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Follow-up tests and outcomes for patients undergoing percutaneous coronary intervention: analysis of a Japanese administrative database
Follow-up tests after percutaneous coronary intervention (PCI) are considered inappropriate for asymptomatic patients. Despite this perception, many cardiologists conduct follow-up tests as routine practice. The objective of this study was to investigate the survival benefits of follow-up testing af...
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| Published in: | Heart and vessels 2019-01, Vol.34 (1), p.33-43 |
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| creator | Seki, Tomotsugu Takeuchi, Masato Miki, Ryusuke Kawakami, Koji |
| description | Follow-up tests after percutaneous coronary intervention (PCI) are considered inappropriate for asymptomatic patients. Despite this perception, many cardiologists conduct follow-up tests as routine practice. The objective of this study was to investigate the survival benefits of follow-up testing after PCI in a real-world setting in Japan. A nationwide Japanese administrative database was used to identify unselected patients who underwent PCI with stent implantation between January 2010 and December 2013. We used time-dependent Cox proportional hazards models to evaluate the association between follow-up testing and outcomes. The primary outcome was the composite of all-cause death and acute myocardial infarction (AMI). Among a total of 21,409 patients, 15,095 (70.5%) completed follow-up testing, of whom 9814 (45.0%) underwent coronary angiography. During a median of 2.7 years of observation, the primary outcome occurred less frequently for patients who underwent follow-up testing (1.21 vs. 4.51% per year; adjusted hazard ratio, 0.59; 95% CI 0.52–0.67;
p
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| doi_str_mv | 10.1007/s00380-018-1224-3 |
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p
< 0.001). Individual rates of all-cause death and AMI were also lower for the patients who underwent follow-up testing. Follow-up testing was associated with a lower risk of all-cause death and/or AMI. However, because of the unexpectedly large effect and many limitations of the administrative data, our findings should be further investigated to assess the net benefit of follow-up tests. In addition, we do not intend to encourage routine follow-up tests for patients without clear clinical indications. Follow-up tests should be conducted in accordance with clinical indications.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-018-1224-3</identifier><identifier>PMID: 30008123</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aged ; Angiography ; Angioplasty ; Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Cause of Death - trends ; Coronary Angiography ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - surgery ; Death ; Female ; Follow-Up Studies ; Health hazards ; Humans ; Implants ; Incidence ; Japan - epidemiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Myocardial infarction ; Original Article ; Patients ; Percutaneous Coronary Intervention ; Registries ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Statistical models ; Stents ; Surgical implants ; Survival Rate - trends ; Treatment Outcome ; Vascular Surgery</subject><ispartof>Heart and vessels, 2019-01, Vol.34 (1), p.33-43</ispartof><rights>Springer Japan KK, part of Springer Nature 2018</rights><rights>Springer Japan KK, part of Springer Nature 2018.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-6941a4e752b9bae9217101430cc405c5b94ff5daa4918d0c8985c6ad70b36d4f3</citedby><cites>FETCH-LOGICAL-c462t-6941a4e752b9bae9217101430cc405c5b94ff5daa4918d0c8985c6ad70b36d4f3</cites><orcidid>0000-0002-7477-4071</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30008123$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seki, Tomotsugu</creatorcontrib><creatorcontrib>Takeuchi, Masato</creatorcontrib><creatorcontrib>Miki, Ryusuke</creatorcontrib><creatorcontrib>Kawakami, Koji</creatorcontrib><title>Follow-up tests and outcomes for patients undergoing percutaneous coronary intervention: analysis of a Japanese administrative database</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Follow-up tests after percutaneous coronary intervention (PCI) are considered inappropriate for asymptomatic patients. Despite this perception, many cardiologists conduct follow-up tests as routine practice. The objective of this study was to investigate the survival benefits of follow-up testing after PCI in a real-world setting in Japan. A nationwide Japanese administrative database was used to identify unselected patients who underwent PCI with stent implantation between January 2010 and December 2013. We used time-dependent Cox proportional hazards models to evaluate the association between follow-up testing and outcomes. The primary outcome was the composite of all-cause death and acute myocardial infarction (AMI). Among a total of 21,409 patients, 15,095 (70.5%) completed follow-up testing, of whom 9814 (45.0%) underwent coronary angiography. During a median of 2.7 years of observation, the primary outcome occurred less frequently for patients who underwent follow-up testing (1.21 vs. 4.51% per year; adjusted hazard ratio, 0.59; 95% CI 0.52–0.67;
p
< 0.001). Individual rates of all-cause death and AMI were also lower for the patients who underwent follow-up testing. Follow-up testing was associated with a lower risk of all-cause death and/or AMI. However, because of the unexpectedly large effect and many limitations of the administrative data, our findings should be further investigated to assess the net benefit of follow-up tests. In addition, we do not intend to encourage routine follow-up tests for patients without clear clinical indications. Follow-up tests should be conducted in accordance with clinical indications.</description><subject>Aged</subject><subject>Angiography</subject><subject>Angioplasty</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Cause of Death - trends</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary Artery Disease - surgery</subject><subject>Death</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health hazards</subject><subject>Humans</subject><subject>Implants</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Original Article</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Statistical models</subject><subject>Stents</subject><subject>Surgical implants</subject><subject>Survival Rate - trends</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kc1qFjEUhoMo9rN6AW4k4Kab6DnJ_CTupNiqFLqp65BJMh9TZpIxyVR6Bd62KVMVBFdZnOe84T0PIa8R3iFA_z4DCAkMUDLkvGHiCTlghy3jbS-ekgMoBCYF70_Ii5xvAbBVqJ6TEwEAErk4kJ8XcZ7jD7attPhcMjXB0bgVGxef6RgTXU2ZfKiTLTifjnEKR7r6ZLdigo9bpjamGEy6p1MoPt1VdorhQw0y832eMo0jNfSrWSuePTVumcKUS6qxd546U8xgsn9Jno1mzv7V43tKvl18ujn_zK6uL7-cf7xitul4YZ1q0DS-b_mgBuMVxx4BGwHWNtDadlDNOLbOmEahdGClkq3tjOthEJ1rRnFKzvbcNcXvW22slylbP897Gc2hh151newr-vYf9DZuqbaqVKc6RJRSVgp3yqaYc_KjXtO01HNoBP1gSe-WdLWkHyxpUXfePCZvw-Ldn43fWirAdyDXUTj69Pfr_6f-AiOhn0o</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Seki, Tomotsugu</creator><creator>Takeuchi, Masato</creator><creator>Miki, Ryusuke</creator><creator>Kawakami, Koji</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7477-4071</orcidid></search><sort><creationdate>20190101</creationdate><title>Follow-up tests and outcomes for patients undergoing percutaneous coronary intervention: analysis of a Japanese administrative database</title><author>Seki, Tomotsugu ; Takeuchi, Masato ; Miki, Ryusuke ; Kawakami, Koji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-6941a4e752b9bae9217101430cc405c5b94ff5daa4918d0c8985c6ad70b36d4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Angiography</topic><topic>Angioplasty</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Cause of Death - trends</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Coronary Artery Disease - surgery</topic><topic>Death</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health hazards</topic><topic>Humans</topic><topic>Implants</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Original Article</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Statistical models</topic><topic>Stents</topic><topic>Surgical implants</topic><topic>Survival Rate - trends</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seki, Tomotsugu</creatorcontrib><creatorcontrib>Takeuchi, Masato</creatorcontrib><creatorcontrib>Miki, Ryusuke</creatorcontrib><creatorcontrib>Kawakami, Koji</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seki, Tomotsugu</au><au>Takeuchi, Masato</au><au>Miki, Ryusuke</au><au>Kawakami, Koji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Follow-up tests and outcomes for patients undergoing percutaneous coronary intervention: analysis of a Japanese administrative database</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>34</volume><issue>1</issue><spage>33</spage><epage>43</epage><pages>33-43</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>Follow-up tests after percutaneous coronary intervention (PCI) are considered inappropriate for asymptomatic patients. Despite this perception, many cardiologists conduct follow-up tests as routine practice. The objective of this study was to investigate the survival benefits of follow-up testing after PCI in a real-world setting in Japan. A nationwide Japanese administrative database was used to identify unselected patients who underwent PCI with stent implantation between January 2010 and December 2013. We used time-dependent Cox proportional hazards models to evaluate the association between follow-up testing and outcomes. The primary outcome was the composite of all-cause death and acute myocardial infarction (AMI). Among a total of 21,409 patients, 15,095 (70.5%) completed follow-up testing, of whom 9814 (45.0%) underwent coronary angiography. During a median of 2.7 years of observation, the primary outcome occurred less frequently for patients who underwent follow-up testing (1.21 vs. 4.51% per year; adjusted hazard ratio, 0.59; 95% CI 0.52–0.67;
p
< 0.001). Individual rates of all-cause death and AMI were also lower for the patients who underwent follow-up testing. Follow-up testing was associated with a lower risk of all-cause death and/or AMI. However, because of the unexpectedly large effect and many limitations of the administrative data, our findings should be further investigated to assess the net benefit of follow-up tests. In addition, we do not intend to encourage routine follow-up tests for patients without clear clinical indications. Follow-up tests should be conducted in accordance with clinical indications.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>30008123</pmid><doi>10.1007/s00380-018-1224-3</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-7477-4071</orcidid></addata></record> |
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| subjects | Aged Angiography Angioplasty Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Cause of Death - trends Coronary Angiography Coronary Artery Disease - diagnosis Coronary Artery Disease - epidemiology Coronary Artery Disease - surgery Death Female Follow-Up Studies Health hazards Humans Implants Incidence Japan - epidemiology Male Medicine Medicine & Public Health Middle Aged Mortality Myocardial infarction Original Article Patients Percutaneous Coronary Intervention Registries Retrospective Studies Risk Assessment Risk Factors Statistical models Stents Surgical implants Survival Rate - trends Treatment Outcome Vascular Surgery |
| title | Follow-up tests and outcomes for patients undergoing percutaneous coronary intervention: analysis of a Japanese administrative database |
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