Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.

<h4>Objective</h4>This study evaluated the manner in which coronary dominance affects in-hospital outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).<h4>Background</h4>Previous studies have shown that left dominant coronary...

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Autores principales:	Toshiki Kuno, Yohei Numasawa, Hiroaki Miyata, Toshiyuki Takahashi, Koichiro Sueyoshi, Takahiro Ohki, Koji Negishi, Akio Kawamura, Shun Kohsaka, Keiichi Fukuda
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/03533843e65340879c6f83e2659bb6f7
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spelling	oai:doaj.org-article:03533843e65340879c6f83e2659bb6f72021-11-18T08:58:11ZImpact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.1932-620310.1371/journal.pone.0072672https://doaj.org/article/03533843e65340879c6f83e2659bb6f72013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23991136/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>This study evaluated the manner in which coronary dominance affects in-hospital outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).<h4>Background</h4>Previous studies have shown that left dominant coronary anatomies are associated with worse prognoses in patients with coronary artery disease.<h4>Methods</h4>Data were analyzed from 4873 ACS patients undergoing PCI between September 2008 and April 2013 at 14 hospitals participating in the Japanese Cardiovascular Database Registry. The patients were grouped based on diagnostic coronary angiograms performed prior to PCI; those with right- or co-dominant anatomy (RD group) and those with left-dominant anatomy (LD group).<h4>Results</h4>The average patient age was 67.6±11.8 years and both patient groups had similar ages, coronary risk factors, comorbidities, and prior histories. The numbers of patients presenting with symptoms of heart failure, cardiogenic shock, or cardiopulmonary arrest were significantly higher in the LD group than in the RD group (heart failure: 650 RD patients [14.7%] vs. 87 LD patients [18.8%], P = 0.025; cardiogenic shock: 322 RD patients [7.3%] vs. 48 LD patients [10.3%], P = 0.021; and cardiopulmonary arrest: 197 RD patients [4.5%] vs. 36 LD patients [7.8%], P = 0.003). In-hospital mortality was significantly higher among LD patients than among RD patients (182 RD patients [4.1%] vs. 36 LD patients [7.8%], P = 0.001). Multivariate logistic regression analysis revealed that LD anatomy was an independent predictor for in-hospital mortality (odds ratio, 1.75; 95% confidence interval, 1.06-2.89; P = 0.030).<h4>Conclusion</h4>Among ACS patients who underwent PCI, LD patients had significantly worse in-hospital outcomes compared with RD patients, and LD anatomy was an independent predictor of in-hospital mortality.Toshiki KunoYohei NumasawaHiroaki MiyataToshiyuki TakahashiKoichiro SueyoshiTakahiro OhkiKoji NegishiAkio KawamuraShun KohsakaKeiichi FukudaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 8, p e72672 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Toshiki Kuno Yohei Numasawa Hiroaki Miyata Toshiyuki Takahashi Koichiro Sueyoshi Takahiro Ohki Koji Negishi Akio Kawamura Shun Kohsaka Keiichi Fukuda Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.
description	<h4>Objective</h4>This study evaluated the manner in which coronary dominance affects in-hospital outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI).<h4>Background</h4>Previous studies have shown that left dominant coronary anatomies are associated with worse prognoses in patients with coronary artery disease.<h4>Methods</h4>Data were analyzed from 4873 ACS patients undergoing PCI between September 2008 and April 2013 at 14 hospitals participating in the Japanese Cardiovascular Database Registry. The patients were grouped based on diagnostic coronary angiograms performed prior to PCI; those with right- or co-dominant anatomy (RD group) and those with left-dominant anatomy (LD group).<h4>Results</h4>The average patient age was 67.6±11.8 years and both patient groups had similar ages, coronary risk factors, comorbidities, and prior histories. The numbers of patients presenting with symptoms of heart failure, cardiogenic shock, or cardiopulmonary arrest were significantly higher in the LD group than in the RD group (heart failure: 650 RD patients [14.7%] vs. 87 LD patients [18.8%], P = 0.025; cardiogenic shock: 322 RD patients [7.3%] vs. 48 LD patients [10.3%], P = 0.021; and cardiopulmonary arrest: 197 RD patients [4.5%] vs. 36 LD patients [7.8%], P = 0.003). In-hospital mortality was significantly higher among LD patients than among RD patients (182 RD patients [4.1%] vs. 36 LD patients [7.8%], P = 0.001). Multivariate logistic regression analysis revealed that LD anatomy was an independent predictor for in-hospital mortality (odds ratio, 1.75; 95% confidence interval, 1.06-2.89; P = 0.030).<h4>Conclusion</h4>Among ACS patients who underwent PCI, LD patients had significantly worse in-hospital outcomes compared with RD patients, and LD anatomy was an independent predictor of in-hospital mortality.
format	article
author	Toshiki Kuno Yohei Numasawa Hiroaki Miyata Toshiyuki Takahashi Koichiro Sueyoshi Takahiro Ohki Koji Negishi Akio Kawamura Shun Kohsaka Keiichi Fukuda
author_facet	Toshiki Kuno Yohei Numasawa Hiroaki Miyata Toshiyuki Takahashi Koichiro Sueyoshi Takahiro Ohki Koji Negishi Akio Kawamura Shun Kohsaka Keiichi Fukuda
author_sort	Toshiki Kuno
title	Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.
title_short	Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.
title_full	Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.
title_fullStr	Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.
title_full_unstemmed	Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.
title_sort	impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/03533843e65340879c6f83e2659bb6f7
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Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.

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