An overview of percutaneous coronary intervention in dialysis patients: Insights from a Japanese nationwide registry

2018 ◽  
Vol 94 (1) ◽  
pp. E1-E8 ◽  
Author(s):  
Yohei Numasawa ◽  
Taku Inohara ◽  
Hideki Ishii ◽  
Kyohei Yamaji ◽  
Keita Hirano ◽  
...  
2020 ◽  
Vol 9 (11) ◽  
pp. 3612
Author(s):  
Yohei Numasawa ◽  
Taku Inohara ◽  
Hideki Ishii ◽  
Kyohei Yamaji ◽  
Shun Kohsaka ◽  
...  

Although baseline hemoglobin and renal function are both important predictors of adverse outcomes after percutaneous coronary intervention (PCI), scarce data exist regarding the combined impact of these factors on outcomes. We sought to investigate the impact and threshold value of the hemoglobin to creatinine (Hgb/Cr) ratio, on in-hospital adverse outcomes among non-dialysis patients in a Japanese nationwide registry. We analyzed 157,978 non-dialysis patients who underwent PCI in 884 Japanese medical institutions in 2017. We studied differences in baseline characteristics and in-hospital clinical outcomes among four groups according to their quartiles of the Hgb/Cr ratios. Compared with patients with higher Hgb/Cr ratios, patients with lower ratios were older and had more comorbidities and complex coronary artery disease. Patients with lower hemoglobin and higher creatinine levels had a higher rate of in-hospital adverse outcomes including in-hospital mortality and procedural complications (defined as occurrence of cardiac tamponade, cardiogenic shock after PCI, emergency operation, or bleeding complications that required blood transfusion). On multivariate analyses, Hgb/Cr ratio was inversely associated with in-hospital mortality (odds ratio: 0.91, 95% confidence interval: 0.89–0.92; p < 0.001) and bleeding complications (odds ratio: 0.92, 95% confidence interval: 0.90–0.94; p < 0.001). Spline curve analysis demonstrated that these risks started to increase when the Hgb/Cr ratio was <15, and elevated exponentially when the ratio was <10. Hgb/Cr ratio is a simple index among non-dialysis patients and is inversely associated with in-hospital mortality and bleeding complications after PCI.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Van Veelen ◽  
J Elias ◽  
I.M Van Dongen ◽  
J.P.S Henriques ◽  
P Knaapen

Abstract Background Females comprise a minority of patients with chronic total occlusions (CTO). It is known that men have a greater benefit from CTO percutaneous coronary intervention (PCI) than women. We aimed to determine gender-based differences in baseline characteristics and outcomes after PCI in patients with CTO. Methods The Netherlands Heart Registration (NHR) is a nationwide registry that registers outcomes of cardiac interventions. For the purpose of this analysis, the data of all patients undergoing PCI from inception of the NHR to December 2018 were selected, that included PCI with at least one CTO in one of the treated coronary arteries. We compared baseline characteristics and the outcomes 1 year mortality, 30 day myocardial infarction (MI) and target vessel revascularization (TVR) &lt;1 year between men and women. Results A total of 7560 patients were identified that underwent PCI between January 1, 2015 and December 31, 2018 with at least 1 CTO in the treated vessel. A total of 5850 was male (77.4%) and 1710 was female (22.6%). Women were older (68.5±10.6 versus 64.7±10.6 years old, p&lt;0.001), and more frequently had diabetes (29.4% [n=529] versus 25.0% [n=1602], p&lt;0.001) and kidney disease (4.5% [n=529] versus 2.2% [n=142], p&lt;0.001). However, men had more extensive cardiovascular disease, i.e. multi-vessel disease (56.0% [n=3584] versus 50.4% [n=912], p&lt;0.001), previous MI (39.7% [n=2527] versus 31.0% [n=555], p&lt;0.001), previous PCI (48.2% [n=1967] versus 40.2% [n=455], p&lt;0.001) and previous coronary artery bypass grafting (16.8% [n=1085] versus 10.5% [n=191], p&lt;0.001) and more frequently presented with an out-of-hospital cardiac arrest, compared to women (2.1% [n=136] versus 1.1% [n=20], p=0.004). The 1-year mortality was higher in women (10.3% versus 7.5%, p&lt;0.001), as well as the 30-day MI (0.9% versus 0.4%, p=0.043), but men had higher risk for TVR&lt;1 year (11.7% versus 9.5%, p=0.044). Corrected for age and comorbidities, female gender was an independent predictor for mortality (Figure 1; odds ratio 1.83, 95% confidence interval 1.08–3.11, p=0.025). Conclusion In this nationwide registry comprising 7560 CTO patients undergoing PCI, significant gender-based differences were found. Males were found to have more extensive cardiovascular disease. However, females were at higher risk of mortality, possibly due to higher age and higher prevalence of concomitant comorbidities. Figure 1. Survival curve Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 36 ◽  
pp. 100856
Author(s):  
Yoshinobu Murasato ◽  
Kyohei Yamaji ◽  
Shun Kohsaka ◽  
Hideki Wada ◽  
Hideki Ishii ◽  
...  

2010 ◽  
Vol 105 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Cedric Delhaye ◽  
Gabriel Maluenda ◽  
Kohei Wakabayashi ◽  
Itsik Ben-Dor ◽  
Sara D. Collins ◽  
...  

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