Development and Implementation of an Advanced Coronary Angiography and Intervention Database System

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概要

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• The ‘evidence’ in evidence-based medicine (EBM) is often limited to knowledge obtained from randomized controlled clinical trials (RCT). Most RCTs, however, have strict enrollment criteria which make patient background characteristics and clinical histories significantly different from those encountered in actual practice. Thus it is important to accumulate and analyze data obtained in daily practice to gain insight into a larger clinical picture. Recent developments in information technology and its lowered cost have enabled us to record clinical activity in much greater detail at a lower cost. These factors prompted us to design and develop a coronary angiography and intervention reporting system (CAIRS) to collect data and analyze outcomes of coronary intervention. The resulting advanced CAIRS can record detailed data on coronary angiographic and interventional procedures.To date, data on 10,025 cases of coronary angiography, of which 3,574 were interventional, have been collected over a 5.5 year period. There were 4,343 unique patients, 3,115 (71.7%) of which were male. The overall mean age was 67.0 ± 11.5. The mean age of males was 66.3 ± 11.4 and that of females was 69.0 ± 11.4. About one-third of the patients never underwent a PCI procedure at our institution. For patients that underwent at least one PCI procedure at our institution, the prescription rate of statin increased from 50.8% in 2005 to 80.3% in 2011, while those of nitrate and ticlopidine decreased from 36.7% and 90.8% in 2005 to 21.3% and 0.8% in 2011, respectively. We have also implemented the same system at another institution and compared the data on stent usage between the two institutions, which revealed vastly different stent usage profiles.In conclusion, we have successfully developed and implemented an advanced coronary angiography and intervention reporting system which we call CAIRS. Implementing the same system at multiple institutions and analyzing data collected from several institutions will provide detailed and timely insight into the ‘real world’ of coronary angiography and interventional procedures and their outcome.

著者

• Kohro Takahide

  Department Of Cardiology Tokyo University School Of Medicine

• Ohe Kazuhiko

  Department Of Medical Informatics And Economics Graduate School Of Medicine University Of Tokyo

• Manabe Ichiro

  Department Of Caldiology University Of Tokyo

• Isobe Mitsuaki

  Departement Of Cardiovascular Medicine Tokyo Medical And Dental University

• Fujita Hideo

  Department Of Aeronautics University Of Tokyo

• Haraguchi Go

  Department Of Cardiology Tokyo Women's Medical University

• Fujiu Katsuhito

  Department Of Cardiology The University Of Tokyo

• Morino Yoshihiro

  Department Of Cardiology Tokai University School Of Medicine

• Kurabayashi Masahiko

  Department Of Cardiology Kanazawa Medical University

• Iwata Hiroshi

  Department Of Cardiology Toranomon Hospital

• Oguri Atsushi

  Department Of Advanced Materials Science University Of Tokyo

• Nagai Ryozo

  Department Cardiovascular Medicine The University Of Tokyo Hospital

• Ikari Yuji

  Department Of Cardiology Tokai Univeristy

• MANABE Ichiro

  Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo

• Ikenouchi Hiroshi

  Department of Cardiology, Japanese Red Cross Medical Center

• Ohe Kazuhiko

  Department of Health Informatics, The University of Tokyo

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