Dataset Information

Clinical Characteristics and In-Hospital Mortality According to Left Main and Non-Left Main Culprit Lesions?- Report From the Japan Acute Myocardial Infarction Registry (JAMIR).

ABSTRACT: Background: Acute coronary syndrome (ACS) due to an unprotected left main coronary artery (LMCA) lesion is a critical condition, but there are limited data available on in-hospital outcomes of percutaneous coronary intervention (PCI). Methods?and?Results: The Japan Acute Myocardial Infarction Registry is a nationwide, real-world database. The clinical data on 13,548 ACS patients hospitalized between January 2011 and December 2013 were retrospectively collected from 10 representative regional ACS registry groups. We compared the 404 patients (3.0%) with LMCA ACS with the remaining 13,144 patients with non-LMCA ACS. The LMCA group was characterized by older age, lower rate of ST-segment elevation myocardial infarction, and higher rate of advanced Killip class. In-hospital mortality was significantly higher in patients with LMCA ACS than in those with non-LMCA ACS (23.3% vs. 5.5%, respectively; P<0.001). Primary PCI for non-LMCA lesions was associated with lower in-hospital mortality (OR, 0.48; 95% CI: 0.34-0.66), but that for LMCA lesions was not (OR, 2.89; 95% CI: 1.13-7.40). Longer door-to-balloon time was associated with Killip class ?2 and higher in-hospital mortality in the non-LMCA group but not in the LMCA group. Conclusions: Primary PCI in patients with LMCA ACS is still challenging; therefore, effective strategies are needed.

SUBMITTER: Nishihira K

PROVIDER: S-EPMC7897686 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Clinical Characteristics and In-Hospital Mortality According to Left Main and Non-Left Main Culprit Lesions　- Report From the Japan Acute Myocardial Infarction Registry (JAMIR).

Nishihira Kensaku K Kojima Sunao S Takegami Misa M Honda Satoshi S Nakao Yoko M YM Takahashi Jun J Itoh Tomonori T Watanabe Tetsu T Takayama Morimasa M Shimokawa Hiroaki H Sumiyoshi Tetsuya T Kimura Kazuo K Yasuda Satoshi S

Circulation reports 20191129 12

Background: Acute coronary syndrome (ACS) due to an unprotected left main coronary artery (LMCA) lesion is a critical condition, but there are limited data available on in-hospital outcomes of percutaneous coronary intervention (PCI). Methods and Results: The Japan Acute Myocardial Infarction Registry is a nationwide, real-world database. The clinical data on 13,548 ACS patients hospitalized between January 2011 and December 2013 were retrospectively collected from 10 ...[more]

PMID: 33693106

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Project description:Thirty-day risk-standardized mortality rates after acute myocardial infarction are commonly used to evaluate and compare hospital performance. However, it is not known whether differences among hospitals in the early survival of patients with acute myocardial infarction are associated with differences in long-term survival.We analyzed data from the Cooperative Cardiovascular Project, a study of Medicare beneficiaries who were hospitalized for acute myocardial infarction between 1994 and 1996 and who had 17 years of follow-up. We grouped hospitals into five strata that were based on case-mix severity. Within each case-mix stratum, we compared life expectancy among patients admitted to high-performing hospitals with life expectancy among patients admitted to low-performing hospitals. Hospital performance was defined by quintiles of 30-day risk-standardized mortality rates. Cox proportional-hazards models were used to calculate life expectancy.The study sample included 119,735 patients with acute myocardial infarction who were admitted to 1824 hospitals. Within each case-mix stratum, survival curves of the patients admitted to hospitals in each risk-standardized mortality rate quintile separated within the first 30 days and then remained parallel over 17 years of follow-up. Estimated life expectancy declined as hospital risk-standardized mortality rate quintile increased. On average, patients treated at high-performing hospitals lived between 0.74 and 1.14 years longer, depending on hospital case mix, than patients treated at low-performing hospitals. When 30-day survivors were examined separately, there was no significant difference in unadjusted or adjusted life expectancy across hospital risk-standardized mortality rate quintiles.In this study, patients admitted to high-performing hospitals after acute myocardial infarction had longer life expectancies than patients treated in low-performing hospitals. This survival benefit occurred in the first 30 days and persisted over the long term. (Funded by the National Heart, Lung, and Blood Institute and the National Institute of General Medical Sciences Medical Scientist Training Program.).

Dataset Information

Clinical Characteristics and In-Hospital Mortality According to Left Main and Non-Left Main Culprit Lesions?- Report From the Japan Acute Myocardial Infarction Registry (JAMIR).

Publications

Clinical Characteristics and In-Hospital Mortality According to Left Main and Non-Left Main Culprit Lesions　- Report From the Japan Acute Myocardial Infarction Registry (JAMIR).

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

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Dataset Information

Clinical Characteristics and In-Hospital Mortality According to Left Main and Non-Left Main Culprit Lesions?- Report From the Japan Acute Myocardial Infarction Registry (JAMIR).

Publications

Clinical Characteristics and In-Hospital Mortality According to Left Main and Non-Left Main Culprit Lesions - Report From the Japan Acute Myocardial Infarction Registry (JAMIR).

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Clinical Characteristics and In-Hospital Mortality According to Left Main and Non-Left Main Culprit Lesions　- Report From the Japan Acute Myocardial Infarction Registry (JAMIR).