Analyses of the long-term outcomes and prognostic factors of Japanese patients undergoing first coronary revascularization.

• Project/Area Number: 18590771
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Circulatory organs internal medicine
• Research Institution: Kyoto University
• Principal Investigator: KIMURA Takeshi Kyoto University, Graduate School of Medicine, Associate Professor (80359786)
• Co-Investigator(Kenkyū-buntansha): FURUKAWA Yutaka Kyoto University, Graduate School of Medicine, Assistant Professor (60359833) ; 中川 義久 京都大学, 医学研究科, 講師 (00378613)
• Project Period (FY): 2006 – 2007
• Project Status: Completed (Fiscal Year 2007)
• Budget Amount: ¥3,950,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥450,000); Fiscal Year 2007: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000); Fiscal Year 2006: ¥2,000,000 (Direct Cost: ¥2,000,000)
• Keywords: coronary artery disease / percutaneous coronary intervention / coronary-artery bypass graft surgery / observational study / prognosis / 経費的冠動脈形成術

Research Abstract

A multicenter study enrolling consecutive patients with coronary artery disease undergoing first PCI or CABG between January 2000 and December 2002 has been conducted. Patients with acute myocardial infarction within a week have been excluded from enrollment Among the 9,877 patients enrolled, 5,420 (PCI: 3,712, CABG: 1,708) had multivessel disease without left main involvement. The present study compared the prognosis of PCI versus CABG in the 5,420 patient s who have possible indication of CABG. Because age is a very important determinant when deciding revascularization strategies, survival analysis was also performed in the stratified subgroups by either age 〓 75 or <75 years. Analyses were also performed in other relevant subgroups. At 3 years, unadjusted survival rates were comparable between the PCI (89.6%) and CABG (91.7%) groups (log rank p=0.26). After adjustment for baseline characteristics, survival outcome tended to be better after CABG (hazard ratio for death after PCI vs. CABG [HR] (95% confidence interval [CI]): 1.23 (0.99-1.53), p=0.06). Adjusted survival outcomes also tended to be better for CABG among the patients 〓 75 years (HR (95%CI): 1.37 (0.98-1.92), p= 0.07), but not among the patients <75 years (BR (95% CI): 1.09 (0.82-1.46), p= 0.55). Unadjusted and adjusted survival outcome for CABG and PCI were not significantly different in any subgroups when elderly patients ($75 years) were excluded from analysis. In regard to the rate of freedom from any revascularization procedures, there was a striking difference between the PCI and CABG groups. At 3 years, only 51.7% of patients in the PCI group were free from any revascularization procedures as compared with 90.2% of patients in the CABG group.
Thus, survival outcomes among patients <75 years of age were similar after PCI and CABG, while the patients after PCI often underwent coronary revascularization procedures in the era of bare metal stent.

Research Products

• [Journal Article] Long-term Outcomes of Coronary-Artery Bypass Graft Surgery versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease in the Bare-Metal Stent Era
  • Author(s): 木村 剛
  • Journal Title: Circulation Supplement (In press)
  • Description: 「研究成果報告書概要(和文)」より
  • Peer Reviewed
• [Journal Article] Long-term Outcomes of Coronary-Artery Bypass Graft Surgery versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease in the Bare-Metal Stent Era
  • Author(s): Takeshi, Kimura, M.D., Takeshi Morimoto, M.D., Yutaka, Furukawa, M.D., Yoshihisa, Nakagawa, M.D., Satoshi, Shizuta, M.D., Natsuhiko, Ehara, M.D., Ryoji, Taniguchi, M.D., Takahiro, Doi, M.D., Kei, Nishiyama, M.D., Neiko Ozasa, M.D., Naritatsu, Saito, M.D., Kozo, Hoshino, M.D., Hirokazu, Mitsuoka, M.D., Mitsuru, Abe, M.D., Masanao, Toma, M.D., Toshihiro, Tamura, M.D., Yoshisumi, Haruna, M.D., Yukiko, Imai, MpH, Satoshi, Teramukai, Ph.D., Masanori, Fukushima, M.D., Toru, Kita, M.D
  • Journal Title: Circulation Supplement (in press)
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] Long-Term Clinical Outcome of Percutaneous Coronary Intervention With Bare Metal Stent for Unprotected Left Main Coronary Artery Disease Compared With Bypass Graft Surgery: From the CREDO-Kyoto (2007)
  • Author(s): 静田 聡
  • Organizer: The 80th Scientific Sessions of the American Heart Association2007
  • Place of Presentation: Orlando
  • Description: 「研究成果報告書概要(和文)」より
• [Presentation] Comparison of Percutaneous Coronary Intervention(PCI)and Coronary Artery Bypass Graft Surgery(CABG)in Diabetic Patients(pts)with Multi-Vbssel Coronary Artery Disease in The Bare-Metal Stent(BMS)Era: From The Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) (2007)
  • Author(s): 江原 夏彦
  • Organizer: The 80th Scientific Sessions of the American Heart Association2007
  • Place of Presentation: Orlando
  • Description: 「研究成果報告書概要(和文)」より
• [Presentation] Contrast-lnduced Nephropathy After Percutaneous Coronary Intervention is Associated With High Long-Term Mortality: Insights From CREDO-Kyoto Registry (2007)
  • Author(s): 阿部 充
  • Organizer: The 80th Scientific Sessions of the American Heart Association2007
  • Place of Presentation: Orlando
  • Description: 「研究成果報告書概要(和文)」より
• [Presentation] Impact of pharmacologic management at discharge for complicated risk factors on outcomes of diabetic. patients undergoing first coronary revascularization : Perspectives from CREDO-Kyoto registry (2007)
  • Author(s): Furukawa, Y., Shizuta, S., Haruna, Y., Ehara, N., Taniguchi, R., Hoshino, K., Tamura, T., Kawanami, M., Kadoya, M., Matsuyama, E., Miki, S., Yoshida, A., Nakajima, H., Sasae, H., Morimoto, T., Imai, Y., Teramukai, S., Fukushima, M., Kita, T., Kimura, T
  • Organizer: The 56th Annual Scientific Session of the American College of Cardiology (ACC.07)
  • Place of Presentation: New Orleans, Louisiana
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] Comparison of Percutaneous Coronary Intervention and Bypass Surgery in Patients With Multi-Vessel Coronary Artery Disease and Reduced Left Ventricular Function in the Bare Metal Stent Era (2007)
  • Author(s): Shizuta, S., Ehara, N., Taniguchi, R., Haruna, Y.,Furukawa, Y., Mitsuoka, H., Doi, T., Saito, N., Miura, A., Kotoura, H., Aota, M., Eizawa, H., Kato, H., Miki, I., Morimoto, T., Imai, Y., Teramukai, S., Fukushima, M., Kita, T., Kimura, T
  • Organizer: The 56th Annual Scientific Session of the American College of Cardiology(ACC.07)
  • Place of Presentation: New Orleans, Louisiana
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] Comparison of Percutaneous Coronary Intervention and Bypass Surgery Among Patients With a Chronic Total Occlusion and Multi-Vessel Coronary Artery Disease in the Bare Metal Stent Era (2007)
  • Author(s): Shizuta, S., Taniguchi, R., Ehara, N., Doi, T., Nishiyama, K., Furukawa, Y., Nakagawa, Y., Tatami, R., Ushijima, T., Hattori, R., Shirotani, M., Nishiwaki, N., Tanaka, M., Minami, K., Sato, Y., Tezuka, S., Morimoto, T., Imai, Y., Teramukai, S., Fukushima, M., Kita, T., Kimura, T
  • Organizer: The 56th Annual Scientific Session of the American College of Cardiology (ACC.07)
  • Place of Presentation: New Orleans, Louisiana
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] ChronicObstructive Pulmonary Disease was an Independent Predictor of Sudden Cardiac Death, Cardiac Death and All-cause Mortality after Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting (2007)
  • Author(s): Nishiyama, K., Shizuta, S., Taniguchi, R., Ehara, N., Haruna, Y., Abe, M., Toma, M., Furukawa, Y., Kaburagi, S., Doi, O., Kambara, H., Nara, M., Matsuda, K., Hamasaki, S., Tei, C., Yamamoto, H., Sakata, R., Morimoto, T., Imai, Y., Teramukai, S., Fukushima, M., Kita, T., Kimura, T
  • Organizer: The 56th Annual Scientific Session of the American College of Cardiology (ACC.07)
  • Place of Presentation: New Orleans, Louisiana
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] CREDO-Kyoto Investigators Long-Term Clinical Outcome of Percutaneous Coronary Intervention With Bare Metal Stent for Unprotected Left Main Coronary Artery Disease Compared With Bypass Graft Surgery : From the CREDO-Kyoto (2007)
  • Author(s): Shizuta, S., Doi, T., Taniguchi, R., Ehara, R., Nishiyama, K., Furukawa, Y., Tatami, R., Ushijima, T., Hattori, R., Nishiwaki, N., Tanaka, M., Minami, K., Sato, Y., Tezuka, S., Morimoto, T., Teramukai, S., Fukushima, M., Kita, T., Kimura, T
  • Organizer: The 80th Scientific Sessions of the American Heart Association
  • Place of Presentation: Orlando Florida
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] CREDO-Kyoto Investigators Comparison of Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft Surgery (CABG) in Diabetic Patients (pts) with Multi-Vessel Coronary Artery Disease in The Bare-Metal Stent (BMS) Era : From The Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) (2007)
  • Author(s): Ehara, N., Shizuta, S., Furukawa, Y., Toma, M., Tamura, T., Kinoshita, M., Morioka, S., Kihara, Y., Okada, Y., Suwa, S., Matsui, S., Himura, Y., Okamoto, N., Saeki, A., Morimoto, T., Teramukai, S., Fukushima, M., Kita, T., Kimura, T
  • Organizer: The 80th Scientific Sessions of the American Heart Association
  • Place of Presentation: Orlando Florida
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] Contrast-Induced Nephropathy After Percutaneous Coronary Intervention is Associated With High Long-Term Mortality : Insights From CREDO-Kyoto Registry (2007)
  • Author(s): Abe, M., Taniguchi, R., Ehara, N., Saito, N., Shizuta, S., Furukawa, Y., Okazaki, K., Sakurai, T., Kataoka, K., Ogawa, H., Kawasuji, M., Hirai, T., Maeda, S., Morimoto, T., Teramukai, S., Fukushima, M., Kita, T., Kimura, T
  • Organizer: The 80th Scientific Sessions of the American Heart Association
  • Place of Presentation: Orlando Florida
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] for the CREDO-Kyoto Investigators Long-term Survival Advantage of CABG over PCI in the real World Clinical Practice ; Is it Real ? : Insight from the CREDO-Kyoto Registry (2006)
  • Author(s): Kimura, T., Sizuta, S., Taniguchi, R., Ehara, N., Ozasa, N., Haruna, Y., Toma, M., Doi, T., Abe, M., Furukawa, Y., Nakagawa, Y., Nobuyoshi, M., Okabayashi, H., Mitsudo, K., Komiya, T., Ogawa, H., Kawasuji, M., Yoshida, H., Takinami, E., Imai, Y., Teramukai, S., Fukushima, M., Komeda, M., Kita, T
  • Organizer: Angioplasty Summit
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] on behalf of the CREDO-Kyoto Investigators Prevalence of mitral regurgitation and their impact on prognosis in patients with coronary artery disease undergone first percutaneous coronary intervention (2006)
  • Author(s): Ozasa, N., Taniguchi, R., Abe, M., Shizuta, S., Haruna, Y., Ehara, N., Furukawa, Y., Nakano, A., Jong-Dae, Lee, Morioka, K., Tanaka, K., Takahashi, Oda, T., Minematsu, S., Imai, Y., Teramukai, S., Fukushima, M., Morimoto, T., Kita, T., Kimura, T
  • Organizer: The 79th Scientific Sessions of the American Heart Association (Scientific Sessions 2006)
  • Place of Presentation: Chicago, Illinois
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] for the CREDO-Kyoto Investigators Impact of Complete Revascularization on Long-term Outcome after Percutaneous Coronary Intervention in the Bare Metal Stent Era (2006)
  • Author(s): Suyama, T., Taniguchi, R., Haruna, Y., Shizuta, S., Tamura, T., Toma, M., Furukawa, Y., Ehara, N., Takashima, H., Hone, M., Higashita, R., Asai, T., Araki, M., Doyama, K., Fujino, Y., Imai, Y., Teramukai, S., Fukushima, M., Kita, T., Kimura, T
  • Organizer: The 79th Scientific Sessions of the American Heart Association (Scientific Sessions 2006)
  • Place of Presentation: Chicago, Illinois
  • Description: 「研究成果報告書概要(欧文)」より
• [Presentation] on behalf of the CREDO-Kyoto Investigators. Anemia Predicts 2 Years Mortality and Cardiovascular Events in Japanese Patients Undergoing First Elective Revascularization : from the Coronary Revascularization Demonstrating Outcomes in Kyoto (CREDO-Kyoto) (2006)
  • Author(s): Haruna, Y., Furukawa, Y., Taniguchi, R., Shizuta, S., Imai, M., Ehara, N., Konishi, T., Sugita, T., Nishimura, K., Matoba, Y., Takahashi, M., Tabata, T., Ishida, K., Murakami, T., Imai, Y., Teramukai, S., Fukushima, M., Morimoto, T., Kita, T., Kimura, T
  • Organizer: The 79th Scientific Sessions of the American Heart Association (Scientific Sessions 2006)
  • Place of Presentation: Chicago, Illinois
  • Description: 「研究成果報告書概要(欧文)」より