Document Detail


Impact of drug-eluting stents on treatment option mix for coronary artery disease in Japan.
MedLine Citation:
PMID:  20562493     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In Japan, drug-eluting stents (DES) were introduced in September 2004. The aim of the present study was to clarify how DES affected the proportions of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) procedures performed in Japan.
METHODS AND RESULTS: Using the Japanese Diagnosis Procedure Combination (DPC) inpatient database, 19,248 patients with angina pectoris (AP) and 2,895 patients with acute myocardial infarction (AMI) were identified from 144 hospitals in July of each year between 2004 and 2007. Among AP patients, the proportion of conservative therapies decreased from 70% in 2004 to 61% in 2007, while the proportion of PCI procedures increased from 25% in 2004 to 32% in 2007. On-pump CABG cases decreased from 3.5% in 2004 to 2.7% in 2007, but the number of off-pump CABG cases continuously increased from 2.2% in 2004 to 4.0% in 2007. Overall in-hospital mortality in AP patients gradually decreased from 0.35% in 2004 to 0.18% in 2007. In 2007, DES was used in 23% of all AP patients and 26% of all AMI patients. Multi-nominal logistic regression analysis showed that the proportional use of DES was greater in non-teaching hospitals than in teaching hospitals.
CONCLUSIONS: There has been marked expansion of PCI and a gradual increase in off-pump CABG after the introduction of DES. It is essential to establish guidelines in Japan for a consensus between cardiologists and cardiovascular surgeons on evidence-based best practice.
Authors:
Hiromasa Horiguchi; Hideo Yasunaga; Hideki Hashimoto; Shinya Matsuda
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-16
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-30     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1635-43     Citation Subset:  IM    
Affiliation:
Department of Health Management and Policy, Graduate School of Medicine, School of Public Health, University of Tokyo, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / mortality,  therapy
Angioplasty, Balloon, Coronary / statistics & numerical data,  utilization*
Combined Modality Therapy
Coronary Artery Bypass / statistics & numerical data,  utilization*
Coronary Artery Disease / therapy*
Databases, Factual
Drug-Eluting Stents* / statistics & numerical data,  utilization
Female
Hospital Mortality
Humans
Japan
Male
Myocardial Infarction / mortality,  therapy
Comments/Corrections
Comment In:
Circ J. 2010 Aug;74(8):1532-3   [PMID:  20647637 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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