The authors apologize for the written mistakes in the manuscript. Corrections are shown below.
Table 1.
Baseline Patient Characteristics (Corrected)
Table 1.
Baseline Characteristics of the ACS Patients
| Variable |
ACS with shock
(n=115) |
ACS without shock
(n=281) |
Stable CAD
(n=1,104) |
P value |
| Age (years) |
70.2±11.7 |
72.0±11.1 |
72.0±9.8 |
0.19 |
| ≥80* |
26 (23%) |
74 (26%) |
263 (24%) |
0.62 |
| Male |
89 (77%) |
205 (73%) |
834 (76%) |
0.57 |
| Hypertension |
62 (54%) |
194 (69%) |
853 (77%) |
<0.0001 |
| Dyslipidemia |
37 (33%) |
122 (43%) |
631 (57%) |
<0.0001 |
| Current smoker |
31 (27%) |
68 (24%) |
151 (14%) |
<0.0001 |
| Diabetes mellitus* |
39 (34%) |
104 (37%) |
478 (43%) |
0.038 |
| Treated with insulin |
7 (6.1%) |
24 (8.6%) |
121 (11%) |
0.16 |
| Familial history of CAD |
19 (17%) |
36 (13%) |
179 (16%) |
0.36 |
| eGFR ≤30 without HD* |
15 (13%) |
19 (6.8%) |
49 (4.4%) |
0.0004 |
| ESRD on HD* |
6 (5.2%) |
11 (3.9%) |
69 (6.3%) |
0.31 |
| Atrial fibrillation |
11 (9.6%) |
19 (6.8%) |
85 (7.7%) |
0.63 |
| Prior PCI* |
19 (17%) |
76 (27%) |
555 (50%) |
<0.0001 |
| Prior CABG |
0 |
2 (0.7%) |
52 (4.7%) |
0.0006 |
| Prior MI |
16 (14%) |
51 (18%) |
350 (32%) |
<0.0001 |
| Prior stroke* |
13 (11%) |
38 (14%) |
144 (13%) |
0.83 |
| Prior HF* |
15 (13%) |
38 (14%) |
140 (13%) |
0.93 |
| COPD |
3 (2.6%) |
6 (2.1%) |
36 (3.3%) |
0.59 |
| Malignancy* |
14 (12%) |
24 (8.5%) |
109 (9.9%) |
0.54 |
| Aortic disease |
5 (4.4%) |
11 (3.9%) |
82 (7.4%) |
0.064 |
| PAD* |
14 (12%) |
26 (9.3%) |
158 (14%) |
0.078 |
| LVEF (%)† |
42.3±14.6 |
54.5±13.8 |
58.1±12.9 |
<0.0001 |
| EURO SCORE |
10.9±4.01 |
7.9±3.6 |
4.7±2.8 |
<0.0001 |
| EURO SCORE >6.0 |
96 (84%) |
173 (62%) |
267 (24%) |
<0.0001 |
| Clinical presentation of ACS |
|
|
|
<0.0001 |
| UA/NSTEMI |
28 (24%) |
226 (80%) |
|
|
| STEMI |
87 (76%) |
55 (20%) |
|
|
| Laboratory data |
| WBC (×103/μL) |
10.5±5.9 (n=102) |
8.2±3.9 (n=273) |
6.1±1.8 (n=1,073) |
<0.0001 |
| Hemoglobin (g/dL) |
12.9±2.9 (n=102) |
12.8±2.5 (n=273) |
12.7±4.3 (n=1,073) |
0.81 |
| Creatinine (mg/dL) |
1.52±1.44 (n=104) |
1.38±1.67 (n=274) |
1.38±1.79 (n=1,087) |
0.71 |
| LDL-C (mg/dL) |
112.6±39.0 (n=37) |
105.8±30.1(n=97) |
110.2±39.0 (n=691) |
0.98 |
| HbA1c (%) |
5.8±0.96 (n=28) |
6.0±1.2 (n=77) |
6.0±1.02 (n=650) |
0.68 |
| BNP (pg/mL) |
554.7±1,713.1 (n=65) |
375.6±534.0 (n=136) |
247.8±497.4 (n=261) |
0.02 |
| Albumin (g/dL) |
3.5±0.68 (n=101) |
3.8±0.5 (n=269) |
3.9±0.46 (n=947) |
<0.0001 |
| CRP (mg/L) |
1.4±3.0 (n=102) |
1.5±3.0 (n=250) |
0.59±1.3 (n=806) |
<0.0001 |
| Max CPK after PCI |
10,225±13,640 (n=86) |
2,539±4,490 (n=180) |
|
<0.0001 |
| Medications at discharge |
| Aspirin |
66 (96%, n=69) |
261 (98%, n=266) |
1,084 (99%, n=1,095) |
0.043 |
| Thienopyridine |
63 (91%, n=69) |
256 (96%, n=266) |
1,067 (98%, n=1,089) |
0.018 |
| Warfarin |
12 (17%, n=69) |
25 (9.4%, n=266) |
101 (9.2%, n=1,095) |
0.083 |
| Statins |
38 (55%, n=69) |
191 (72%, n=266) |
699 (64%, n=1,095) |
0.011 |
| β-blockers |
24 (35%, n=69) |
84 (32%, n=266) |
301 (28%, n=1,095) |
0.21 |
| ACEI/ARB |
41 (59%, n=69) |
167 (63%, n=266) |
599 (55%, n=1,095) |
0.05 |
| PPI |
42 (61%, n=69) |
148 (56%, n=266) |
423 (39%, n=1,089) |
<0.0001 |
Data are presented as number (%) or mean±SD unless otherwise noted. *Risk-adjusting variables selected for Cox proportional hazards models. †Calculated in 883 patients in the stable CAD group, in 64 patients in the ACS with shock group, and 217 patients in the ACS without shock group. ACEI, angiotensin-converting enzyme inhibitor; ACS, acute coronary syndrome; ARB, angiotensin II receptor blocker; BNP, B-type natriuretic polypeptide; CABG, coronary artery bypass grafting; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; CPK, creatine phosphokinase; CRP, C-reactive protein; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; HbA1c, hemoglobin A1c; HD, hemodialysis; HF, heart failure; LDL-C, low-density lipoprotein cholesterol; LVEF, left ventricular ejection fraction; MI, myocardial infarction; PAD, peripheral artery disease; PCI, percutaneous coronary intervention; PPI, proton pump inhibitor; NSTEMI, non-ST-segment elevation MI; STEMI, ST-segment elevation MI; UA, unstable angina; WBC, white blood cell.
Table 2.
Lesion and Procedural Characteristics (Corrected)
Table 2.
Lesion and Procedural Characteristics
| Variable |
ACS with shock
(n=115) |
ACS without shock
(n=281) |
Stable CAD
(n=1,104) |
P value |
| Extent of CAD |
|
|
|
0.013 |
| Left main only |
23 (20%) |
36 (13%) |
115 (10%) |
|
| 1-vessel disease |
27 (24%) |
70 (25%) |
347 (31%) |
|
| 2-vessel disease* |
43 (37%) |
107 (38%) |
428 (39%) |
|
| 3-vessel disease* |
22 (19%) |
68 (24%) |
214 (19%) |
|
| CTO |
25 (22%) |
44 (16%) |
191 (17%) |
0.35 |
| RCA-CTO |
10 (8.7%) |
10 (3.6%) |
75 (6.8%) |
0.077 |
| Stenosis (%) |
|
|
|
<0.0001 |
| Total occlusion |
25 (22%) |
9 (3.2%) |
11 (1.0%) |
|
| Non-occlusive stenosis |
90 (78%) |
272 (97%) |
1,093 (99%) |
|
| TIMI grade |
|
|
|
<0.0001 |
| ≤1 |
25 (22%) |
9 (3.2%) |
11 (1.0%) |
|
| 2 |
32 (28%) |
38 (14%) |
29 (2.6%) |
|
| 3 |
58 (50%) |
234 (83%) |
1,064 (96%) |
|
| AHA/ACC classification (B2/C lesion) |
92 (80%) |
223 (83%) |
997 (90%) |
<0.0001 |
| Emergency PCI |
114 (99%) |
264 (94%) |
20 (1.8%) |
<0.0001 |
| De novo lesion |
113 (98%) |
269 (96%) |
1,071 (97%) |
0.37 |
| Moderate/severe calcification* |
16 (14%) |
41 (15%) |
167 (15%) |
0.93 |
| Trifurcation |
12 (11%) |
29 (10%) |
131 (12%) |
0.72 |
| 2-stent procedure |
|
|
|
0.24 |
| Cullote |
18/23 (78%) |
45/62 (73%) |
131/189 (69%) |
|
| T-stenting |
3/23 (13%) |
16/62 (26%) |
52/189 (28%) |
|
| V-stenting |
0/23 (0%) |
0/62 (0%) |
1/189 (0.5%) |
|
| Crush |
0/23 (0%) |
2/62 (0%) |
3/189 (1.6%) |
|
| Mini-crush |
2 (8.7%) |
1 (1.6%) |
2/189 (1.1%) |
|
| Stenting ostial LMCA |
92 (80%) |
231 (82%) |
899 (81%) |
0.88 |
| POT |
12 (10%) |
39 (14%) |
143 (13%) |
0.65 |
| Final kissing balloon technique |
71 (62%) |
204 (73%) |
737 (67%) |
0.069 |
| Stent type* |
|
|
|
<0.0001 |
| BMS |
60 (52%) |
76 (27%) |
150 (14%) |
|
| G1-DES |
22 (19%) |
117 (42%) |
576 (52%) |
|
| G2-DES |
33 (29%) |
88 (31%) |
378 (34%) |
|
| No. of implanted stents |
1.25±0.54 |
1.21±0.49 |
1.26±0.56 |
0.41 |
| Stent length (main branch) (mm) |
22.4±1.16 |
22.9±0.74 |
23.9±0.37 |
0.45 |
| Stent diameter (main branch) (mm) |
3.31±0.38 |
3.28±0.36 |
3.28±0.36 |
0.72 |
| Stent length (side branch) (mm) |
19.6±1.41 |
18.4±0.87 |
20.7±0.50 |
0.06 |
| Stent diameter (side branch) (mm) |
2.88±0.37 |
2.93±0.37 |
2.88±0.41 |
0.70 |
| Stent length (main branch) ≥30 mm* |
21 (18%) |
56 (20%) |
223 (20%) |
0.88 |
| Stent diameter (main branch) ≥3.5 mm* |
75 (65%) |
158 (56%) |
689 (62%) |
0.11 |
| IVUS* |
69 (60%) |
192 (68%) |
731 (66%) |
0.28 |
| Rotablator |
3 (2.6%) |
6 (2.1%) |
89 (8.1%) |
0.0003 |
| IABP |
98 (85%) |
67 (24%) |
30 (2.7%) |
<0.0001 |
| PCPS |
30 (26%) |
5 (1.8%) |
3 (0.3%) |
<0.0001 |
| No-reflow/slow flow during procedure |
31 (27%) |
17 (6.1%) |
30 (2.7%) |
<0.0001 |
| Approach site |
|
|
|
0.77 |
| Radial artery |
18 (16%) |
55 (20%) |
209 (19%) |
|
| Brachial artery |
11 (9.6%) |
32 (11%) |
133 (12%) |
|
| Femoral artery |
86 (75%) |
194 (69%) |
759 (69%) |
|
Data are presented as number (%) or mean±SD unless otherwise noted. *Potential independent risk-adjusting variables selected for Cox proportional hazards models. ACC, American College of Cardiology; AHA, American Heart Association; BMS, bare metal stent; CTO, chronic total occlusion; G1-DES, 1st-generation drug-eluting stent; G2-DES, 2nd-generation drug-eluting stent; IABP, intra-aortic balloon pumping; IVUS, intravascular ultrasound; PCPS, percutaneous cardiopulmonary support; POT, proximal optimization technique; RCA, right coronary artery. Other abbreviations as in Table 1.
Table 3.
Crude Clinical Outcomes (Corrected)
Table 3.
Crude Clinical Outcomes
| |
No. of patients with event (cumulative incidence, %) |
P value |
ACS with shock
(n=115) |
ACS without shock
(n=281) |
Stable CAD
(n=1,104) |
| 30-day |
| All-cause death |
42 (36.6%) |
8 (2.9%) |
13 (1.2%) |
|
| Cardiac death |
38 (33.3%) |
7 (2.5%) |
12 (1.1%) |
|
| Sudden death |
1 (1.0%) |
0 |
3 (0.3%) |
|
| MI |
1 (1.1%) |
2 (0.7%) |
8 (0.7%) |
|
| Definite ST |
3 (3.2%) |
3 (1.1%) |
6 (0.5%) |
|
| TLR |
3 (3.2%) |
6 (2.2%) |
5 (0.5%) |
|
| Any CR |
5 (6.0%) |
15 (5.5%) |
12 (1.1%) |
|
| Major bleeding |
6 (6.7%) |
3 (1.1%) |
8 (0.7%) |
|
| 180-day |
| All-cause death |
56 (49.5%) |
24 (8.6%) |
36 (3.3%) |
|
| Cardiac death |
49 (44.1%) |
15 (5.4%) |
18 (1.6%) |
|
| Sudden death |
1 (1.0%) |
2 (0.8%) |
7 (0.6%) |
|
| MI |
3 (4.4%) |
3 (1.1%) |
10 (0.9%) |
|
| Definite ST |
4 (5.0%) |
3 (1.1%) |
8 (0.7%) |
|
| TLR |
5 (6.9%) |
24 (9.2%) |
40 (3.7%) |
|
| Any CR |
10 (14.8%) |
47 (18%) |
83 (7.8%) |
|
| Major bleeding |
7 (8.5%) |
9 (3.4%) |
16 (1.4%) |
|
| 5-year |
| All-cause death |
65 (61.3%) |
55 (24.4%) |
179 (20.3%) |
<0.0001 |
| Cardiac death |
51 (46.4%) |
23 (9.5%) |
55 (6.5%) |
<0.0001 |
| Sudden death |
2 (3.0%) |
3 (1.2%) |
19 (2.2%) |
0.63 |
| MI |
4 (9.0%) |
9 (4.7%) |
23 (2.8%) |
0.04 |
| Definite ST |
5 (7.1%) |
3 (1.1%) |
8 (0.73%) |
<0.0001 |
| TLR |
8 (12.9%) |
38 (16.2%) |
140 (15.0%) |
0.58 |
| Any CR |
17 (29.6%) |
89 (41.2%) |
304 (32.5%) |
0.08 |
| Major bleeding |
11 (17.2%) |
18 (8.4%) |
68 (8.2%) |
0.0007 |
CI, confidence interval; CR, coronary revascularization; HR, hazard ratio; ST, stent thrombosis; TLR, target lesion revascularization. Other abbreviations as in Table 1.
Table 4.
Adjusted Clinical Outcomes: Overall Results and Landmark Analysis (Corrected)
Table 4.
Adjusted Clinical Outcomes: Overall Results and Landmark Analysis
| |
ACS with shock vs.
Stable CAD |
ACS without shock vs.
Stable CAD |
No. of patient
with event (crude
incidence rate) |
Adjusted HR
(95% CI) |
P value |
No. of patient
with event (crude
incidence rate) |
Adjusted HR
(95% CI) |
P value |
| Entire follow-up period |
| All-cause death |
66 (57.4%) vs.
217 (19.7%) |
5.29
(3.85–7.19) |
<0.0001 |
68 (24.2%) vs.
217 (19.7%) |
1.31
(0.98–1.74) |
0.07 |
| Cardiac death |
51 (44.3%) vs.
71 (6.4%) |
12.16
(7.86–18.80) |
<0.0001 |
30 (10.7%) vs.
71 (6.4%) |
1.92
(1.21–2.98) |
0.007 |
| Sudden death |
2 (1.7%) vs.
25 (2.3%) |
NA |
|
4 (1.4%) vs.
25 (2.3%) |
NA |
|
| MI |
5 (4.3%) vs.
31 (2.8%) |
5.15
(1.58–14.33) |
0.009 |
10 (3.6%) vs.
31 (2.8%) |
NA |
|
| Definite ST |
5 (4.3%) vs.
8 (0.7%) |
NA |
|
4 (1.4%) vs.
8 (0.7%) |
NA |
|
| TLR |
9 (7.8%) vs.
155 (10.4%) |
0.98
(0.45–1.87) |
0.95 |
41 (14.6%) vs.
155 (10.4%) |
1.13
(0.78–1.61) |
0.52 |
| Any CR |
17 (14.8%) vs.
335 (30.3%) |
1.19
(0.70–1.91) |
0.50 |
92 (32.7%) vs.
335 (30.3%) |
1.38
(1.08–1.75) |
0.012 |
| Major bleeding |
12 (10.4%) vs.
82 (7.4%) |
3.32
(1.62–6.33) |
0.0017 |
23 (8.2%) vs.
82 (7.4%) |
1.20
(0.72–1.91) |
0.47 |
| Within 180 days |
| All-cause death |
56 (48.7%) vs.
36 (3.3%) |
11.13
(6.90–18.20) |
<0.0001 |
24 (8.5%) vs.
36 (3.3%) |
2.35
(1.34–4.05) |
0.003 |
| Cardiac death |
49 (42.6%) vs.
18 (1.6%) |
30.99
(16.78–59.56) |
<0.0001 |
15 (5.3%) vs.
18 (1.6%) |
2.94
(1.40–6.13) |
0.005 |
| Sudden death |
1 (0.9%) vs.
7 (0.6%) |
NA |
|
2 (0.7%) vs.
7 (0.6%) |
NA |
|
| MI |
3 (2.6%) vs.
10 (0.9%) |
4.43
(1.37–12.04) |
0.015 |
3 (1.1%) vs.
10 (0.9%) |
NA |
|
| Definite ST |
4 (3.5%) vs.
8 (0.7%) |
9.73
(2.03–42.68) |
0.0058 |
3 (1.1%) vs.
8 (0.7%) |
NA |
|
| TLR |
5 (4.3%) vs.
40 (3.6%) |
1.45
(0.48–3.62) |
0.48 |
24 (8.5%) vs.
40 (3.6%) |
2.24
(1.27–3.88) |
0.006 |
| Any CR |
10 (8.7%) vs.
83 (7.5%) |
1.58
(0.74–3.06) |
0.22 |
47 (16.7%) vs.
83 (7.5%) |
2.33
(1.58–3.40) |
<0.0001 |
| Major bleeding |
7 (6.1%) vs.
16 (1.4%) |
6.13
(2.87–12.64) |
<0.0001 |
9 (3.2%) vs.
16 (1.4%) |
1.57
(0.74–3.12) |
0.23 |
| Beyond 180 days |
| All-cause death |
10 (17.9%) vs.
181 (17.2%) |
1.30
(0.63–2.39) |
0.45 |
44 (17.5%) vs.
181 (17.2%) |
1.07
(0.75–1.49) |
0.72 |
| Cardiac death |
2 (4.1%) vs.
53 (5.0%) |
1.11
(0.18–3.80) |
0.89 |
15 (6.0%) vs.
53 (5.0%) |
1.45
(0.76–2.59) |
0.25 |
| Sudden death |
1 (2.3%) vs.
18 (1.9%) |
NA |
|
2 (1.0%) vs.
18 (1.9%) |
NA |
|
| MI |
2 (3.9%) vs.
21 (2.0%) |
4.31
(0.61–19.06) |
0.13 |
7 (2.8%) vs.
21 (2.0%) |
NA |
|
| Definite ST |
1 (2.0%) vs.
0 |
NA |
|
1 (0.4%) vs.
0 |
NA |
|
| TLR |
4 (8.0%) vs.
115 (11.3%) |
0.74
(0.22–1.82) |
0.55 |
17 (7.4%) vs.
115 (11.3%) |
0.70
(0.40–1.15) |
0.16 |
| Any CR |
7 (15.9%) vs.
252 (25.9%) |
0.83
(0.35–1.67) |
0.63 |
45 (22.1%) vs.
252 (25.9%) |
1.02
(0.72–1.40) |
0.92 |
| Major bleeding |
5 (6.9%) vs.
66 (6.1%) |
2.07
(0.69–5.05) |
0.18 |
14 (5.1%) vs.
66 (6.1%) |
0.94
(0.50–1.67) |
0.85 |
Abbreviations as in Tables 1,3.
Corrected parameters were written in
red.
Figure 2.
Kaplan-Meier curves for all-cause death, (A) throughout the entire follow-up period, and (B) in landmark analysis within
180
days and beyond 180 days after LMCA stenting.
Figure 3.
Kaplan-Meier curves for major bleeding, (A) throughout the entire follow-up period, and (B) in landmark analysis within 180 days and beyond 180 days after LMCA stenting.
We amended the parameters those were shown in the chart below the figures (number of patients with event and cumulative incidence) after 180 days. Kaplan-Meier curves and Log rank P values do not change.
Corrected parameters were written in
red.
Page 202, left column, line 1
Incorrect:
We show continuous variables as the mean and standard deviation unless otherwise noted, and they were compared using
Student’s t-test or the Wilcoxon rank-sum
test based on their distributions.
Correct:
We show continuous variables as the mean and standard deviation unless otherwise noted, and they were compared using
one-way analysis of variance or the Kruskal-Wallis
test based on their distributions.
Page 202, left column, line 12
Incorrect:
We used
20
clinically relevant factors as the risk-adjusting variables (Table 1).
Correct:
We used
16
clinically relevant factors as the risk-adjusting variables (Table 1).
Page 206, left column, line 22
Incorrect:
In the ACS with shock group, 56 of 115 patients died within 180 days of LMCA stenting; of these, 75% died of refractory heart failure, which was the most frequent cause of death, 7% of bleeding, and 7% of infection. In contrast,
26
of 281 patients died within 180 days in the ACS without shock group; of these, 50% died because of refractory heart failure, 15% of arrhythmia, and 12% of infection.
Correct:
In the ACS with shock group, 56 of 115 patients died within 180 days of LMCA stenting; of these, 75% died of refractory heart failure, which was the most frequent cause of death, 7% of bleeding, and 7% of infection. In contrast,
24
of 281 patients died within 180 days in the ACS without shock group; of these, 50% died because of refractory heart failure, 15% of arrhythmia, and 12% of infection.
Page 206, left column, line 4
Incorrect:
After adjusting confounders, the excess mortality risk of the ACS with shock group relative to the stable CAD group remained significant, while the mortality risk of the ACS without shock group relative to the stable CAD group was
not significant.
Correct:
After adjusting confounders, the excess mortality risk of the ACS with shock group relative to the stable CAD group remained significant, while the
excess
mortality risk of the ACS without shock group relative to the stable CAD group was
modest.
