Exploring triaging and short-term outcomes of early invasive strategy in non-st segment elevation acute coronary syndrome: A report from japanese multicenter registry

Nobuhiro Ikemura, Yasuyuki Shiraishi, Mitsuaki Sawano, Ikuko Ueda, Yohei Numasawa, Shigetaka Noma, Masahiro Suzuki, Yukihiko Momiyama, Kentaro Hayashida, Shinsuke Yuasa, Hiroaki Miyata, Keiichi Fukuda, Shun Kohsaka

研究成果: Article査読

1 被引用数 (Scopus)

抄録

This observational study aimed to examine the extent of early invasive strategy (EIS) utilization in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) according to the National Cardiovascular Data Registry (NCDR) CathPCI risk score, and its association with clinical outcomes. Using a prospective multicenter Japanese registry, 2968 patients with NSTE-ACS undergoing percutaneous coronary intervention within 72 hours of hospital arrival were analyzed. Multivariable logistic regression analyses were performed to determine predictors of EIS utilization. Additionally, adverse outcomes were compared between patients treated with and without EIS. Overall, 82.1% of the cohort (n = 2436) were treated with EIS, and the median NCDR CathPCI risk score was 22 (interquartile range: 14-32) with an expected 0.3-0.6% in-hospital mortality. Advanced age, peripheral artery disease, chronic kidney disease or patients without elevation of cardiac biomarkers were less likely to be treated with EIS. EIS utilization was not associated with a risk of in-hospital mortality; yet, it was associated with an increased risk of acute kidney injury (AKI) (adjusted odds ratio: 1.42; 95% confidence interval: 1.02-2.01) regardless of patients’ in-hospital mortality risk. Broader use of EIS utilization comes at the cost of increased AKI development risk; thus, the pre-procedural risk-benefit profile of EIS should be reassessed appropriately in patients with lower mortality risk.

本文言語English
論文番号1106
ジャーナルJournal of Clinical Medicine
9
4
DOI
出版ステータスPublished - 2020 4月

ASJC Scopus subject areas

  • 医学(全般)

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