著者

Hitoshi Ogino Osamu Iida Koichi Akutsu Yoshiro Chiba Hiromitsu Hayashi Hatsue Ishibashi-Ueda Shuichiro Kaji Masaaki Kato Kimihiro Komori Hitoshi Matsuda Kenji Minatoya Hiroko Morisaki Takao Ohki Yoshikatsu Saiki Kunihiro Shigematsu Norihiko Shiiya Hideyuki Shimizu Nobuyoshi Azuma Hirooki Higami Shigeo Ichihashi Toru Iwahashi Kentaro Kamiya Takahiro Katsumata Nobuyoshi Kawaharada Yoshihisa Kinoshita Takuya Matsumoto Shinji Miyamoto Takayuki Morisaki Tetsuro Morota Kiyonori Nanto Toshiya Nishibe Kenji Okada Kazumasa Orihashi Junichi Tazaki Masanao Toma Takuro Tsukube Keiji Uchida Tatsuo Ueda Akihiko Usui Kazuo Yamanaka Haruo Yamauchi Kunihiro Yoshioka Takeshi Kimura Tetsuro Miyata Yutaka Okita Minoru Ono Yuichi Ueda on behalf of the Japanese Circulation Society the Japanese Society for Cardiovascular Surgery the Japanese Association for Thoracic Surgery and the Japanese Society for Vascular Surgery Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0794, (Released:2023-09-01)

参考文献数

1943

被引用文献数

7

著者

Yosuke Hata Osamu Iida Mitsutoshi Asai Masaharu Masuda Shin Okamoto Takayuki Ishihara Kiyonori Nanto Takashi Kanda Takuya Tsujumura Shota Okuno Yasuhiro Matsuda Mitsuyoshi Takahara Toshiaki Mano

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.57711, (Released:2020-07-23)

参考文献数

11

被引用文献数

13

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Aim: The latest Global Vascular Guidelines (GVG) recommend assessing the 2-year mortality risk in patients with chronic limb-threatening ischemia (CLTI) before revascularization. This study aimed to reveal whether the Wound, Ischemia and foot Infection (WIfI) classification, developed originally as a risk assessment tool for limb prognosis, would be useful in predicting the 2-year mortality risk in patients with CLTI in the era of GVG and WIfI. Methods: We retrospectively analyzed 849 patients with CLTI who were primarily treated with endovascular therapy (EVT) between April 2010 and December 2016. The impact of baseline characteristics, including the WIfI classification on mortality risk, was investigated using the Cox proportional hazards regression model. Results: During a mean follow-up of 19.3 months, 243 deaths were observed. The 2-year mortality rate was 32.3%. Multivariate analysis demonstrated that WIfI classification stages (p=0.037), in addition to male sex (p=0.010), age (p<0.001), non-ambulatory status (p<0.001), body mass index (p=0.002), and hemodialysis (p <0.001), were independent predictors for an increased risk of mortality, while the Rutherford classification was not. Conclusions: WIfI classification stages were independently associated with mortality risk in patients with CLTI undergoing EVT, while the Rutherford classification was not. The WIfI classification would be a practical tool for planning the revascularization strategy in CLTI treatment.

著者

Aki Tsuji Masaharu Masuda Mitsutoshi Asai Osamu Iida Shin Okamoto Takayuki Ishihara Kiyonori Nanto Takashi Kanda Takuya Tsujimura Yasuhiro Matsuda Shota Okuno Yosuke Hata Toshiaki Mano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0191, (Released:2020-07-17)

参考文献数

18

被引用文献数

8

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Background:The purpose of this study was to elucidate the effect of the temporal relationship between atrial fibrillation (AF) and heart failure (HF) on clinical outcomes after catheter ablation.Methods and Results:We included 129 consecutive patients with AF and HF who underwent catheter ablation in hospital from December 2014 to September 2017. The patients were divided into 2 groups based on the temporal relationship between AF and HF. Group 1 consisted of 42 patients with AF following HF while Group 2 consisted of 87 patients with AF preceding HF or those who developed both of them simultaneously at the timing of first visit to a doctor. The primary endpoint was a composite of death and hospitalization due to HF during a 2-year follow-up. AF recurrence was more common in Group 1 (45% vs. 23%; hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.25–4.94; P=0.009). Death and HF hospitalization were more frequent in Group 1 (19 [45%], 6 [7%] patients, respectively, P<0.0001). After adjustment for several covariates, patients in Group 1 were independently associated with poorer outcomes after AF ablation (HR, 8.66; 95% CI, 2.942–5.5; P<0.0001).Conclusions:Adverse clinical outcomes of death, HF hospitalization and AF recurrence were more frequent in patients with AF following HF than in those with AF preceding HF.

著者

Yosuke Hata Osamu Iida Shin Okamoto Takayuki Ishihara Kiyonori Nanto Takuya Tsujimura Naoko Higashino Taku Toyoshima Ikurou Kitano Yoshihiko Tsuji Mitsuyoshi Takahara Toshiaki Mano

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.63773, (Released:2022-08-27)

参考文献数

25

被引用文献数

1

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Aims: This study aimed to investigate the long-term impact of guideline-directed medical therapy (GDMT) on 10-year mortality in patients with chronic limb-threatening ischaemia (CLTI) after revascularization. Methods: We performed a retrospective multicentre study enrolle 459 patients with CLTI who underwent revascularization (396 endovascular therapy [EVT] and 63 bypass surgery [BSX] cases) between January 2007 and December 2011. The primary outcome measure was all-cause mortality. We additionally explored the predictors for all-cause mortality using Cox regression hazard models; the influence of GDMT, defined as prescription of antiplatelet agents, statins, and angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) in aggregate, on all-cause mortality, and the association between baseline characteristics using interaction effects. Results: During the 10-year follow-up after revascularization, 234 patients died. In Kaplan-Meier analysis, 10-year mortality was significantly lower in patients who received statins (p<.001) and ACE inhibitors or ARBs (p=.010) than those who did not. However, there were no differences in 10-year mortality between patients who received anti-platelet agents and those who did not (p=.62). Interaction analysis revealed that GDMT had a significantly different hazard ratio in patients who were and were not on hemodialysis and in those treated with EVT or BSX (p for interaction =.002 and .044, respectively). In the multivariate analysis, age >75 years, non-ambulatory status, hemodialysis, congestive heart failure, left ventricular ejection fraction <50%, and GDMT were significantly associated with all-cause mortality. Conclusions: Appropriate GDMT use was independently associated with 10-year mortality in patients with CLTI after revascularization.