Comparison of Outcomes for Patients Undergoing Balloon Angioplasty vs Coronary Stenting for Acute Myocardial Infarction : Results From Nationwide Japanese Registry
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概要
- 論文の詳細を見る
Randomized clinical trials have demonstrated that coronary stenting is more successful than balloon angioplasty in improving short- and long-term outcomes. However, it remains unknown whether those results can be generalized to broad-based practice. This study aimed to determine whether the outcome for patients with acute myocardial infarction (AMI) undergoing coronary stent placement would be better than those undergoing balloon angio-plasty. The risk-adjusted mortality and subsequent revascularization rates were compared for 2,185 patients from a nationwide Japanese registry during 1997. A total of 1,349 patients were treated with balloon angioplasty alone and 836 had stent placement. There were no statistically significant differences in the prevalence of demographic, clinical, and angiographic variables, except that the angioplasty group had a greater proportion of female patients and those with a left circumflex lesion. Unadjusted in-hospital mortality was comparable (7.6 vs 6.3% ; p=0.28), despite higher angiographic success rate for the stent group (89.7 vs 97.7% ; p<0.01). Adjusted odds ratio for in-hospital mortality was 0.75 (p=0.19). The same-admission bypass surgery rate was also similar. The 1.9-year post-discharge mortality rate was similar. The need for subsequent revascularization procedures was also similar, but restenosis was significantly lower in the stent group (34 vs 45% ; p<0.01). The superiority of clinical outcome for stenting rather than balloon angioplasty could not be demonstrated in broad-based registry patients, despite technically successful results.
- 社団法人日本循環器学会の論文
- 2003-04-20
著者
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Tsutsui Hiroyuki
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Hokkaido University
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Takeshita Akira
Department of Cardiology, Saiseikai Futsukaichi Hospital
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KONO Suminori
Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University
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Kono Suminori
Departments Of Preventive Medicine Graduate School Of Medical Sciences Kyushu University:japanese Co
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Tsuchihashi Miyuki
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Tada Hideo
Department Of Cardiovascular Medicine Kyushu University Hospital
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Tsutsui Hiroyuki
Department Of Cardiovascular Medicine
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SHIHARA Miwako
Department of Cardiovascular Medicine, Cardiovascular Science, Graduate School of Medical Sciences,
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Shihara Miwako
Departments Of Cardiovascular Medicine Graduate School Of Medical Sciences Kyushu University:japanes
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Shihara Miwako
Department Of Cardiovascular Medicine Cardiovascular Science Graduate School Of Medical Sciences Kyu
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Takeshita Akira
Department Of Cardiology Faculty Of Medicine Kyushu University
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Makaya Miyuki
Department Of Cardiovasucular Medicine Graduate School Of Medical Sciences Kyushu University
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Tada Hideo
Departments Of Cardiovascular Medicine Graduate School Of Medical Sciences Kyushu University:japanes
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Tada Hideo
Department Of Cardiology Kyushu University
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Takeshita Akira
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Makaya Miyuki
International Medical Center Of Japan
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Kono Suminori
Department Of Medicine And Bioregulatory Science Graduate School Of Medical Sciences Kyushu Universi
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Tanaka Atsushi
Department Of Cardiovascular Medicine Kyushu University
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Tsuchihashi Makaya
Department Of Clinical Research And Informatics Research Institute International Medical Center Of J
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Tsutsui Hiroyuki
Departments Of Cardiovascular Medicine Graduate School Of Medical Sciences Kyushu University:japanese Coronary Intervention Study (jcis) Group
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TSUTSUI Hiroyuki
Department of Cardiology, Iizuka Hospital
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