Difference in Patient Profiles and Outcomes in Japanese Versus American Patients Undergoing Coronary Revascularization (Collaborative Study by CREDO-Kyoto and the Texas Heart Institute Research Database)

Shun Kohsaka, Takeshi Kimura, Masashi Goto, Vei Vei Lee, MacArthur Elayda, Yutaka Furukawa, Masanori Fukushima, Masashi Komeda, Ryuuzou Sakata, James T. Willerson, James M. Wilson, Toru Kita

研究成果: Article査読

46 被引用数 (Scopus)

抄録

Although coronary revascularization is common in both Japan and the United States (US), no direct comparison has been performed to demonstrate differences in the clinical characteristics and long-term outcomes of patients in these 2 countries. We analyzed the preprocedural, in-hospital, and long-term data from the Coronary Revascularization Demonstrating Outcome registry (Kyoto, Japan) and the Texas Heart Institute Research Database (Houston, Texas) of 16,100 patients who had undergone elective, initial percutaneous coronary intervention or coronary artery bypass grafting. The Japanese procedures were performed from 2000 to 2002 (n = 8,871, follow-up period 3.5 years, interquartile range 2.6 to 4.3) and the US procedures from 1999 to 2003 (n = 7,229, follow-up period 5.2 years, interquartile range 3.8 to 6.5). The Japanese patients tended to be older (mean age 67.2 vs 62.7 years; p <0.001), to smoke (52.9% vs 46.0%; p <0.001), and to have diabetes (39.2% vs 31.0%; p <0.001) and stroke (16.4% vs 5.0%; p <0.001). The US patients were more obese (body mass index 23.7 vs 29.3 kg/m2; p <0.001), with greater rates of systemic atherosclerotic disease. Both groups had a similar in-hospital mortality rate (Japanese patients 0.9% vs US patients 1.1%; p = 0.19) and crude long-term mortality rate (Japanese patients 27.7/1,000 person-years, US patients 28.2/1,000 person-years; p = 0.35). After adjustment for known predictors, the US group had greater long-term mortality than the Japanese group (hazard ratio 1.71, 95% confidence interval 1.50 to 1.95; p <0.001). This finding was consistent among all high-risk subgroups. In conclusion, the 2 registries showed similar crude outcomes but important differences in patient risk factors such as obesity. In the adjusted analysis, the Japanese patients had better outcomes than did the US patients. Additional study is needed to assess the effect of ethnic and risk factor variations on coronary artery disease.

本文言語English
ページ(範囲)1698-1704
ページ数7
ジャーナルAmerican Journal of Cardiology
105
12
DOI
出版ステータスPublished - 2010 6月 15
外部発表はい

ASJC Scopus subject areas

  • 循環器および心血管医学

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