文献一覧: Hisashi Ogawa (著者)

11 0 0 0 OA A Novel Risk Stratification System for Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation

著者: Ken Okumura Hirofumi Tomita Michikazu Nakai Eitaro Kodani Masaharu Akao Shinya Suzuki Kenshi Hayashi Mitsuaki Sawano Masahiko Goya Takeshi Yamashita Keiichi Fukuda Hisashi Ogawa Toyonobu Tsuda Mitsuaki Isobe Kazunori Toyoda Yoshihiro Miyamoto Hiroaki Miyata Tomonori Okamura Yusuke Sasahara for the J-RISK AF Research Group
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-20-1075, (Released:2021-03-25)
参考文献数: 22
被引用文献数: 1 15

Background:Recently, identification of independent risk factors for ischemic stroke in Japanese non-valvular atrial fibrillation (NVAF) patients was made by analyzing the 5 major Japanese registries: J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and the Hokuriku-Plus AF Registry.Methods and Results:The predictive value of the risk scheme in Japanese NVAF patients was assessed. Of 16,918 patients, 12,289 NVAF patients were analyzed (mean follow up, 649±181 days). Hazard ratios (HRs) of each significant, independent risk factor were determined by using adjusted Cox-hazard proportional analysis. Scoring system for ischemic stroke was created by transforming HR logarithmically and was estimated by c-statistic. During the 21,820 person-years follow up, 241 ischemic stroke events occurred. Significant risk factors were: being elderly (aged 75–84 years [E], HR=1.74), extreme elderly (≥85 years [EE], HR=2.41), having hypertension (H, HR=1.60), previous stroke (S, HR=2.75), type of AF (persistent/permanent) (T, HR=1.59), and low body mass index <18.5 kg/m2(L, HR=1.55) after adjusting for oral anticoagulant treatment. The score was assigned as follows: 1 point to H, E, L, and T, and 2 points to EE and S (HELT-E2S2score). The C-statistic, using this score, was 0.681 (95% confidence interval [CI]=0.647–0.714), which was significantly higher than those using CHADS2(0.647; 95% CI=0.614–0.681, P=0.027 for comparison) and CHA2DS2-VASc scores (0.641; 95% CI=0.608–0.673, P=0.008).Conclusions:The HELT-E2S2score may be useful for identifying Japanese NVAF patients at risk of ischemic stroke.

2022-04-12 18:28:21
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6 0 0 0 OA Current Status and Outcomes of Direct Oral Anticoagulant Use in Real-World Atrial Fibrillation Patients ― Fushimi AF Registry ―

著者: Yugo Yamashita Ryuji Uozumi Yasuhiro Hamatani Masahiro Esato Yeong-Hwa Chun Hikari Tsuji Hiromichi Wada Koji Hasegawa Hisashi Ogawa Mitsuru Abe Satoshi Morita Masaharu Akao
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-16-1337, (Released:2017-04-19)
参考文献数: 27
被引用文献数: 107

Background:The current status and outcomes of direct oral anticoagulant (DOAC) use have not been widely evaluated in unselected patients with atrial fibrillation (AF) in the real world.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical institutions (n=80) in Fushimi, Kyoto, Japan. Follow-up data with oral anticoagulant (OAC) status were available for 3,731 patients by the end of November 2015. We evaluated OAC status and clinical outcomes according to OAC status. The number (incidence rate) of stroke/systemic embolism (SE) and major bleeding events during the median follow-up of 3.0 years was 224 (2.3%/year) and 177 (1.8%/year), respectively. After the release of DOAC, the prevalence of DOAC use increased gradually and steadily, and that of warfarin, DOAC and no OAC was 37%, 26% and 36%, respectively in 2015. On Cox proportional hazards modeling incorporating change in OAC status as a time-dependent covariate for stroke/SE and major bleeding events, use of DOAC compared with warfarin was not associated with stroke/SE events (HR, 0.95; 95% CI: 0.59–1.51, P=0.82) or major bleeding events (HR, 0.82; 95% CI: 0.50–1.36, P=0.45).Conclusions:In real-world clinical practice, there were no significant differences in stroke/SE events or major bleeding events for DOAC compared with warfarin in patients with AF.

2017-10-22 00:08:13
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4 0 0 0 OA JCS/JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias

著者: Katsushige Ono Yu-ki Iwasaki Masaharu Akao Takanori Ikeda Kuniaki Ishii Yasuya Inden Kengo Kusano Yoshinori Kobayashi Yukihiro Koretsune Tetsuo Sasano Naokata Sumitomo Naohiko Takahashi Shinichi Niwano Nobuhisa Hagiwara Ichiro Hisatome Tetsushi Furukawa Haruo Honjo Toru Maruyama Yuji Murakawa Masahiro Yasaka Eiichi Watanabe Takeshi Aiba Mari Amino Hideki Itoh Hisashi Ogawa Yasuo Okumura Chizuko Aoki-Kamiya Jun Kishihara Eitaro Kodani Takashi Komatsu Yusuke Sakamoto Kazuhiro Satomi Tsuyoshi Shiga Tetsuji Shinohara Atsushi Suzuki Shinya Suzuki Yukio Sekiguchi Satoshi Nagase Noriyuki Hayami Masahide Harada Tadashi Fujino Takeru Makiyama Mitsunori Maruyama Junichiro Miake Shota Muraji Hiroshige Murata Norishige Morita Hisashi Yokoshiki Koichiro Yoshioka Kenji Yodogawa Hiroshi Inoue Ken Okumura Takeshi Kimura Hiroyuki Tsutsui Wataru Shimizu on behalf of the Japanese Circulation Society and Japanese Heart Rhythm 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-20-1212, (Released:2022-03-11)
参考文献数: 998
被引用文献数: 41

2022-03-11 18:57:07
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4 0 0 0 OA Incidence and Risk Factors of Stroke or Systemic Embolism in Patients With Atrial Fibrillation and Heart Failure ― The Fushimi AF Registry ―

著者: Moritake Iguchi Yuji Tezuka Hisashi Ogawa Yasuhiro Hamatani Daisuke Takagi Yoshimori An Takashi Unoki Mitsuru Ishii Nobutoyo Masunaga Masahiro Esato Hikari Tsuji Hiromichi Wada Koji Hasegawa Mitsuru Abe Gregory Y.H. Lip Masaharu Akao
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-17-1155, (Released:2018-03-09)
参考文献数: 32
被引用文献数: 26

Background:Heart failure (HF) is a heterogeneous syndrome, but the effect of the type and severity of HF on the incidence of stroke or systemic embolism (SE) in atrial fibrillation (AF) patients is unclear.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. Follow-up data were available for 3,749 patients. We defined pre-existing HF as having one of the following: prior hospitalization for HF, presence of HF symptoms (NYHA ≥2), or reduced ejection fraction (<40%). At baseline, 1,008 (26.9%) patients had pre-existing HF. On multivariate analysis, the incidence of stroke/SE was not associated with pre-existing HF (hazard ratio (HR), 1.24; 95% confidence interval (CI), 0.92–1.64) or each criterion for the definition of pre-existing HF, but was associated with high B-type natriuretic peptide (BNP) or N-terminal proBNP levels (above the median of the pre-existing HF group) at baseline (HR, 1.65; 95% CI, 1.06–2.53). Stroke/SE was markedly increased in the initial 30-day period following hospital admission for HF (HR, 12.0; 95% CI, 4.59–31.98).Conclusions:The effect of HF on the incidence of stroke/SE may depend on the stage or severity of HF in patients with AF. The incidence of stroke/SE was markedly increased in the 30 days after admission for HF, but compensated ‘stable’ HF did not appear to confer an independent risk.

2018-03-15 23:25:48
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3 0 0 0 OA Current Status and Outcomes of Direct Oral Anticoagulant Use in Real-World Atrial Fibrillation Patients ― Fushimi AF Registry ―

著者: Yugo Yamashita Ryuji Uozumi Yasuhiro Hamatani Masahiro Esato Yeong-Hwa Chun Hikari Tsuji Hiromichi Wada Koji Hasegawa Hisashi Ogawa Mitsuru Abe Satoshi Morita Masaharu Akao
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.81, no.9, pp.1278-1285, 2017-08-25 (Released:2017-08-25)
参考文献数: 27
被引用文献数: 107

2021-06-17 11:20:42
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3 0 0 0 OA Sex-Related Differences in the Clinical Events of Patients With Atrial Fibrillation ― The Fushimi AF Registry ―

著者: Hisashi Ogawa Yasuhiro Hamatani Kosuke Doi Yuji Tezuka Yoshimori An Mitsuru Ishii Moritake Iguchi Nobutoyo Masunaga Masahiro Esato Yeong-Hwa Chun Hikari Tsuji Hiromichi Wada Koji Hasegawa Mitsuru Abe Gregory YH Lip Masaharu Akao on behalf of the Fushimi AF 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-17-0071, (Released:2017-05-25)
参考文献数: 33
被引用文献数: 13

Background:Female sex is considered a risk factor for thromboembolism in patients with atrial fibrillation (AF), and is included in the risk stratification scheme, CHA2DS2-VASc score. The purpose of the present study was to investigate the clinical outcomes of female Japanese AF patients.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of the AF patients in Fushimi-ku, Kyoto. Follow-up data were available for 3,878 patients. Female AF patients (n=1,551, 40.0%) were older (77.0 vs. 71.4 years; P<0.001) than male patients (n=2,327, 60.0%). Female patients were more likely to have heart failure (31.1% vs. 23.7%; P<0.001). Previous stroke incidence (19.2% vs. 21.4%; P=0.083) was comparable between male and female patients. During the median follow-up period of 1,102 days, Cox regression analysis demonstrated that female sex was not independently associated with a risk of stroke or systemic embolism (adjusted hazard ratio [HR] 0.74; 95% confidence interval [CI]: 0.54–1.00, P=0.051). However, female sex showed an association with a lower risk of intracranial hemorrhage (adjusted HR 0.54; 95% CI: 0.30–0.95, P=0.032) and all-cause death (adjusted HR 0.56; 95% CI: 0.46–0.68, P<0.001).Conclusions:We demonstrated that female sex is not independently associated with an increased risk of thromboembolism, but is associated with a decreased risk of intracranial hemorrhage and all-cause death in Japanese AF patients enrolled in the Fushimi AF Registry.

2017-05-25 14:20:30
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2 0 0 0 OA 10-Year Trends of Antithrombotic Therapy Status and Outcomes in Japanese Atrial Fibrillation Patients ― The Fushimi AF Registry ―

著者: Masaharu Akao Hisashi Ogawa Nobutoyo Masunaga Kimihito Minami Kenjiro Ishigami Syuhei Ikeda Kosuke Doi Yasuhiro Hamatani Takashi Yoshizawa Yuya Ide Akiko Fujino Mitsuru Ishii Moritake Iguchi Hiromichi Wada Koji Hasegawa Hikari Tsuji Masahiro Esato Mitsuru Abe for the Fushimi AF Registry Investigators
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-22-0023, (Released:2022-03-13)
参考文献数: 32
被引用文献数: 15

Background:Atrial fibrillation (AF) increases the risk of stroke and death. Oral anticoagulants (OAC) are highly effective in reducing the risk of stroke, and direct oral anticoagulants (DOAC) became available worldwide in 2011.Methods and Results:The Fushimi AF Registry is an on-going prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. The study cohort consisted of 4,489 patients (mean age 73.6 years, 59.6% male, mean CHADS2score 2.03), enrolled in 2011–2017. From 2011 to 2021, antithrombotic therapy has undergone a major transition; the proportion of patients receiving OAC has increased from 53% to 70%, with a steady uptake of DOAC (from 2% to 52%), whereas the proportion of patients receiving antiplatelet agents has decreased from 32% to 14%. Over a median follow-up of 5.1 years, the incidence of stroke/systemic embolism (SE), major bleeding, and all-cause death was 2.2%, 1.9%, and 4.9% per patient-year, respectively. The incidence of stroke/SE (1.6% vs. 2.3%; P<0.01), major bleeding (1.6% vs. 2.0%; P=0.07), and death (4.2% vs. 5.0%; P<0.01) was lower among patients enrolled in 2014–2017 than in 2011–2013, despite comparable baseline characteristics (age 73.2 vs. 73.7 years, CHADS2score 2.03 vs. 2.04, and HAS-BLED score 1.67 vs. 1.77, respectively).Conclusions:Over the past 10 years, there has been a major transition in antithrombotic therapy and a decline in the incidence of adverse events in AF patients.

2022-03-22 07:15:11
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2 0 0 0 OA Guideline-Adherent Treatment for Stroke and Death in Atrial Fibrillation Patients From UK and Japanese AF Registries

著者: Kazuo Miyazawa Hisashi Ogawa Michał Mazurek Eduard Shantsila Deirdre A. Lane Andreas Wolff Masaharu Akao Gregory Y.H. Lip
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-19-0546, (Released:2019-11-06)
参考文献数: 31
被引用文献数: 6

Background:Guideline-adherent antithrombotic treatment (ATT) reduces the risk of stroke and death in patients with atrial fibrillation (AF). However, the effect of ATT adherence among different ethnicities remains uncertain. We compared the prognosis of AF patients in Japan and the UK according to guideline adherence status.Methods and Results:We compared the clinical characteristics and outcomes of AF patients from the Fushimi AF registry (Japan; n=4,239) and the Darlington AF registry (UK; n=2,259). ATT adherence was assessed against the Japanese Circulation Society Guidelines and UK National Institute for Health and Care Excellence guidelines. The rates of guideline-adherent ATT were 58.6% and 50.8% in the Fushimi and Darlington registries, respectively. There was no significant difference in 1-year stroke rates between Fushimi and Darlington (2.6% vs. 3.0%, P=0.342). On multivariate logistic regression analysis, non-guideline adherent-ATT was significantly associated with an increased risk of stroke (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.21–2.34, P=0.002 for undertreatment, OR: 2.13, 95% CI: 1.19–3.80, P=0.010 for overtreatment). No significant interaction for ATT and the 2 populations was found in the incidence of stroke, all-cause death, and the composite outcome.Conclusions:Approximately half of the AF patients received optimal ATT according to guideline recommendations, which was associated with a lower risk of stroke. Furthermore, there was no interaction for the 2 populations and the influence of ATT adherence.

2019-11-06 08:15:29
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2 0 0 0 OA Current Status, Time Trends and Outcomes of Combination Therapy With Oral Anticoagulant and Antiplatelet Drug in Patients With Atrial Fibrillation ― The Fushimi AF Registry ―

著者: Nobutoyo Masunaga Mitsuru Abe Hisashi Ogawa Yuya Aono Syuhei Ikeda Kosuke Doi Yoshimori An Mitsuru Ishii Moritake Iguchi Masahiro Esato Hikari Tsuji Hiromichi Wada Koji Hasegawa Gregory Y.H. Lip Masaharu Akao on behalf of the Fushimi AF Registry Investigators
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.82, no.12, pp.2983-2991, 2018-11-24 (Released:2018-11-24)
参考文献数: 28
被引用文献数: 16

Background: The combination of oral anticoagulant (OAC) and antiplatelet drug (APD) increases the bleeding risk in atrial fibrillation (AF). Non-vitamin K antagonist OAC (NOAC) have been increasingly used since 2011. We investigated current status, time trends and outcomes of AF patients using combination therapy in 2011–2017. Methods and Results: The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. Of 2,378 patients with OAC at enrollment, 521 (22%) received combination therapy, while 1,857 (78%) received OAC alone. When compared with OAC alone, combination therapy patients had more comorbidities, but approximately 30% had no atherosclerotic disease. From 2011 to 2017, the prevalence of combination therapy decreased from 26% to 14%. The prevalence of NOAC increased in those on combination therapy. Off-label under-dosing of NOAC increased year by year, especially in combination therapy. During follow-up, the incidence of major bleeding (hazard ratio [HR], 1.42; 95% CI: 1.03–1.95) and stroke/systemic embolism (HR, 1.48; 95% CI: 1.09–2.00) was higher in the combination therapy than in the OAC alone group. Conclusions: In Japanese AF patients receiving OAC, the prevalence of combination therapy decreased, with the proportion of NOAC use increasing in 2011–2017. Many patients, however, received off-label NOAC under-dosing, especially in the combination therapy group. Patients with combination therapy had higher incidences of major bleeding as well as stroke/systemic embolism, compared with OAC monotherapy.

2018-11-24 13:08:41
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2 0 0 0 OA Current Status, Time Trends and Outcomes of Combination Therapy With Oral Anticoagulant and Antiplatelet Drug in Patients With Atrial Fibrillation ― The Fushimi AF Registry ―

著者: Nobutoyo Masunaga Mitsuru Abe Hisashi Ogawa Yuya Aono Syuhei Ikeda Kosuke Doi Yoshimori An Mitsuru Ishii Moritake Iguchi Masahiro Esato Hikari Tsuji Hiromichi Wada Koji Hasegawa Gregory Y.H. Lip Masaharu Akao on behalf of the Fushimi AF Registry Investigators
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-18-0872, (Released:2018-10-31)
参考文献数: 28
被引用文献数: 16

2018-11-05 14:09:22
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2 0 0 0 OA Sex-Related Differences in the Clinical Events of Patients With Atrial Fibrillation ― The Fushimi AF Registry ―

著者: Hisashi Ogawa Yasuhiro Hamatani Kosuke Doi Yuji Tezuka Yoshimori An Mitsuru Ishii Moritake Iguchi Nobutoyo Masunaga Masahiro Esato Yeong-Hwa Chun Hikari Tsuji Hiromichi Wada Koji Hasegawa Mitsuru Abe Gregory YH Lip Masaharu Akao on behalf of the Fushimi AF Registry Investigators
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.81, no.10, pp.1403-1410, 2017-09-25 (Released:2017-09-25)
参考文献数: 33
被引用文献数: 13

2 0 0 0 OA Low Body Weight Is Associated With the Incidence of Stroke in Atrial Fibrillation Patients

著者: Yasuhiro Hamatani Hisashi Ogawa Ryuji Uozumi Moritake Iguchi Yugo Yamashita Masahiro Esato Yeong-Hwa Chun Hikari Tsuji Hiromichi Wada Koji Hasegawa Mitsuru Abe Satoshi Morita Masaharu Akao
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-14-1245, (Released:2015-02-13)
参考文献数: 33
被引用文献数: 9 59

Background:Japanese patients with atrial fibrillation (AF) are generally small and lean, but knowledge of the clinical characteristics of those with low body weight (LBW: ≤50 kg) is limited.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical institutions in Fushmi-ku, Japan. The BW and follow-up data were available for 2,945 patients. We compared the background and the incidence of clinical events during a median follow-up of 746 days between a LBW and non-LBW group. Patients in the LBW group accounted for 26.8% (788 patients) of the total. The LBW group was more often female, older, and had higher CHADS2score. The incidence of stroke/systemic embolism (SE) during follow-up was higher in the LBW group (hazard ratio (HR): 2.19, 95% confidence interval (CI): 1.57–3.04; P<0.01), whereas that of major bleeding was comparable (HR: 1.05, 95% CI: 0.64–1.68; P=0.84). This trend was consistently observed in the subgroups stratified by age, sex, and oral anticoagulant prescription at baseline. Multivariate analysis as well as propensity-score matching analysis further supported the significance of LBW as a risk of stroke/SE.Conclusions:Patients in the LBW group had high risk profiles and showed a higher incidence of stroke/SE, but the incidence of major bleeding was not particularly high.

2015-02-13 14:42:32
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2 0 0 0 OA Incidence of Ischemic Stroke in Japanese Patients With Atrial Fibrillation Not Receiving Anticoagulation Therapy

著者: Shinya Suzuki Takeshi Yamashita Ken Okumura Hirotsugu Atarashi Masaharu Akao Hisashi Ogawa Hiroshi Inoue
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-14-1131, (Released:2014-12-11)
参考文献数: 26
被引用文献数: 16 97

Background:The incidence rate of ischemic stroke in Japanese non-valvular atrial fibrillation (NVAF) patients without anticoagulation therapy remains unclear.Methods and Results:We performed a pooled analysis of 3,588 patients from the Shinken Database (n=1,099), J-RHYTHM Registry (n=1,002), and Fushimi AF Registry (n=1,487) to determine the incidence rate of ischemic stroke in Japanese NVAF patients without anticoagulation therapy. Average patient age was 68.1 years. During the follow-up period (total, 5,188 person-years; average, 1.4 years), 69 patients suffered from ischemic stroke (13.3 per 1,000 person-years; 95% confidence intervals [CI]: 10.5–16.8). The incidence rates of ischemic stroke were 5.4, 9.3, and 24.7 per 1,000 person-years and 5.3, 5.5, and 18.4 per 1,000 person-years in patients with low (0), intermediate (1), and high (≥2) CHADS2 and CHA2DS2-VASc scores, respectively. History of ischemic stroke or transient ischemic attack (hazard ratio [HR], 3.25; 95% CI: 1.86–5.67), age ≥75 years (HR, 2.31; 95% CI: 1.18–4.52), and hypertension (HR, 1.69; 95% CI: 1.01–2.86) were independent risk factors for ischemic stroke.Conclusions:A low incidence rate of ischemic stroke was observed in Japanese NVAF patients except for those with CHADS2 score ≥2. In this pooled analysis, history of ischemic stroke or transient ischemic attack, advanced age, and hypertension were identified as independent risk factors for ischemic stroke.

2014-12-11 06:09:44
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1 0 0 0 OA Association of Concomitant Coronary Artery Disease With Cardiovascular Events in Patients With Atrial Fibrillation ― The Fushimi AF Registry ―

著者: Nobutoyo Masunaga Hisashi Ogawa Kimihito Minami Kenjiro Ishigami Syuhei Ikeda Kosuke Doi Yasuhiro Hamatani Takashi Yoshizawa Yuya Ide Akiko Fujino Mitsuru Ishii Moritake Iguchi Hiromichi Wada Koji Hasegawa Hikari Tsuji Masahiro Esato Mitsuru Abe Masaharu Akao on behalf of the Fushimi AF Registry Investigators
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-22-0180, (Released:2022-07-01)
参考文献数: 22
被引用文献数: 1

Background: Atrial fibrillation (AF) patients often have concomitant coronary artery disease (CAD); however, there are little data on clinical characteristics and outcomes of such patients in daily clinical practice in Japan.Methods and Results: The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. Follow-up data were available for 4,464 patients, and the median follow up was 5.1 (interquartile range: 2.3–8.0) years. History of CAD was present in 647 patients (14%); of those patients, 267 (41%) had history of myocardial infarction (MI). Patients with CAD were older and had more comorbidities than those without CAD. The crude incidences (% per patient-year) of cardiovascular events were significantly higher in patients with CAD than those without CAD (cardiac death: 1.8 vs. 0.7, stroke or systemic embolism [SE]: 2.9 vs. 2.1, MI: 0.6 vs. 0.1, composite of those events: 5.1 vs. 2.8, respectively, all log-rank P<0.01). After multivariate adjustment, concomitant CAD was associated with incidence of cardiac events, and history of MI was associated with incidence of MI; however, neither history of CAD nor MI was associated with the incidence of stroke/SE.Conclusions: In Japanese AF patients, concomitant CAD was associated with higher prevalences of major co-morbidities and higher incidences of cardiovascular events; however, history of CAD was not associated with the incidence of stroke/SE.

2022-07-07 08:25:41
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1 0 0 0 OA Isometric Handgrip Stress Test during Right Heart Catheterization in Patients with Mitral Regurgitation -A Case Series Study-

著者: Yasuhiro Hamatani Moritake Iguchi Kimihito Minami Kenjiro Ishigami Syuhei Ikeda Kosuke Doi Takashi Yoshizawa Yuya Ide Akiko Fujino Mitsuru Ishii Hisashi Ogawa Nobutoyo Masunaga Mitsuru Abe Masaharu Akao
出版者: The Japanese Society of Internal Medicine
雑誌: Internal Medicine (ISSN:09182918)
巻号頁・発行日: vol.61, no.12, pp.1817-1822, 2022-06-15 (Released:2022-06-15)
参考文献数: 21
被引用文献数: 1

Objective The severity of mitral regurgitation (MR) dynamically changes during a stress test. Isometric handgrip is a readily-available stress test in daily practice; however, little is known regarding the response to isometric handgrip in MR patients during right heart catheterization. We aimed to evaluate this issue from our case-series study. Methods We retrospectively investigated consecutive MR patients using the isometric handgrip stress test during right heart catheterization at our institution between October 2019 and April 2021. After resting measurements were obtained, sustained maximum-effort hand dynamometer grasping was maintained for about 2-3 minutes. We investigated the differences in right heart catheterization data between at rest and during handgrip, and evaluated the individual response to the isometric handgrip stress test. Results We investigated a total of 15 patients (mean age: 75±6 years, moderate/severe MR: 7/8, primary/secondary MR: 8/7, mean left ventricular ejection fraction: 56±16%, exertional dyspnea: 10). During the handgrip test, the pulmonary capillary wedge pressure (PCWP) significantly increased [9 (8, 13) mmHg at rest to 20 (15, 27) mmHg during handgrip; p<0.001]. PCWP changes varied among individuals (range 2-22 mmHg) and were not correlated with patients' backgrounds including age, the natriuretic peptide levels, left ventricular ejection fraction, left atrial diameter or E/e' (all p>0.05). Patients with PCWP ≥25 mmHg during handgrip had a higher prevalence of exertional dyspnea than those without [6 (100%) vs. 4 (44%); p=0.04]. Conclusion We observed dynamic and varied hemodynamic changes during isometric handgrip in MR patients, suggesting that further research is needed to evaluate the clinical value of this maneuver.

2022-06-17 23:11:34
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1 0 0 0 OA A Novel Risk Stratification System for Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation

著者: Ken Okumura Hirofumi Tomita Michikazu Nakai Eitaro Kodani Masaharu Akao Shinya Suzuki Kenshi Hayashi Mitsuaki Sawano Masahiko Goya Takeshi Yamashita Keiichi Fukuda Hisashi Ogawa Toyonobu Tsuda Mitsuaki Isobe Kazunori Toyoda Yoshihiro Miyamoto Hiroaki Miyata Tomonori Okamura Yusuke Sasahara for the J-RISK AF Research Group
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.85, no.8, pp.1254-1262, 2021-07-21 (Released:2021-07-21)
参考文献数: 22
被引用文献数: 1 15

2022-04-10 09:51:51
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1 0 0 0 OA Clinical Characteristics and Outcomes of Very Elderly Patients With Atrial Fibrillation at High Bleeding Risk ― The Fushimi AF Registry ―

著者: Yuya Ide Hisashi Ogawa Kenjiro Ishigami Syuhei Ikeda Kosuke Doi Yasuhiro Hamatani Akiko Fujino Yoshimori An Mitsuru Ishii Moritake Iguchi Nobutoyo Masunaga Masahiro Esato Hikari Tsuji Hiromichi Wada Koji Hasegawa Mitsuru Abe Gregory Y.H. Lip Masaharu Akao for the Fushimi AF Registry Investigators
出版者: The Japanese Circulation Society
雑誌: Circulation Reports (ISSN:24340790)
巻号頁・発行日: vol.3, no.11, pp.629-638, 2021-11-10 (Released:2021-11-10)
参考文献数: 19
被引用文献数: 2

Background:The ELDERCARE-AF trial demonstrated that low-dose edoxaban prevented stroke or systemic embolism (SE) in very elderly Japanese patients with non-valvular atrial fibrillation (NVAF) in whom standard oral anticoagulant therapy was inappropriate because of high bleeding risk. The aim of this study was to elucidate the characteristics and outcomes of such patients in routine clinical practice.Methods and Results:Data were extracted from the Fushimi AF Registry for ELDERCARE-eligible NVAF patients aged ≥80 years, with a CHADS2score ≥2 and ≥1 bleeding risk factors, as shown in the ELDERCARE-AF trial. ELDERCARE-eligible patients (n=549; 12.8% of the entire cohort, 52.9% of those aged ≥80 years and with CHADS2score ≥2) were less often male, were older, had more comorbidity and higher risk scores than non-eligible patients from the entire cohort (n=3,734). The crude incidence (% per patient-year) of adverse events was significantly higher in ELDERCARE-eligible than non-eligible patients (stroke/SE, 4.8% vs. 2.0%; major bleeding, 3.6% vs. 1.9%; all-cause mortality, 15.5% vs. 3.9%; cardiovascular death, 2.7% vs. 0.6%; all log-rank P<0.001). Compared with non-eligible patients aged ≥80 years and with a CHADS2score ≥2 (n=488), the incidence of stroke/SE, all-cause mortality, and cardiovascular death remained significantly higher in ELDERCARE-eligible patients.Conclusions:Patients with NVAF who met the inclusion criteria of the ELDERCARE-AF trial were common in routine clinical practice, and had poor clinical outcomes.

2021-11-27 00:46:22
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1 0 0 0 OA Incidence of Ischemic Stroke in Japanese Patients With Atrial Fibrillation Not Receiving Anticoagulation Therapy

著者: Shinya Suzuki Takeshi Yamashita Ken Okumura Hirotsugu Atarashi Masaharu Akao Hisashi Ogawa Hiroshi Inoue
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.79, no.2, pp.432-438, 2015-01-23 (Released:2015-01-23)
参考文献数: 26
被引用文献数: 16 97

2015-03-09 23:47:10
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