- 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
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
- Tadatomo Fukushima Masato Fukunaga Akihiro Isotani Miho Nakamura Ko Yamamoto Kenichi Ishizu Takashi Morinaga Shinichi Shirai Kenji Ando
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0553, (Released:2023-11-30)
- 参考文献数
- 12
Background: Left atrial appendage closure (LAAC) usually requires contrast medium during the procedure. However, patients with chronic kidney disease (CKD) are at high risk of developing contrast nephropathy. This study aimed to assess the safety and feasibility of zero-contrast LAAC in patients with CKD.Methods and Results: Zero-contrast LAAC was attempted in 15 patients with CKD Stages 3b-5 who were not on hemodialysis. All procedures were performed successfully, without any periprocedural complications. At the 45-day follow-up, no device-related complications or acute kidney disease were observed.Conclusions: The strategy of zero-contrast LAAC in patients with CKD can be an acceptable option.
- 著者
- Hirotoshi Watanabe Takeshi Morimoto Ko Yamamoto Yuki Obayashi Masahiro Natsuaki Kyohei Yamaji Manabu Ogita Satoru Suwa Tsuyoshi Isawa Takenori Domei Kenji Ando Shojiro Tatsushima Hiroki Watanabe Masanobu Oya Kazushige Kadota Hideo Tokuyama Tomohisa Tada Hiroki Sakamoto Hiroyoshi Mori Hiroshi Suzuki Tenjin Nishikura Kohei Wakabayashi Takeshi Kimura for the STOPDAPT-2 ACS Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.87, no.5, pp.657-668, 2023-04-25 (Released:2023-04-25)
- 参考文献数
- 28
Background: The REAL-CAD trial, reported in 2017, demonstrated a significant reduction in cardiovascular events with high-intensity statins in patients with chronic coronary syndrome. However, data are scarce on the use of high-intensity statins in Japanese patients with acute coronary syndrome (ACS).Methods and Results: In STOPDAPT-2 ACS, which exclusively enrolled ACS patients between March 2018 and June 2020, 1,321 (44.2%) patients received high-intensity statins at discharge, whereas of the remaining 1,667 patients, 96.0% were treated with low-dose statins. High-intensity statins were defined as the maximum approved doses of strong statins in Japan. The incidence of the cardiovascular composite endpoint (cardiovascular death, myocardial infarction, definite stent thrombosis, stroke) was significantly lower in patients with than without high-intensity statins (1.44% vs. 2.69% [log-rank P=0.025]; adjusted hazard ratio [aHR] 0.48, 95% confidence interval [CI] 0.24–0.94, P=0.03) and the effect was evident beyond 60 days after the index percutaneous coronary intervention (log-rank P=0.01; aHR 0.38, 95% CI 0.17–0.86, P=0.02). As for the bleeding endpoint, there was no significant difference between the 2 groups (0.99% vs. 0.73% [log-rank P=0.43]; aHR 0.96, 95% CI 0.35–2.60, P=0.93).Conclusions: The prevalence of high-intensity statins has increased substantially in Japan. The use of the higher doses of statins in ACS patients recommended in the guidelines was associated with a significantly lower risk of the primary cardiovascular composite endpoint compared with lower-dose statins.
- 著者
- Hirotoshi Watanabe Takeshi Morimoto Ko Yamamoto Yuki Obayashi Masahiro Natsuaki Kyohei Yamaji Manabu Ogita Satoru Suwa Tsuyoshi Isawa Takenori Domei Kenji Ando Shojiro Tatsushima Hiroki Watanabe Masanobu Oya Kazushige Kadota Hideo Tokuyama Tomohisa Tada Hiroki Sakamoto Hiroyoshi Mori Hiroshi Suzuki Tenjin Nishikura Kohei Wakabayashi Takeshi Kimura for the STOPDAPT-2 ACS Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-22-0650, (Released:2022-12-08)
- 参考文献数
- 28
Background: The REAL-CAD trial, reported in 2017, demonstrated a significant reduction in cardiovascular events with high-intensity statins in patients with chronic coronary syndrome. However, data are scarce on the use of high-intensity statins in Japanese patients with acute coronary syndrome (ACS).Methods and Results: In STOPDAPT-2 ACS, which exclusively enrolled ACS patients between March 2018 and June 2020, 1,321 (44.2%) patients received high-intensity statins at discharge, whereas of the remaining 1,667 patients, 96.0% were treated with low-dose statins. High-intensity statins were defined as the maximum approved doses of strong statins in Japan. The incidence of the cardiovascular composite endpoint (cardiovascular death, myocardial infarction, definite stent thrombosis, stroke) was significantly lower in patients with than without high-intensity statins (1.44% vs. 2.69% [log-rank P=0.025]; adjusted hazard ratio [aHR] 0.48, 95% confidence interval [CI] 0.24–0.94, P=0.03) and the effect was evident beyond 60 days after the index percutaneous coronary intervention (log-rank P=0.01; aHR 0.38, 95% CI 0.17–0.86, P=0.02). As for the bleeding endpoint, there was no significant difference between the 2 groups (0.99% vs. 0.73% [log-rank P=0.43]; aHR 0.96, 95% CI 0.35–2.60, P=0.93).Conclusions: The prevalence of high-intensity statins has increased substantially in Japan. The use of the higher doses of statins in ACS patients recommended in the guidelines was associated with a significantly lower risk of the primary cardiovascular composite endpoint compared with lower-dose statins.
- 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
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
- 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
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.