Published in:
Open Access
01-01-2021 | Angiography | Original Article
Imaging-guided PCI for event suppression in Japanese acute coronary syndrome patients: community-based observational cohort registry
Authors:
Takayoshi Yamashita, Kenji Sakamoto, Noriaki Tabata, Masanobu Ishii, Ryota Sato, Suguru Nagamatsu, Kota Motozato, Kenshi Yamanaga, Daisuke Sueta, Satoshi Araki, Yuichiro Arima, Eiichiro Yamamoto, Seiji Takashio, Koichiro Fujisue, Kazuteru Fujimoto, Hideki Shimomura, Ryusuke Tsunoda, Hideki Maruyama, Natsuki Nakamura, Naritsugu Sakaino, Shinichi Nakamura, Nobuyasu Yamamoto, Toshiyuki Matsumura, Ichiro Kajiwara, Shinji Tayama, Tomohiro Sakamoto, Koichi Nakao, Shuichi Oshima, Koichi Kaikita, Seiji Hokimoto, Kenichi Tsujita, Kumamoto Intervention Conference Study (KICS) Investigators
Published in:
Cardiovascular Intervention and Therapeutics
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Issue 1/2021
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Abstract
Although there is accumulating evidence for the usefulness of imaging-guided percutaneous coronary intervention (PCI), there are few studies for acute coronary syndrome (ACS), and the impact of the frequency of use has not been well addressed. From the Kumamoto Intervention Conference Study; a Japanese registry comprising 17 institutions, consecutive patients undergoing successful PCI from April 2008 through March 2014 were enrolled. Subjects were divided into two groups: imaging-guided PCI and angiography-guided PCI. Clinical outcome was a composite of cardiac death, non-fatal myocardial infarction, and stent thrombosis within 1 year. A total of 6025 ACS patients were enrolled: 3613 and 2412 patients with imaging- and angiography-guided PCI, respectively. Adverse cardiac events were significantly lower in the imaging-guided PCI group (long-rank
P < 0.001). Even after propensity-score matching, the event rates still showed significant differences between the two groups (log-rank
P = 0.004). To assess the effects of frequency of imaging usage, we divided the 17 institutions into six low-, six moderate-, and five high-frequency groups. The event rates decreased depending on the frequency, seemingly driven by stepwise event suppression in angiography-guided PCI. In Japanese ACS patients, the incidence of adverse clinical events in patients treated with imaging-guided PCI were significantly lower than that in patients with angiography-guided PCI. Better clinical result was found in the institutions using intravascular imaging more frequently. University Hospital Medical Information Network (UMIN)-CTR (
http://www.umin.ac.jp/ctr/). Identifier: KICS (UMIN000015397).