Comparative Trends in Percutaneous Coronary Intervention in Japan and the United States, 2013 to 2017,Journal of the American College of Cardiology

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Comparative Trends in Percutaneous Coronary Intervention in Japan and the United States, 2013 to 2017
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2020-09-01 , DOI: 10.1016/j.jacc.2020.07.037
Taku Inohara ₁ , Shun Kohsaka ₁ , John A Spertus ₂ , Frederick A Masoudi ₃ , John S Rumsfeld ₃ , Kevin F Kennedy ₂ , Tracy Y Wang ₄ , Kyohei Yamaji ₁ , Tetsuya Amano ₁ , Masato Nakamura ₁

Affiliation

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. 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. 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. 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). 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.

中文翻译：

2013-2017年日本和美国经皮冠状动脉介入治疗的比较趋势

背景经皮冠状动脉介入治疗 (PCI) 大规模随机对照试验结果的采用在国际上可能有所不同，但很少有研究描述 PCI 实践模式的潜在变化。目标我们使用具有代表性的国家注册，比较了美国和日本的手术量、患者特征、手术前测试、手术特征和质量指标的时间趋势。方法美国国家心血管数据登记处 CathPCI 用于描述护理，J-PCI 用于评估日本的实践模式（参与医院数量：美国 1,752 家，日本 1,108 家）。两个注册都在 2013 年和 2017 年之间进行了总结。结果美国的 PCI 量从 2013 年的 550,872 次增加到 637 次，增加了 15.8%，2017 年为 650，主要是因为非选择性 PCI 增加（趋势 p <0.001）。在日本，PCI 的数量增加了 36%，从 2013 年的 181,750 次增加到 2017 年的 247,274 次，主要是因为选择性 PCI 的增加（p 趋势 <0.001）。选择性条件下 PCI 病例的比例在日本 (72.7%) 是美国 (33.8%; p < 0.001) 的 2 倍以上。总体而言，非选择性 PCI（与选择性 PCI；27.3% 与 66.2%；p < 0.001）和稳定疾病患者的无创压力测试性能（15.2% 与 55.3%；p < 0.001）的比率较低在日本比在美国。计算机断层扫描血管造影在日本更常用（22.3% 对 2.0%；p < 0.001）。结论在当代实践中，选择性 PCI 在日本是美国的两倍多。

更新日期：2020-09-01

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