, and institutional volume of RA).

Original languageEnglish
Article numbere004278
JournalCirculation: Cardiovascular Interventions
Volume9
Issue number11
DOIs
Publication statusPublished - 2016 Nov 1
Externally publishedYes

Fingerprint

Coronary Atherectomy
Percutaneous Coronary Intervention
Registries
Odds Ratio
Confidence Intervals
Incidence
Myocardial Infarction
Kidney
Cardiac Tamponade
Japan
Outcome Assessment (Health Care)
Morbidity
Mortality

Keywords

  • atherectomy
  • complication
  • incidence
  • registry
  • rotational atherectomy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Incidence and Determinants of Complications in Rotational Atherectomy : Insights from the National Clinical Data (J-PCI Registry). / Sakakura, Kenichi; Inohara, Taku; Kosaka, Shun; Amano, Tetsuya; Uemura, Shiro; Ishii, Hideki; Kadota, Kazushige; Nakamura, Masato; Funayama, Hiroshi; Fujita, Hideo; Momomura, Shin Ichi.

In: Circulation: Cardiovascular Interventions, Vol. 9, No. 11, e004278, 01.11.2016.

Research output: Contribution to journalArticle

Sakakura, K, Inohara, T, Kosaka, S, Amano, T, Uemura, S, Ishii, H, Kadota, K, Nakamura, M, Funayama, H, Fujita, H & Momomura, SI 2016, 'Incidence and Determinants of Complications in Rotational Atherectomy: Insights from the National Clinical Data (J-PCI Registry)', Circulation: Cardiovascular Interventions, vol. 9, no. 11, e004278. https://doi.org/10.1161/CIRCINTERVENTIONS.116.004278
Sakakura, Kenichi ; Inohara, Taku ; Kosaka, Shun ; Amano, Tetsuya ; Uemura, Shiro ; Ishii, Hideki ; Kadota, Kazushige ; Nakamura, Masato ; Funayama, Hiroshi ; Fujita, Hideo ; Momomura, Shin Ichi. / Incidence and Determinants of Complications in Rotational Atherectomy : Insights from the National Clinical Data (J-PCI Registry). In: Circulation: Cardiovascular Interventions. 2016 ; Vol. 9, No. 11.
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abstract = "Background-The usage of rotational atherectomy (RA) is growing in the current percutaneous coronary intervention (PCI) because of the expansion of PCI indication to more complex lesions. However, the complications after RA have been linked to procedure-related morbidity and mortality. The purpose of this study was to investigate the incidence and determinants of complications in RA using a large nationwide registration system in Japan (J-PCI). Methods and Results-The primary composite outcome of this study was defined as the occurrence of in-hospital death, cardiac tamponade, and emergent surgery after RA. A total of 13 335 RA cases (3.2{\%} of registered PCI cases) were analyzed. The composite outcome was observed in 175 cases (1.31{\%}) and included 80 in-hospital deaths (0.60{\%}), 86 tamponades (0.64{\%}), and 24 emergent surgeries (0.18{\%}). The clinical variables associated with occurrence of the composite outcome were age (odds ratio [OR] 1.03 per unit increment, 95{\%} confidence interval [CI] 1.02-1.05), impaired kidney function (OR 1.59, 95{\%} CI 1.15-2.19), previous myocardial infarction (OR 1.69, 95{\%} CI 1.21-2.35), emergent PCI (OR 4.02, 95{\%} CI 1.66-8.27), and triple-vessel disease (versus single-vessel disease: OR 2.17, 95{\%} CI 1.43-3.28). Notably, institutional volume of RA cases was inversely associated with the composite outcomes (high-versus low-volume institution: OR 0.56, 95{\%} CI 0.36-0.89). Conclusions-The reported incidence of important procedure-related complication rate was 1.3{\%}, with each component ranging between 0.2{\%} and 0.6{\%} in J-PCI. Its determinants were both patient related (age, impaired kidney function, and previous myocardial infarction) and procedure related (emergent procedures, number of diseased vessels, and institutional volume of RA).",
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AU - Kosaka, Shun

AU - Amano, Tetsuya

AU - Uemura, Shiro

AU - Ishii, Hideki

AU - Kadota, Kazushige

AU - Nakamura, Masato

AU - Funayama, Hiroshi

AU - Fujita, Hideo

AU - Momomura, Shin Ichi

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N2 - Background-The usage of rotational atherectomy (RA) is growing in the current percutaneous coronary intervention (PCI) because of the expansion of PCI indication to more complex lesions. However, the complications after RA have been linked to procedure-related morbidity and mortality. The purpose of this study was to investigate the incidence and determinants of complications in RA using a large nationwide registration system in Japan (J-PCI). Methods and Results-The primary composite outcome of this study was defined as the occurrence of in-hospital death, cardiac tamponade, and emergent surgery after RA. A total of 13 335 RA cases (3.2% of registered PCI cases) were analyzed. The composite outcome was observed in 175 cases (1.31%) and included 80 in-hospital deaths (0.60%), 86 tamponades (0.64%), and 24 emergent surgeries (0.18%). The clinical variables associated with occurrence of the composite outcome were age (odds ratio [OR] 1.03 per unit increment, 95% confidence interval [CI] 1.02-1.05), impaired kidney function (OR 1.59, 95% CI 1.15-2.19), previous myocardial infarction (OR 1.69, 95% CI 1.21-2.35), emergent PCI (OR 4.02, 95% CI 1.66-8.27), and triple-vessel disease (versus single-vessel disease: OR 2.17, 95% CI 1.43-3.28). Notably, institutional volume of RA cases was inversely associated with the composite outcomes (high-versus low-volume institution: OR 0.56, 95% CI 0.36-0.89). Conclusions-The reported incidence of important procedure-related complication rate was 1.3%, with each component ranging between 0.2% and 0.6% in J-PCI. Its determinants were both patient related (age, impaired kidney function, and previous myocardial infarction) and procedure related (emergent procedures, number of diseased vessels, and institutional volume of RA).

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