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Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry

BACKGROUND: Performance of percutaneous coronary intervention (PCI) in side-branch vessels (SB-PCI) has not been fully investigated despite the technical advancement of PCI. METHODS: We investigated 257,492 patients registered in the Japanese nationwide PCI registry from January to December 2018; 19...

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Autores principales: Murasato, Yoshinobu, Yamaji, Kyohei, Kohsaka, Shun, Wada, Hideki, Ishii, Hideki, Kinoshita, Yoshihisa, Shite, Junya, Hikichi, Yutaka, Amano, Tetsuya, Ikari, Yuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374521/
https://www.ncbi.nlm.nih.gov/pubmed/34430704
http://dx.doi.org/10.1016/j.ijcha.2021.100856
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author Murasato, Yoshinobu
Yamaji, Kyohei
Kohsaka, Shun
Wada, Hideki
Ishii, Hideki
Kinoshita, Yoshihisa
Shite, Junya
Hikichi, Yutaka
Amano, Tetsuya
Ikari, Yuji
author_facet Murasato, Yoshinobu
Yamaji, Kyohei
Kohsaka, Shun
Wada, Hideki
Ishii, Hideki
Kinoshita, Yoshihisa
Shite, Junya
Hikichi, Yutaka
Amano, Tetsuya
Ikari, Yuji
author_sort Murasato, Yoshinobu
collection PubMed
description BACKGROUND: Performance of percutaneous coronary intervention (PCI) in side-branch vessels (SB-PCI) has not been fully investigated despite the technical advancement of PCI. METHODS: We investigated 257,492 patients registered in the Japanese nationwide PCI registry from January to December 2018; 199,767 (78%) underwent PCI for major vessel PCI (MV-PCI), 21,555 (8.4%) underwent SB-PCI, and 24,862 (9.6%) underwent PCI for both vessels (SB + MV-PCI). The frequencies of primary composite adverse events, defined as in-hospital mortality and procedural complications (i.e., peri-procedural myocardial infarction, tamponade, new-onset cardiogenic shock, stent thrombosis, emergent surgery, and bleeding), and PCI for restenotic lesions were investigated. Their association with institutional frequency of each PCI was also investigated. RESULTS: Fewer drug-eluting stents (66% vs. 86%) and more drug-coated balloons (23% vs. 9%) were used in SB-PCI than in MV-PCI (p < 0.001). Pre-procedure non-invasive testing was similarly performed in SB-PCI and MV-PCI (57% vs. 61%). The composite endpoint was observed in 0.7%, 1.9%, and 2.2% of the SB-PCI, SB + MV-PCI, and MV-PCI groups, respectively (p < 0.001). Institutional frequency of SB-PCI was inversely associated with the composite-endpoint risk for all PCI procedures (odds ratio 1.37, 95% confidence interval 1.04–1.81 in the lowest tertile, with reference to the middle tertile, p = 0.02). Frequency of PCI for restenotic lesions was also inversely associated with the institutional frequency of MV-PCI (p < 0.001). CONCLUSION: SB-PCI was performed safely with a low frequency of acute complications, and higher SB-PCI frequency presented a lower risk of in-hospital adverse events, albeit with a cost of an increase in PCI for restenotic lesions.
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spelling pubmed-83745212021-08-23 Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry Murasato, Yoshinobu Yamaji, Kyohei Kohsaka, Shun Wada, Hideki Ishii, Hideki Kinoshita, Yoshihisa Shite, Junya Hikichi, Yutaka Amano, Tetsuya Ikari, Yuji Int J Cardiol Heart Vasc Original Paper BACKGROUND: Performance of percutaneous coronary intervention (PCI) in side-branch vessels (SB-PCI) has not been fully investigated despite the technical advancement of PCI. METHODS: We investigated 257,492 patients registered in the Japanese nationwide PCI registry from January to December 2018; 199,767 (78%) underwent PCI for major vessel PCI (MV-PCI), 21,555 (8.4%) underwent SB-PCI, and 24,862 (9.6%) underwent PCI for both vessels (SB + MV-PCI). The frequencies of primary composite adverse events, defined as in-hospital mortality and procedural complications (i.e., peri-procedural myocardial infarction, tamponade, new-onset cardiogenic shock, stent thrombosis, emergent surgery, and bleeding), and PCI for restenotic lesions were investigated. Their association with institutional frequency of each PCI was also investigated. RESULTS: Fewer drug-eluting stents (66% vs. 86%) and more drug-coated balloons (23% vs. 9%) were used in SB-PCI than in MV-PCI (p < 0.001). Pre-procedure non-invasive testing was similarly performed in SB-PCI and MV-PCI (57% vs. 61%). The composite endpoint was observed in 0.7%, 1.9%, and 2.2% of the SB-PCI, SB + MV-PCI, and MV-PCI groups, respectively (p < 0.001). Institutional frequency of SB-PCI was inversely associated with the composite-endpoint risk for all PCI procedures (odds ratio 1.37, 95% confidence interval 1.04–1.81 in the lowest tertile, with reference to the middle tertile, p = 0.02). Frequency of PCI for restenotic lesions was also inversely associated with the institutional frequency of MV-PCI (p < 0.001). CONCLUSION: SB-PCI was performed safely with a low frequency of acute complications, and higher SB-PCI frequency presented a lower risk of in-hospital adverse events, albeit with a cost of an increase in PCI for restenotic lesions. Elsevier 2021-08-18 /pmc/articles/PMC8374521/ /pubmed/34430704 http://dx.doi.org/10.1016/j.ijcha.2021.100856 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Murasato, Yoshinobu
Yamaji, Kyohei
Kohsaka, Shun
Wada, Hideki
Ishii, Hideki
Kinoshita, Yoshihisa
Shite, Junya
Hikichi, Yutaka
Amano, Tetsuya
Ikari, Yuji
Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry
title Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry
title_full Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry
title_fullStr Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry
title_full_unstemmed Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry
title_short Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry
title_sort percutaneous coronary intervention in side branch coronary arteries: insights from the japanese nationwide registry
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374521/
https://www.ncbi.nlm.nih.gov/pubmed/34430704
http://dx.doi.org/10.1016/j.ijcha.2021.100856
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