Published in:
01-01-2022 | Clopidogrel | Original Article
Temporal trends in coronary intervention strategies and the impact on one-year clinical events: data from a Japanese multi-center real-world cohort study
Authors:
Kenji Sakamoto, Ryota Sato, Noriaki Tabata, Masanobu Ishii, Takayoshi Yamashita, Suguru Nagamatsu, Kota Motozato, Kenshi Yamanaga, Seiji Hokimoto, Daisuke Sueta, Satoshi Araki, Koichiro Fujisue, Yuichiro Arima, Seiji Takashio, Kazuteru Fujimoto, Hideki Shimomura, Ryusuke Tsunoda, Toyoki Hirose, Koji Sato, Koichi Kikuta, Naritsugu Sakaino, Shinichi Nakamura, Nobuyasu Yamamoto, Toshiyuki Matsumura, Ichiro Kajiwara, Shinji Tayama, Tomohiro Sakamoto, Koichi Nakao, Shuichi Oshima, Eiichiro Yamamoto, Koichi Kaikita, Kenichi Tsujita, The Kumamoto Intervention Conference Study (KICS) Investigators
Published in:
Cardiovascular Intervention and Therapeutics
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Issue 1/2022
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Abstract
Percutaneous coronary intervention (PCI) has significantly advanced over the last 40 years, but it is not clear whether there have been any changes in prognosis in recent years. The Kumamoto Intervention Conference Study Real-World Registry is a multi-center registry that enrolls consecutive patients undergoing PCI in 17 centers in Kyushu, Japan. To elucidate the clinical impact of recent changes in treatment strategies, 8841 consecutive participants (historical PCI: n = 4038, enrolled between January 2013 and December 2014, and current PCI: n = 4803, between January 2015 and March 2017) with 1-year follow-up data were analyzed. The incidences of major adverse cardiovascular and other clinical events were comparable between historical PCI and current PCI, even though complex lesions were more frequent during the more recent period. During this period, the use of radial approaches, drug eluting stents, and coronary imaging was greater. The use of prasugrel was more frequent (P < 0.001) during the time periods. Comparable event rates were associated with the use of clopidogrel (52.7%) and prasugrel (47.3%). In the sub-analysis for acute coronary syndrome (n = 5047), similar clinical event rates were recorded for historical and current PCI. Although the lesions to be treated are becoming more severe and complex, equivalent clinical outcomes have been maintained in recent years, possibly due to advances in the devices and medication used.