著者

Eiji Hiraoka Kengo Tanabe Shinichiro Izuta Tadao Kubota Shun Kohsaka Amane Kozuki Kazuhiro Satomi Hiroki Shiomi Toshiro Shinke Toshiyuki Nagai Susumu Manabe Yasuhide Mochizuki Taku Inohara Mitsuhiko Ota Tetsuma Kawaji Yutaka Kondo Yumiko Shimada Yohei Sotomi Tomofumi Takaya Atsushi Tada Tomohiko Taniguchi Kazuya Nagao Kenichi Nakazono Yukiko Nakano Kazuhiko Nakayama Yuichiro Matsuo Takashi Miyamoto Yoshinao Yazaki Kazuyuki Yahagi Takuya Yoshida Kohei Wakabayashi Hideki Ishii Minoru Ono Akihiro Kishida Takeshi Kimura Tetsuro Sakai Yoshihiro Morino on behalf of the Japanese Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0609, (Released:2023-08-10)

参考文献数

439

被引用文献数

7

著者

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

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1282, (Released:2022-01-31)

参考文献数

1179

被引用文献数

38

著者

Ko Yamamoto Hiroki Shiomi Takeshi Morimoto Hiroki Watanabe Akiyoshi Miyazawa Kyohei Yamaji Masanobu Ohya Sunao Nakamura Satoru Mitomo Satoru Suwa Takenori Domei Shojiro Tatsushima Koh Ono Hiroki Sakamoto Kiyotaka Shimamura Masataka Shigetoshi Ryoji Taniguchi Yuji Nishimoto Hideki Okayama Kensho Matsuda Kenji Nakatsuma Yohei Takayama Jun Kuribara Hidekuni Kirigaya Kohei Yoneda Yuta Imai Umihiko Kaneko Hiroshi Ueda Kota Komiyama Naotaka Okamoto Satoru Sasaki Kengo Tanabe Mitsuru Abe Kiyoshi Hibi Kazushige Kadota Kenji Ando Takeshi Kimura on behalf of the OPTIVUS-Complex PCI Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0837, (Released:2023-03-11)

参考文献数

11

被引用文献数

5

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Background: There is a paucity of data on the effect of optimal intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) compared with standard PCI or coronary artery bypass grafting (CABG) in patients with multivessel disease.Methods and Results: The OPTIVUS-Complex PCI study multivessel cohort was a prospective multicenter single-arm study enrolling 1,021 patients undergoing multivessel PCI including the left anterior descending coronary artery using IVUS aiming to meet the prespecified criteria for optimal stent expansion. We conducted propensity score matching analyses between the OPTIVUS group and historical PCI or CABG control groups from the CREDO-Kyoto registry cohort-3 (1,565 and 899 patients) fulfilling the inclusion criteria for this study. The primary endpoint was a composite of death, myocardial infarction, stroke, or any coronary revascularization. In the propensity score-matched cohort (OPTIVUS vs. historical PCI control: 926 patients in each group; OPTIVUS vs. historical CABG control: 436 patients in each group), the cumulative 1-year incidence of the primary endpoint was significantly lower in the OPTIVUS group than in the historical PCI control group (10.4% vs. 23.3%; log-rank P<0.001) or the historical CABG control group (11.8% vs. 16.5%; log-rank P=0.02).Conclusions: IVUS-guided PCI targeting the OPTIVUS criteria combined with contemporary clinical practice was associated with superior clinical outcomes at 1 year compared with not only the historical PCI control, but also the historical CABG control.

著者

Jiro Sakamoto Yugo Yamashita Takeshi Morimoto Hidewo Amano Toru Takase Seiichi Hiramori Kitae Kim Maki Oi Masaharu Akao Yohei Kobayashi Mamoru Toyofuku Toshiaki Izumi Tomohisa Tada Po-Min Chen Koichiro Murata Yoshiaki Tsuyuki Syunsuke Saga Yuji Nishimoto Tomoki Sasa Minako Kinoshita Kiyonori Togi Hiroshi Mabuchi Kensuke Takabayashi Yusuke Yoshikawa Hiroki Shiomi Takao Kato Takeru Makiyama Koh Ono Toshihiro Tamura Yoshihisa Nakagawa Takeshi Kimura on behalf of the COMMAND VTE Registry Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0515, (Released:2019-09-20)

参考文献数

28

被引用文献数

5 57

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Background:There is a paucity of data on the management and prognosis of cancer-associated venous thromboembolism (VTE), leading to uncertainty about optimal management strategies.Methods and Results:The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive acute symptomatic VTE patients in Japan between 2010 and 2014. We divided the entire cohort into 3 groups: active cancer (n=695, 23%), history of cancer (n=243, 8%), and no history of cancer (n=2089, 69%). The rate of anticoagulation discontinuation was higher in patients with active cancer (43.5%, 27.0%, and 27.0%, respectively, at 1 year, P<0.001). The cumulative 5-year incidences of recurrent VTE, major bleeding, and all-cause death were higher in patients with active cancer (recurrent VTE: 17.7%, 10.2%, and 8.6%, P<0.001; major bleeding: 26.6%, 8.8%, and 9.3%, P<0.001; all-cause death: 73.1%, 28.6%, 14.6%, P<0.001). Among the 4 groups classified according to active cancer status, the cumulative 1-year incidence of recurrent VTE was higher in the metastasis group (terminal stage group: 6.4%, metastasis group: 22.1%, under chemotherapy group: 10.8%, and other group: 5.8%, P<0.001).Conclusions:In a current real-world VTE registry, patients with active cancer had higher risk for VTE recurrence, bleeding, and death, with variations according to cancer status, than patients without active cancer. Anticoagulation therapy was frequently discontinued prematurely in patients with active cancer in discordance with current guideline recommendations.

著者

Masakazu Yamagishi Nagara Tamaki Takashi Akasaka Takanori Ikeda Kenji Ueshima Shiro Uemura Yutaka Otsuji Yasuki Kihara Kazuo Kimura Takeshi Kimura Yoshiki Kusama Shinichiro Kumita Hajime Sakuma Masahiro Jinzaki Hiroyuki Daida Yasuchika Takeishi Hiroshi Tada Taishiro Chikamori Kenichi Tsujita Kunihiko Teraoka Kenichi Nakajima Tomoaki Nakata Satoshi Nakatani Akihiko Nogami Koichi Node Atsushi Nohara Atsushi Hirayama Nobusada Funabashi Masaru Miura Teruhito Mochizuki Hiroyoshi Yokoi Kunihiro Yoshioka Masafumi Watanabe Toshihiko Asanuma Yuichi Ishikawa Takahiro Ohara Koichi Kaikita Tokuo Kasai Eri Kato Hiroshi Kamiyama Masaaki Kawashiri Keisuke Kiso Kakuya Kitagawa Teruhito Kido Toshio Kinoshita Tomonari Kiriyama Teruyoshi Kume Akira Kurata Satoshi Kurisu Masami Kosuge Eitaro Kodani Akira Sato Yasutsugu Shiono Hiroki Shiomi Junichi Taki Masaaki Takeuchi Atsushi Tanaka Nobuhiro Tanaka Ryoichi Tanaka Takuya Nakahashi Takehiro Nakahara Akihiro Nomura Akiyoshi Hashimoto Kenshi Hayashi Masahiro Higashi Takafumi Hiro Daisuke Fukamachi Hitoshi Matsuo Naoya Matsumoto Katsumi Miyauchi Masao Miyagawa Yoshitake Yamada Keiichiro Yoshinaga Hideki Wada Tetsu Watanabe Yukio Ozaki Shun Kohsaka Wataru Shimizu Satoshi Yasuda Hideaki Yoshino on behalf of the Japanese Circulation Society Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-1131, (Released:2021-02-16)

参考文献数

1401

被引用文献数

50

著者

Koh Ono Satoshi Shizuta Erika Yamamoto Naritatsu Saito Neiko Ozasa Takao Kato Eri Kato Takahiro Horie Junichi Tazaki Hiroki Shiomi Shin Watanabe Hirotoshi Watanabe Yugo Yamashita Yusuke Yoshikawa Hideyuki Kinoshita Takeru Makiyama Yoshinori Yoshida Noboru Ashida Yasuaki Nakagawa Yasuhiro Nakashima Osamu Baba Hirohiko Kohjitani Masahiro Kimura Hideaki Inazumi Takashi Yoshizawa Akihiro Komasa Takeshi Kimura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0041, (Released:2021-01-30)

参考文献数

10

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Due to the COVID-19 pandemic, the 84thAnnual Meeting of the Japanese Circulation Society (JCS) was held in a web-based format for the first time in its history as “The Week for JCS 2020” from Monday, July 27 to Sunday, August 2, 2020. All sessions, including general abstracts, were streamed live or on-demand. The main theme of the meeting was “Change Practice!” and the aim was to organize the latest findings in the field of cardiovascular medicine and discuss how to change practice. The total number of registered attendees was over 16,800, far exceeding our expectations, and many of the sessions were viewed by far more people than at conventional face-to-face scientific meetings. At this conference, the power of online information dissemination was fully demonstrated, and the evolution of online academic meetings will be a direction that cannot be reversed in the future. The meeting was completed with great success, and we express our heartfelt gratitude to all affiliates for their enormous amount of work, cooperation, and support.

著者

Keitaro Shinada Takashi Kohno Keiichi Fukuda Michiaki Higashitani Naoto Kawamatsu Takeshi Kitai Tatsuhiro Shibata Makoto Takei Kotaro Nochioka Gaku Nakazawa Hiroki Shiomi Mitsunori Miyashita Atsushi Mizuno

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0507, (Released:2023-11-22)

参考文献数

29

被引用文献数

1

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Background: Enhanced discussions regarding end-of-life (EOL) are crucial to provide appropriate care for seriously ill patients. However, the current status of EOL discussions, especially their timing and influencing factors, among patients with cardiovascular diseases (CVD) remains unknown.Methods and Results: We conducted a cross-sectional questionnaire survey of bereaved family members of CVD patients who died at 10 tertiary care institutes in Japan. In all, 286 bereaved family members (38.2% male; median age 66.0 [interquartile range 58.0–73.0] years) of CVD patients were enrolled; of these, 200 (69.9%) reported that their families had had EOL discussions with physicians. The major topic discussed was resuscitation (79.0%), and 21.5% discussed the place of EOL care. Most discussions were held during hospitalization of the patient (88.2%). More than half (57.1%) the discussions were initiated less than 1 month before the patient died, and 22.6% of family members felt that this timing of EOL discussions was late. Bereaved family members’ perception of late EOL discussions was associated with the family members aggressive attitude towards life-prolonging treatment, less preparedness for bereavement, and less satisfaction with EOL care.Conclusions: Approximately 70% of bereaved family members of CVD patients had EOL discussions, which were often held shortly before the patient died. Further research is required to establish an ideal approach to EOL discussions at an appropriate time, which may improve the quality of EOL care.

著者

Yasuaki Takeji Tomohiko Taniguchi Takeshi Morimoto Shinichi Shirai Takeshi Kitai Hiroyuki Tabata Kazuki Kitano Nobuhisa Ono Ryosuke Murai Kohei Osakada Koichiro Murata Masanao Nakai Hiroshi Tsuneyoshi Tomohisa Tada Masashi Amano Hiroki Shiomi Hirotoshi Watanabe Yusuke Yoshikawa Ko Yamamoto Mamoru Toyofuku Shojiro Tatsushima Norino Kanamori Makoto Miyake Hiroyuki Nakayama Kazuya Nagao Masayasu Izuhara Kenji Nakatsuma Moriaki Inoko Takanari Fujita Masahiro Kimura Mitsuru Ishii Shunsuke Usami Kenichiro Sawada Fumiko Nakazeki Marie Okabayashi Manabu Shirotani Yasutaka Inuzuka Tatsuhiko Komiya Kenji Minatoya Takeshi Kimura on behalf of the CURRENT AS Registry-2 Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-1062, (Released:2022-04-19)

参考文献数

29

被引用文献数

2

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Background: There is scarce data evaluating the current practice pattern and clinical outcomes for patients with severe aortic stenosis (AS), including both those who underwent surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) and those who were managed conservatively in the TAVI era.Methods and Results: The Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis (CURRENT AS) Registry-2 is a prospective, physician-initiated, multicenter registry enrolling consecutive patients who were diagnosed with severe AS between April 2018 and December 2020 among 21 centers in Japan. The rationale for the prospective enrollment was to standardize the assessment of symptomatic status, echocardiographic evaluation, and other recommended diagnostic examinations such as computed tomography and measurement of B-type natriuretic peptide. Moreover, the schedule of clinical and echocardiographic follow up was prospectively defined and strongly recommended for patients who were managed conservatively. The entire study population consisted of 3,394 patients (mean age: 81.6 years and women: 60%). Etiology of AS was degenerative in 90% of patients. AS-related symptoms were present in 60% of patients; these were most often heart failure symptoms. The prevalence of high- and low-gradient AS was 58% and 42%, respectively, with classical and paradoxical low-flow low-gradient AS in 4.5% and 6.7%, respectively.Conclusions: The CURRENT AS Registry-2 might be large and meticulous enough to determine the appropriate timing of intervention for patients with severe AS in contemporary clinical practice.

著者

Yasuaki Takeji Hiroki Shiomi Takeshi Morimoto Yutaka Furukawa Natsuhiko Ehara Yoshihisa Nakagawa Takao Kato Junichi Tazaki Eri Toda Kato Hidenori Yaku Yusuke Yoshikawa Tomohisa Tada Michiya Hanyu Kazushige Kadota Tatsuhiko Komiya Kenji Ando Takeshi Kimura CREDO-Kyoto PCI/CABG Registry Cohort Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0980, (Released:2020-01-29)

参考文献数

31

被引用文献数

7

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Background:The effect of diabetes mellitus (DM) status on the long-term risk for heart failure (HF) in patients undergoing coronary revascularization has not been adequately evaluated.Methods and Results:In this study, 15,231 patients who underwent coronary revascularization in the CREDO-Kyoto Registry Cohort-2 were divided into 2 groups according to DM status (DM group: n=5,999; Non-DM group: n=9,232). The DM group was further divided into 2 groups according to insulin treatment (insulin-treated DM [ITDM]: n=1,353; non-insulin-treated DM [NITDM]: n=4,646). The primary outcome measure was HF hospitalization. The cumulative 5-year incidence of HF hospitalization was significantly higher in the DM than non-DM group (11.0% vs. 6.6%, respectively; log-rank P<0.0001), and in the ITDM than NITDM group (14.6% vs. 10.0%, respectively; log-rank P<0.0001). After adjusting for confounders, the increased risk of HF hospitalization with DM relative to non-DM remained significant (hazard ratio [HR] 1.47, 95% confidence interval [CI] 1.30–1.67, P<0.0001), whereas the risk associated with ITDM relative to NITDM was not significant (HR 1.17, 95% CI 0.96–1.43, P=0.12).Conclusions:The adjusted long-term risk for HF hospitalization after coronary revascularization was significantly higher in DM than non-DM patients, regardless of revascularization strategy, but did not differ between ITDM and NITDM patients.

著者

Yuji Nishimoto Yugo Yamashita Kitae Kim Takeshi Morimoto Syunsuke Saga Hidewo Amano Toru Takase Seiichi Hiramori Maki Oi Masaharu Akao Yohei Kobayashi Mamoru Toyofuku Toshiaki Izumi Tomohisa Tada Po-Min Chen Koichiro Murata Yoshiaki Tsuyuki Tomoki Sasa Jiro Sakamoto Minako Kinoshita Kiyonori Togi Hiroshi Mabuchi Kensuke Takabayashi Yusuke Yoshikawa Hiroki Shiomi Takao Kato Takeru Makiyama Koh Ono Yukihito Sato Takeshi Kimura on behalf of the COMMAND VTE Registry Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.84, no.11, pp.2006-2014, 2020-10-23 (Released:2020-10-23)

参考文献数

33

被引用文献数

21

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Background:Patients with cancer-associated venous thromboembolism (VTE) are at high risk for recurrent VTE and are recommended to receive prolonged anticoagulation therapy if they are at a low risk for bleeding. However, there are no established risk factors for bleeding during anticoagulation therapy.Methods and Results:The COMMAND VTE Registry is a multicenter retrospective registry enrolling 3,027 consecutive patients with acute symptomatic VTE among 29 Japanese centers. The present study population consisted of 592 cancer-associated VTE patients with anticoagulation therapy. We constructed a multivariable Cox proportional hazard model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the potential risk factors for major bleeding. During a median follow-up period of 199 days, major bleeding occurred in 72 patients. The cumulative incidence of major bleeding was 5.8% at 3 months, 13.8% at 1 year, 17.5% at 2 years, and 28.1% at 5 years. The most frequent major bleeding site was gastrointestinal tract (47%). Terminal cancer (adjusted HR, 4.17; 95% CI, 2.22–7.85, P<0.001), chronic kidney disease (adjusted HR, 1.89; 95% CI 1.06–3.37, P=0.031), and gastrointestinal cancer (adjusted HR, 1.78; 95% CI, 1.04–3.04, P=0.037) were independently associated with an increased risk of major bleeding.Conclusions:Major bleeding events were common during anticoagulation therapy in real-world cancer-associated VTE patients. Terminal cancer, chronic kidney disease, and gastrointestinal cancer were the independent risk factors for major bleeding.

著者

Kazuo Kimura Takeshi Kimura Masaharu Ishihara Yoshihisa Nakagawa Koichi Nakao Katsumi Miyauchi Tomohiro Sakamoto Kenichi Tsujita Nobuhisa Hagiwara Shunichi Miyazaki Junya Ako Hirokuni Arai Hideki Ishii Hideki Origuchi Wataru Shimizu Hirofumi Takemura Yoshio Tahara Yoshihiro Morino Kenji Iino Tomonori Itoh Yoshitaka Iwanaga Keiji Uchida Hirohisa Endo Ken Kongoji Kenji Sakamoto Hiroki Shiomi Takao Shimohama Atsushi Suzuki Jun Takahashi Ichiro Takeuchi Akihito Tanaka Toshihiro Tamura Takahiro Nakashima Teruo Noguchi Daisuke Fukamachi Tomohiro Mizuno Junichi Yamaguchi Kenji Yodogawa Masami Kosuge Shun Kohsaka Hideaki Yoshino Satoshi Yasuda Hiroaki Shimokawa Atsushi Hirayama Takashi Akasaka Kazuo Haze Hisao Ogawa Hiroyuki Tsutsui Tsutomu Yamazaki on behalf of the Japanese Circulation Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0133, (Released:2019-03-29)

参考文献数

1064

被引用文献数

31 316

著者

Tomohiko Taniguchi Takeshi Morimoto Hiroki Shiomi Kenji Ando Shinichi Shirai Norio Kanamori Koichiro Murata Takeshi Kitai Yuichi Kawase Kazushige Kadota Makoto Miyake Chisato Izumi Eri Minamino-Muta Takao Kato Katsuhisa Ishii Kazuya Nagao Naritatsu Saito Kenji Minatoya Takeshi Kimura on behalf of the CURRENT AS Registry Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0026, (Released:2020-05-19)

参考文献数

20

被引用文献数

19

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Background:Patients with severe aortic stenosis (AS) might be at high risk for adverse cardiovascular events at the time of non-cardiac surgery.Methods and Results:The current study population included 348 patients who underwent elective non-cardiac surgery under general or spinal anesthesia during the follow up of 3,815 patients in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) registry. There were 187 patients with untreated severe AS at time of surgery (untreated severe AS group) and 161 patients who had undergone aortic valve replacement (AVR) before surgery (prior AVR group), including 23 patients with prophylactic AVR. The primary outcome measure was 30-day mortality after non-cardiac surgery. At 30 days after non-cardiac surgery, 8 patients (4.3%) died in the untreated severe AS group, while no patients died in the prior AVR group (P=0.008). The causes of death were cardiovascular in 6 out of 8 patients. Mortality at 30 days was higher in untreated severe AS patients with AS-related symptoms before surgery than in those without AS-related symptoms (7.2% vs. 3.1%). Higher surgical risk estimates of the non-cardiac surgery incrementally increased the risk of 30-day mortality in patients with untreated severe AS, though the difference was not statistically significant (low-risk: 0%, intermediate-risk: 4.3%, and high-risk: 6.6 %, P=0.46).Conclusions:Symptomatic and asymptomatic severe AS might be associated with higher risk of 30-day mortality if untreated before elective intermediate- and high-risk non-cardiac surgery, while no patient with prior AVR died after elective non-cardiac surgery.

著者

Yasuaki Takeji Tomohiko Taniguchi Takeshi Morimoto Naritatsu Saito Kenji Ando Shinichi Shirai Genichi Sakaguchi Yoshio Arai Yasushi Fuku Yuichi Kawase Tatsuhiko Komiya Natsuhiko Ehara Takeshi Kitai Tadaaki Koyama Shin Watanabe Hirotoshi Watanabe Hiroki Shiomi Eri Minamino-Muta Shintaro Matsuda Hidenori Yaku Yusuke Yoshikawa Kazuhiro Yamazaki Masahide Kawatou Kazuhisa Sakamoto Toshihiro Tamura Makoto Miyake Hisashi Sakaguchi Koichiro Murata Masanao Nakai Norio Kanamori Chisato Izumi Hirokazu Mitsuoka Masashi Kato Yutaka Hirano Tsukasa Inada Kazuya Nagao Hiroshi Mabuchi Yasuyo Takeuchi Keiichiro Yamane Takashi Tamura Mamoru Toyofuku Mitsuru Ishii Moriaki Inoko Tomoyuki Ikeda Katsuhisa Ishii Kozo Hotta Toshikazu Jinnai Nobuya Higashitani Yoshihiro Kato Yasutaka Inuzuka Yuko Morikami Kenji Minatoya Takeshi Kimura on befalf of the CURRENT AS Registry Investigators and K-TAVI Registry Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0951, (Released:2020-02-01)

参考文献数

35

被引用文献数

12

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Background:There are no data comparing transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) outcomes in real clinical practice in Japan.Methods and Results:We combined 2 independent registries, the K-TAVI Registry (a 6-center prospective registry of consecutive patients who underwent TAVI) and the CURRENT AS Registry (a large, 27-center registry of 3,815 consecutive patients with severe aortic stenosis [AS]). In the K-TAVI Registry, 338 patients underwent TAVI with SAPIEN XT balloon-expandable valves from October 2013 to January 2016, whereas in the CURRENT AS Registry 237 patients with severe AS underwent SAVR from January 2003 to December 2011. Propensity score matching was conducted, with final cohort comprising 306 patients. The cumulative 2-year incidence of all-cause death and heart failure (HF) hospitalization did not differ significantly between the TAVI and SAVR groups (13.7% vs. 12.4% [P=0.81] and 7.9% vs 3.9% [P=0.13], respectively). After adjusting for residual confounders, there were no significant differences between the TAVI and SAVR groups in the risk for all-cause death (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.35–1.58; P=0.43) or HF hospitalization (HR 1.27; 95% CI 0.40–4.59; P=0.69).Conclusions:These findings from 2 independent Japanese registries suggest that the 2-year risk of all-cause mortality and HF does not differ significantly between TAVI and SAVR groups in real-world practice in Japan.

著者

Kenji Nakatsuma Hiroki Shiomi Takeshi Morimoto Yutaka Furukawa Yoshihisa Nakagawa Kenji Ando Kazushige Kadota Takashi Yamamoto Satoru Suwa Minoru Horie Takeshi Kimura on behalf of the CREDO-Kyoto AMI investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-0204, (Released:2016-06-28)

参考文献数

24

被引用文献数

2 22

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Background:Inter-facility transfer for primary percutaneous coronary intervention (PCI) from referring facilities to PCI centers causes a significant delay in treatment of ST-segment elevation acute myocardial infarction (STEMI) patients undergoing primary PCI. However, little is known about the clinical outcomes of STEMI patients undergoing inter-facility transfer in Japan.Methods and Results:In the CREDO-Kyoto acute myocardial infarction (AMI) registry that enrolled 5,429 consecutive AMI patients in 26 centers in Japan, the current study population consisted of 3,820 STEMI patients who underwent primary PCI within 24 h of symptom onset. We compared long-term clinical outcomes between inter-facility transfer patients and those directly admitted to PCI centers. The primary outcome measure was a composite of all-cause death or heart failure (HF) hospitalization. There were 1,725 (45.2%) inter-facility transfer patients, and 2,095 patients (54.8%) with direct admission to PCI centers. The cumulative 5-year incidence of death/HF hospitalization was significantly higher in the inter-facility transfer patients than in those with direct admission (26.9% vs. 22.2%; log-rank P<0.001). After adjusting for potential confounders, the risk for death/HF hospitalization was significantly higher (adjusted hazard ratio: 1.22, 95% confidence interval: 1.07–1.40, P<0.001) in the inter-facility transfer patients than in those directly admitted.Conclusions:Inter-facility transfer was associated with significantly worse long-term clinical outcomes for patients with STEMI undergoing primary PCI.

著者

Kenji Nakatsuma Hiroki Shiomi Takeshi Morimoto Kenji Ando Kazushige Kadota Hiroki Watanabe Tomohiko Taniguchi Takashi Yamamoto Yutaka Furukawa Yoshihisa Nakagawa Minoru Horie Takeshi Kimura on behalf of the CREDO-Kyoto AMI investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-15-0870, (Released:2015-12-15)

参考文献数

19

被引用文献数

2 32

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Background:In the setting of elective percutaneous coronary intervention (PCI), intravascular ultrasound (IVUS)-guided PCI is associated with a reduction in the incidence of target vessel revascularization (TVR), but the impact of IVUS on long-term clinical outcome in the setting of emergency PCI for ST-segment elevation acute myocardial infarction (STEMI) is still unclear.Methods and Results:The subjects consisted of 3,028 STEMI patients who underwent primary PCI within 24 h of symptom onset in the CREDO-Kyoto acute myocardial infarction registry. Of these, 932 patients (31%) underwent IVUS-guided PCI. Compared with the angiography-guided PCI without IVUS, IVUS-guided PCI was associated with significantly lower incidences of TVR (primary outcome measure; 22% vs. 27%, log-rank P<0.001) and definite stent thrombosis (ST; 1.2% vs. 3.1%, log-rank P=0.003). The cumulative incidence of all-cause death was not significantly different between the 2 groups. After adjusting for confounders, however, there were no significant differences between the 2 groups in risk for TVR (adjusted HR, 1.14; 95% CI: 0.86–1.51, P=0.38) and definite ST (adjusted HR, 0.58; 95% CI: 0.19–1.72, P=0.33).Conclusions:IVUS-guided PCI was not associated with a lower risk for TVR or ST in STEMI patients undergoing primary PCI.

著者

Toshiaki Toyota Takeshi Morimoto Satoshi Iimuro Retsu Fujita Hiroshi Iwata Katsumi Miyauchi Teruo Inoue Yoshihisa Nakagawa Yosuke Nishihata Hiroyuki Daida Yukio Ozaki Satoru Suwa Ichiro Sakuma Yutaka Furukawa Hiroki Shiomi Hirotoshi Watanabe Kyohei Yamaji Naritatsu Saito Masahiro Natsuaki Yasuo Ohashi Masunori Matsuzaki Ryozo Nagai Takeshi Kimura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0168, (Released:2022-09-14)

参考文献数

20

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Background: The relationship between very low on-treatment low-density lipoprotein cholesterol (LDL-C) level and cardiovascular event risk is still unclear in patients receiving the same doses of statins.Methods and Results: From the REAL-CAD study comparing high-dose (4 mg/day) with low-dose (1 mg/day) pitavastatin therapy in patients with stable coronary artery disease, 11,105 patients with acceptable statin adherence were divided into 3 groups according to the on-treatment LDL-C level at 6 months (<70 mg/dL, 70–100 mg/dL, and ≥100 mg/dL). The primary outcome measure was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission. The adjusted risks of the LDL-C <70 mg/dL group relative to the LDL-C 70–100 mg/dL group (reference) was not significantly different for the primary outcome measure in both 1 mg/day and 4 mg/day strata (HR 0.84, 95% CI 0.58–1.18, P=0.32, and HR 1.25, 95% CI 0.88–1.79, P=0.22). The adjusted risk of the LDL-C ≥100 mg/dL group relative to the reference group was not significant for the primary outcome measure in the 1 mg/day stratum (HR 0.82, 95% CI 0.60–1.11, P=0.21), whereas it was highly significant in the 4 mg/day stratum (HR 3.32, 95% CI 2.08–5.17, P<0.001).Conclusions: A very low on-treatment LDL-C level (<70 mg/dL) was not associated with lower cardiovascular event risk compared with moderately low on-treatment LDL-C level (70–100 mg/dL) in patients receiving the same doses of statins.

著者

Masahiro Natsuaki Takeshi Morimoto Hiroki Shiomi Ko Yamamoto Kyohei Yamaji Hirotoshi Watanabe Takashi Uegaito Mitsuo Matsuda Toshihiro Tamura Ryoji Taniguchi Moriaki Inoko Hiroshi Mabuchi Teruki Takeda Takenori Domei Manabu Shirotani Natsuhiko Ehara Hiroshi Eizawa Katsuhisa Ishii Masaru Tanaka Tsukasa Inada Tomoya Onodera Ryuzo Nawada Eiji Shinoda Miho Yamada Takashi Yamamoto Hiroshi Sakai Mamoru Toyofuku Takashi Tamura Mamoru Takahashi Tomohisa Tada Hiroki Sakamoto Takeshi Tada Kazuhisa Kaneda Shinji Miki Takeshi Aoyama Satoru Suwa Yukihito Sato Kenji Ando Yutaka Furukawa Yoshihisa Nakagawa Kazushige Kadota Takeshi Kimura on behalf of the CREDO-Kyoto PCI/CABG Registry Cohort-Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0526, (Released:2021-09-16)

参考文献数

27

被引用文献数

1

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Background:Optimal intensity is unclear for P2Y12receptor blocker therapy after percutaneous coronary intervention (PCI) in real-world clinical practice.Methods and Results:From the CREDO-Kyoto Registry, the current study population consisted of 25,419 patients (Cohort-2: n=12,161 and Cohort-3: n=13,258) who underwent their first PCI. P2Y12receptor blocker therapies were reduced dose of ticlopidine (200 mg/day), and global dose of clopidogrel (75 mg/day) in 87.7% and 94.8% of patients in Cohort-2 and Cohort-3, respectively. Cumulative 3-year incidence of GUSTO moderate/severe bleeding was significantly higher in Cohort-3 than in Cohort-2 (12.1% and 9.0%, P<0.0001). After adjusting 17 demographic factors and 9 management factors potentially related to the bleeding events other than the type of P2Y12receptor blocker, the higher bleeding risk in Cohort-3 relative to Cohort-2 remained significant (hazard ratio (HR): 1.52 95% confidence interval (CI) 1.37–1.68, P<0.0001). Cohort-3 compared with Cohort-2 was not associated with lower adjusted risk for myocardial infarction/ischemic stroke (HR: 0.96, 95% CI: 0.87–1.06, P=0.44).Conclusions:In this historical comparative study, Cohort-3 compared with Cohort-2 was associated with excess bleeding risk, which might be at least partly explained by the difference in P2Y12receptor blockers.

著者

Mamoru Toyofuku Tomohiko Taniguchi Takeshi Morimoto Kyohei Yamaji Yutaka Furukawa Kosuke Takahashi Takashi Tamura Hiroki Shiomi Kenji Ando Norio Kanamori Koichiro Murata Takeshi Kitai Yuichi Kawase Chisato Izumi Makoto Miyake Hirokazu Mitsuoka Masashi Kato Yutaka Hirano Shintaro Matsuda Tsukasa Inada Tomoyuki Murakami Yasuyo Takeuchi Keiichiro Yamane Mitsuru Ishii Eri Minamino-Muta Takao Kato Moriaki Inoko Tomoyuki Ikeda Akihiro Komasa Katsuhisa Ishii Kozo Hotta Nobuya Higashitani Yoshihiro Kato Yasutaka Inuzuka Chiyo Maeda Toshikazu Jinnai Yuko Morikami Naritatsu Saito Kenji Minatoya Takeshi Kimura on behalf of the CURRENT AS Registry Investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-1244, (Released:2017-04-08)

参考文献数

23

被引用文献数

34

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Background:There is a paucity of data on the sex differences in the prevalence, clinical presentation, and prognosis of aortic stenosis (AS).Methods and Results:A total of 3,815 consecutive patients with severe AS were enrolled in the multicenter CURRENT AS registry between January 2003 and December 2011. The registry included 1,443 men (38%) and 2,372 women (62%). Women were much older than men (79±10 vs. 75±10 years, P<0.0001), and the ratio of women to men increased with age. The cumulative 5-year incidence of all-cause death was significantly higher in men than in women (47% vs. 41%, P=0.003), although women were more symptomatic and much older. The 5-year mortality was similar between men and women at age <65 years (16% vs. 15%, P=0.99), whereas it was significantly higher in men than in women at age ≥65 years (65–74 years, 38% vs. 19%, P<0.0001; 75–84 years, 55% vs. 34%, P<0.0001; ≥85 years: 82% vs. 72%, P=0.03).Conclusions:A large Japanese multicenter registry of consecutive patients with severe AS included a much higher proportion of women than men, with the female:male sex ratio increasing with age. The 5-year mortality rate of women was lower than that of men. Lower 5-year mortality rates in women were consistently seen across all age groups >65 years.

著者

Toshiaki Toyota Takeshi Morimoto Hiroki Shiomi Kenji Ando Koh Ono Satoshi Shizuta Takao Kato Naritatsu Saito Yutaka Furukawa Yoshihisa Nakagawa Minoru Horie Takeshi Kimura on behalf of the CREDO-Kyoto PCI/CABG Registry Cohort-2 Investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-0987, (Released:2017-02-07)

参考文献数

31

被引用文献数

10

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Background:Few studies have evaluated the prevalence and clinical outcomes of ad hoc percutaneous coronary intervention (PCI), performing diagnostic coronary angiography and PCI in the same session, in stable coronary artery disease (CAD) patients.Methods and Results:From the CREDO-Kyoto PCI/CABG registry cohort-2, 6,943 patients were analyzed as having stable CAD and undergoing first PCI. Ad hoc PCI and non-ad hoc PCI were performed in 1,722 (24.8%) and 5,221 (75.1%) patients, respectively. The cumulative 5-year incidence and adjusted risk for all-cause death were not significantly different between the 2 groups (15% vs. 15%, P=0.53; hazard ratio: 1.15, 95% confidence interval: 0.98–1.35, P=0.08). Ad hoc PCI relative to non-ad hoc PCI was associated with neutral risk for myocardial infarction, any coronary revascularization, and bleeding, but was associated with a trend towards lower risk for stroke (hazard ratio: 0.78, 95% confidence interval: 0.60–1.02, P=0.06).Conclusions:Ad hoc PCI in stable CAD patients was associated with at least comparable 5-year clinical outcomes as with non-ad hoc PCI. Considering patients’ preference and the cost-saving, the ad hoc PCI strategy might be a safe and attractive option for patients with stable CAD, although the prevalence of ad hoc PCI was low in the current study population.

著者

Hiroki Shiomi Takeshi Morimoto Yutaka Furukawa Yoshihisa Nakagawa Ryuzo Sakata Hitoshi Okabayashi Michiya Hanyu Mitsuomi Shimamoto Noboru Nishiwaki Tatsuhiko Komiya Takeshi Kimura on behalf of the CREDO-Kyoto PCI/CABG registry cohort-2 investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-15-0034, (Released:2015-03-30)

参考文献数

23

被引用文献数

9 36

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Background:Studies evaluating long-term (≥5 years) outcome of percutaneous coronary intervention (PCI) compared with coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease (ULMCAD) are still limited, despite concerns for late adverse events after drug-eluting stents implantation.Methods and Results:We identified 1,004 patients with ULMCAD (PCI: n=364, CABG: n=640) among 15,939 patients with first coronary revascularization enrolled in the CREDO-Kyoto PCI/CABG registry cohort-2. The primary outcome measure in the current analysis was a composite of death, myocardial infarction, and stroke (death/MI/stroke). The cumulative 5-year incidence of and the adjusted risk for death/MI/stroke were significantly higher in the PCI group than in the CABG group (34.5% vs. 24.1%, log-rank P<0.001, adjusted hazard ratio (HR): 1.48 [95% confidence interval (CI): 1.07–2.05, P=0.02]). The adjusted risks for all-cause death was not significantly different between the 2 groups. Regarding the stratified analysis by the SYNTAX score, the adjusted risk for death/MI/stroke was not significantly different between the 2 groups in patients with low (<23) or intermediate (23–33) SYNTAX score, whereas it was significantly higher in the PCI group than in the CABG group in patients with high (≤33) SYNTAX score.Conclusions:CABG as compared with PCI was associated with better long-term outcome in patients with ULMCAD, especially those with high anatomical complexity.