JCS/JSCVS 2018 Guideline on Revascularization of Stable Coronary Artery Disease

Nakamura, Masato; Yaku, Hitoshi; Ako, Junya; Arai, Hirokuni; Asai, Tomohiro; Chikamori, Taishiro; Daida, Hiroyuki; Doi, Kiyoshi; Fukui, Toshihiro; Ito, Toshiaki; Kadota, Kazushige; Kobayashi, Junjiro; Komiya, Tatsuhiko; Kozuma, Ken; Nakagawa, Yoshihisa; Nakao, Kōichi; Niinami, Hiroshi; Ohno, Takayuki; Ozaki, Yukio; Sata, Masataka; Takanashi, Shuichiro; Takemura, Hirofumi; Ueno, Takayoshi; Yasuda, Satoshi; Yokoyama, Hitoshi; Fujita, Tomoyuki; Kasai, Tokuo; Kohsaka, Shun; Kubo, Takashi; Manabe, Susumu; Matsumoto, Naoya; Miyagawa, Shigeru; Mizuno, Tomohiro; Motomura, Noboru; Numata, Shusuke; Nakajima, Hiroyuki; Oda, Hirotaka; Otake, Hiromasa; Otsuka, Fumiyuki; Sasaki, Ken-ichiro; Shimada, Kazunori; Shimokawa, Tomoki; Shinke, Toshiro; Suzuki, Tomoaki; Takahashi, Masao; Tanaka, Nobuhiro; Tsuneyoshi, Hiroshi; Tojo, Taiki; Une, Dai; Wakasa, Satoru; Yamaguchi, Koji; Akasaka, Takashi; Hirayama, Atsushi; Kimura, Kazuo; Kimura, Takeshi; Matsui, Yoshiro; Miyazaki, Shunichi; Okamura, Yoshitaka; Ōno, Minoru; Shiomi, Hiroki; Tanemoto, Kazuo

doi:10.1253/circj.cj-20-1282

Cited by 53 publications

(41 citation statements)

References 1,147 publications

(832 reference statements)

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“…Radial artery access is recommended for patients with acute MI as well as chronic coronary syndrome [ 4 ]. Prior studies have provided clinical evidence of the reduction of complications and lower radiation exposure [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, since there may be little difference in clinical safety with or without CE assistance, we excluded those patients who underwent planned PCI. Noninvasive anatomical or functional assessments are frequently conducted before coronary angiography; therefore, ad hoc PCI can be adapted to some cases at the physician’s discretion according to the guidelines [ 4 ]. Patients undergoing hemodialysis; those with cardiogenic shock with or without mechanical devices; and those who underwent PCI for chronic total occlusion, a left main stem coronary artery, graft vessels, or multivessel simultaneously were excluded.…”

Section: Methodsmentioning

confidence: 99%

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Safety of clinical engineer-assisted percutaneous coronary intervention

Oguri

Ishii

Shigematsu

et al. 2022

Cardiovasc Interv and Ther

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Percutaneous coronary intervention (PCI) requires multiple staff members, including interventional cardiologists, with the physical burden of heavy protective measures to minimize radiation exposure. Here, we aimed to investigate the safety of task sharing with clinical engineers (CEs) working as 1st assistant during ad hoc PCI. We retrospectively included 286 patients who underwent ad hoc PCI following diagnostic catheterization for coronary artery disease between April 2019 and March 2021. Procedural complications including coronary perforation or rupture, myocardial infarction, cerebral embolism, cardiovascular death, decreased kidney function, and radiation parameters were compared between the two clinical settings [CE group, CEs as the 1st assistant from the beginning of diagnostic coronary angiography to the end of PCI vs. doctor (DR) group, others]. There was no increase in the ratio of procedural complications in the CE group (1.7%) versus the DR group (1.2%). Fluorescence time and radiation exposure dose were significantly reduced in the CE group {25 min [interquartile range (IQR), 19–35 min] vs. 28 min (IQR, 20–39 min), P = 0.036; 908 mGy (IQR, 654–1326 mGy) vs. 1062 mGy (IQR, 732–1594 mGy), P = 0.049}. The median amount of contrast medium was significantly reduced in the CE group [100 mL (IQR, 80–119 mL) vs. 110 mL (IQR 90–140 mL), P < 0.001]. After propensity matching, fluorescence time, radiation exposure dose, and contrast medium amount were similar between groups. Task sharing with CEs as the 1st assistant during ad hoc PCI could contribute to clinical safety in patients with coronary artery disease.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Safety of clinical engineer-assisted percutaneous coronary intervention

Oguri

Ishii

Shigematsu

et al. 2022

Cardiovasc Interv and Ther

View full text Add to dashboard Cite

show abstract

“…The CVIT introduced quality metrics in 2017 to standardise the quality of PCIs, 22 , 23 including (1) preprocedural AP therapy use, (2) DTB time for STEMI (≤90 min), (3) TRA, and (4) preprocedural noninvasive stress testing for stable ischaemic heart disease. The rationale for each quality measure is described below: The importance of aspirin administration before PCI is widely recognised.…”

Section: Methodsmentioning

confidence: 99%

“… 22 , 24 Before PCI for stable ischaemic heart disease, it is essential to assess the patient's individual risk (and to potentially exclude cases that are rarely appropriate for revascularisation [e.g., patients with anatomical stenosis without concurrent ischaemia]), and clinical practice guidelines recommend preprocedural noninvasive stress testing in most elective cases. 23 , 24 Preprocedural noninvasive stress testing for this study included any of the following: stress electrocardiography (ECG), stress myocardial perfusion imaging (MPI), stress echocardiography, or stress magnetic resonance imaging (MRI). …”

Section: Methodsmentioning

confidence: 99%

“…21 The J-PCI registry closely works with the American College of Cardiology-National Cardiovascular Data Registry in the development of its quality metrics, 2 and four quality metrics [(1) preprocedural antiplatelet (AP) therapy use, (2) door-to-balloon (DTB) time for ST-elevation myocardial infarction (STEMI) (≤90 min), (3) transradial approach (TRA), and (4) preprocedural noninvasive stress testing for stable ischaemic heart disease] were developed in 2017. 22,23 This provided us with the first opportunity to describe the achievement rates of and variations in quality metrics for both acute and elective cases.…”

Section: Introductionmentioning

confidence: 99%

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