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Comparative Trends in Percutaneous Coronary Intervention in Japan and the United States, 2013 to 2017.
- Source :
-
Journal of the American College of Cardiology [J Am Coll Cardiol] 2020 Sep 15; Vol. 76 (11), pp. 1328-1340. - Publication Year :
- 2020
-
Abstract
- Background: Adoption of the results of large-scale randomized controlled trials in percutaneous coronary intervention (PCI) may differ internationally, yet few studies have described the potential variations in PCI practice patterns.<br />Objectives: Using representative national registries, we compared temporal trends in procedural volume, patient characteristics, pre-procedural testing, procedural characteristics, and quality metrics in the United States and Japan.<br />Methods: The National Cardiovascular Data Registry CathPCI was used to describe care in the United States, and the J-PCI was used to assess practice patterns in Japan (numbers of participating hospitals: 1,752 in the United States and 1,108 in Japan). Both registries were summarized between 2013 and 2017.<br />Results: PCI volume increased by 15.8% in the United States from 550,872 in 2013 to 637,650 in 2017, primarily because of an increase in nonelective PCIs (p for trend <0.001). In Japan, the volume of PCIs increased by 36%, from 181,750 in 2013 to 247,274 in 2017, primarily because of an increase in elective PCIs (p for trend <0.001). The proportion of PCI cases for elective conditions was >2-fold greater in Japan (72.7%) than in the United States (33.8%; p < 0.001). Overall, the ratio of nonelective PCI (vs. elective PCI; 27.3% vs. 66.2%; p < 0.001) and the performance of noninvasive stress testing in patients with stable disease (15.2% vs. 55.3%; p < 0.001) was lower in Japan than in the United States. Computed tomography angiography was more commonly used in Japan (22.3% vs. 2.0%; p < 0.001).<br />Conclusions: Elective PCI is more than twice as common in Japan as in the United States in contemporary practice. Computed tomography angiography is much more frequently used pre-procedurally in Japan than in the United States.<br /> (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Computed Tomography Angiography standards
Female
Humans
Japan epidemiology
Male
Middle Aged
Percutaneous Coronary Intervention standards
Prospective Studies
Quality of Health Care standards
Risk Factors
Treatment Outcome
United States epidemiology
Computed Tomography Angiography trends
Percutaneous Coronary Intervention trends
Quality of Health Care trends
Registries standards
Subjects
Details
- Language :
- English
- ISSN :
- 1558-3597
- Volume :
- 76
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 32912447
- Full Text :
- https://doi.org/10.1016/j.jacc.2020.07.037