{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:12:07Z","timestamp":1771233127918,"version":"3.50.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,11]]},"abstract":"\n Background<\/jats:title>\n \n Whereas composite end points are often used in clinical trials of percutaneous coronary interventions (\n PCI<\/jats:styled-content>\n ), the impact of individual components on subsequent survival is incompletely defined. We evaluated the association of subsequent acute coronary syndromes (\n ACS<\/jats:styled-content>\n ) and unplanned coronary revascularization post\u2010\n PCI<\/jats:styled-content>\n with long\u2010term survival.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n From 2009 to 2011, the Ki\n CS<\/jats:styled-content>\n \u2010\n PCI<\/jats:styled-content>\n (Keio interhospital Cardiovascular Studies) consecutively enrolled patients undergoing\n PCI<\/jats:styled-content>\n in 14 Japanese teaching hospitals. We identified patients who experienced\n ACS<\/jats:styled-content>\n or unplanned coronary revascularization following their index\n PCI<\/jats:styled-content>\n and compared subsequent survival during the 2\u2010year follow\u2010up period using propensity\u2010matched cohorts of patients who did and did not experience these events. Cox proportional hazard models were used to assess 2\u2010year all\u2010cause mortality. Because unstable angina is less severe than acute myocardial infarction, we also generated a separate propensity\u2010matched cohort for\n UA<\/jats:styled-content>\n post\u2010\n PCI<\/jats:styled-content>\n . Among 3348\n PCI<\/jats:styled-content>\n patients (mean age, 67.5\u00b110.7\u00a0years; 79.7% male), 214 (6.4%) experienced a subsequent\n ACS<\/jats:styled-content>\n (168 events [78.5%] were unstable angina), and 198 (5.9%) underwent unplanned revascularization. In the propensity\u2010matched cohorts, patients with a subsequent\n ACS<\/jats:styled-content>\n admission had an increased risk of mortality as compared with those without (hazard ratio, 4.73; 95% confidence interval=1.35\u201316.6;\n P<\/jats:italic>\n =0.015), whereas those with an unplanned revascularization did not have significantly higher risk (hazard ratio, 2.97; 95% confidence interval=0.57\u201314.3;\n P<\/jats:italic>\n =0.19). Among unstable angina events, no association with mortality was observed (hazard ratio, 1.39; 95% confidence interval=0.48\u20134.00;\n P<\/jats:italic>\n =0.54).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In the Ki\n CS<\/jats:styled-content>\n \u2010\n PCI<\/jats:styled-content>\n registry, the incidence of a subsequent\n ACS<\/jats:styled-content>\n was associated with higher mortality, but this association was less apparent after unplanned coronary revascularization or unstable angina. The prognostic implications of different outcomes in a composite end point should be considered when interpreting the results of clinical trials in\n PCI<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006529","type":"journal-article","created":{"date-parts":[[2017,10,28]],"date-time":"2017-10-28T00:10:32Z","timestamp":1509149432000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Prognostic Impact of Subsequent Acute Coronary Syndrome and Unplanned Revascularization on Long\u2010Term Mortality After an Index Percutaneous Coronary Intervention: A Report From a Japanese Multicenter Registry"],"prefix":"10.1161","volume":"6","author":[{"given":"Taku","family":"Inohara","sequence":"first","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan"},{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Kohsaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Miyata","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuaki","family":"Sawano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikuko","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichiro","family":"Maekawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan"},{"name":"Internal Medicine III, Hamamatsu University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichi","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip G.","family":"Jones","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenxiang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Global Health Outcomes, Eli Lilly and Company, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"},{"name":"University of Missouri Kansas City, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim G.","family":"Smolderen","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute, Kansas City, MO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2554"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39136.682083.AE"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0807611"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205361"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200104123441502"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.09.010"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804626"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.06.006"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.08.011"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.03.004"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.06.008"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.5119"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.09.017"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.049"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01372-9"},{"key":"e_1_3_4_17_2","first-page":"459","article-title":"The American College of Cardiology National Database: progress and challenges. American College of Cardiology database committee","volume":"29","author":"Weintraub WS","year":"1997","unstructured":"Weintraub WS, McKay CR, Riner RN, Ellis SG, Frommer PL, Carmichael DB, Hammermeister KE, Effros MN, Bost JE, Bodycombe DP. The American College of Cardiology National Database: progress and challenges. American College of Cardiology database committee. J Am Coll Cardiol. 1997;29:459\u2013465.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_4_18_2","unstructured":"National Cardiovascular Data Registry (NCDR) CathPCI Registry . Available at: http:\/\/www.ncdr.com\/webncdr\/cathpci\/. Accessed March 23 2017."},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000112604.74713.35"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38985.646481.55"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000133"},{"key":"e_1_3_4_22_2","first-page":"1019","article-title":"Guidelines for noninvasive diagnosis of coronary artery lesions (JCS 2009)","volume":"73","author":"JCS Joint Working Group","year":"2009","unstructured":"JCS Joint Working Group . Guidelines for noninvasive diagnosis of coronary artery lesions (JCS 2009). Circ J. 2009;73:1019\u20131089.","journal-title":"Circ J"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02597-4"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01476-0"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.02.060"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.10.018"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.117.006529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:38:46Z","timestamp":1715596726000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.117.006529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1161\/JAHA.117.006529"],"URL":"https:\/\/doi.org\/10.1161\/jaha.117.006529","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11]]},"assertion":[{"value":"2017-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-10-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e006529"}}