Consequence of reimbursement policy alteration for urgent PCI in Japan

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Consequence of reimbursement policy alteration for urgent PCI in Japan Nobuhiro Ikemura, Mitsuaki Sawano, Ikuko Ueda, Keiichi Fukuda, Shun Kohsaka The Lancet Volume 391, Issue 10136, Pages 2208-2209 (June 2018) DOI: 10.1016/S0140-6736(18)30857-2 Copyright © 2018 Elsevier Ltd Terms and Conditions

Figure Annual trends in mortality, DTB time, and utilisation of EIS for patients with STEMI (A) and NSTE-ACS (B) in metropolitan area of Tokyo, Japan Data for patient mortality risk were calculated with the NCDR CathPCI risk score and were compared with observed in-hospital mortality. The trend analysis for the proportion of patients who achieved a DTB time of 90 min or less in STEMI cohorts (A) and the proportion who received an EIS in NSTE-ACS cohorts (B) was applied to prespecified subgroups composed of patients with low (below the calculated median) and high (above the calculated median) NCDR CathPCI risk scores. DTB time and CathPCI risk score are given as the median, with the IQR (from quartile 1 to quartile 3) in parentheses. The dotted line shows when the reimbursement policy was introduced. We used Mantel-Haenszel chi-square test of linear association for categorical variables and linear regression for continuous variables. All p values are two-sided with a significance threshold of p<0·001 (a lower-than-usual p-value threshold was selected to correct for the inflation of type I error because of repeated testing using a large number of variables). DTB=door-to-balloon. EIS=early invasive strategy. STEMI=ST-elevation myocardial infarction. NSTE-ACS=non-ST-elevation acute coronary syndrome. NCDR=National Cardiovascular Data Registry. PCI=percutaneous coronary intervention The Lancet 2018 391, 2208-2209DOI: (10.1016/S0140-6736(18)30857-2) Copyright © 2018 Elsevier Ltd Terms and Conditions