Coronary disease & ACSCohort study
Impact of Facility Criteria Revision for Rotational Atherectomy on Outcomes After Percutaneous Coronary Intervention (PCI)
- retrospective, time-series analysis
- quasi-experimental difference-in-differences analysis
- J-PCI registry
Authors' conclusion
The 2020 RA facility criteria revision in Japan did not significantly increase in-hospital mortality after PCI in low-volume, nontraining facilities without on-site surgical backup that were newly accredited for RA use after the revision.
Study context
- Population
- Patients who underwent PCI in Japan, training and nontraining facilities, before (2019–2020) and after (2021–2023) the 2020 rotational atherectomy (RA) facility criteria revisionPCIs performed in 1,243 hospitals from 2019 to 2023
- Participants
- 1,161,862 patients
- Exposure
- changes in PCI outcomes between training and nontraining facilities before (2019-2020) and after (2021-2023) the 2020 RA facility criteria revision
- Outcome
- In-hospital mortality after PCI
- Follow-up
- Before (2019-2020) and after (2021-2023) the revision
Main finding
As reported in the abstract
training facilities
1.6% to 1.9%
nontraining facilities
1.7% to 1.9%
- Trends did not differ significantly between the 2 groups
- adjusted P = 0.55 for interaction [facility × time]
Observational data: associations, not effects.
Further findings
Rate of RA use during PCI · 2019 to 2023
- RA use in 2019
- 4.2%
- RA use in 2023
- 5.2%
Hospitals that had never performed RA · 2023
- of the 1,181 hospitals performing PCI in 2023, never performed RA
- 400 (33.9%)
Original publication
Impact of Facility Criteria Revision for Rotational Atherectomy on Outcomes After PCI. JACC Adv. Published 12 March 2026. doi:10.1016/j.jacadv.2026.102672
Summarised from the published abstract; every number is checked against it