著者

Shin Takayama Tetsuhiro Yoshino Sayaka Koizumi Yasuhito Irie Tomoko Suzuki Susumu Fujii Rie Katori Mosaburo Kainuma Seiichi Kobayashi Tatsuya Nogami Kenichi Yokota Mayuko Yamazaki Satoko Minakawa Shigeki Chiba Norio Suda Yoshinobu Nakada Tatsuya Ishige Hirofumi Maehara Yutaka Tanaka Mahiko Nagase Akihiko Kashio Kazuhisa Komatsu Makoto Nojiri Osamu Shimooki Kayo Nakamoto Ryutaro Arita Rie Ono Natsumi Saito Akiko Kikuchi Minoru Ohsawa Hajime Nakae Tadamichi Mitsuma Masaru Mimura Tadashi Ishii Kotaro Nochioka Shih-Wei Chiu Takuhiro Yamaguchi Takao Namiki Akito Hisanaga Kazuo Mitani Takashi Ito

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0027-22, (Released:2022-11-02)

参考文献数

41

被引用文献数

3

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Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature <37 °C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.

著者

Hiroyuki Tsutsui Mitsuaki Isobe Hiroshi Ito Hiroshi Ito Ken Okumura Minoru Ono Masafumi Kitakaze Koichiro Kinugawa Yasuki Kihara Yoichi Goto Issei Komuro Yoshikatsu Saiki Yoshihiko Saito Yasushi Sakata Naoki Sato Yoshiki Sawa Akira Shiose Wataru Shimizu Hiroaki Shimokawa Yoshihiko Seino Koichi Node Taiki Higo Atsushi Hirayama Miyuki Makaya Tohru Masuyama Toyoaki Murohara Shin-ichi Momomura Masafumi Yano Kenji Yamazaki Kazuhiro Yamamoto Tsutomu Yoshikawa Michihiro Yoshimura Masatoshi Akiyama Toshihisa Anzai Shiro Ishihara Takayuki Inomata Teruhiko Imamura Yu-ki Iwasaki Tomohito Ohtani Katsuya Onishi Takatoshi Kasai Mahoto Kato Makoto Kawai Yoshiharu Kinugasa Shintaro Kinugawa Toru Kuratani Shigeki Kobayashi Yasuhiko Sakata Atsushi Tanaka Koichi Toda Takashi Noda Kotaro Nochioka Masaru Hatano Takayuki Hidaka Takeo Fujino Shigeru Makita Osamu Yamaguchi Uichi Ikeda Takeshi Kimura Shun Kohsaka Masami Kosuge Masakazu Yamagishi Akira Yamashina on behalf of the Japanese Circulation Society and the Japanese Heart Failure Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.10, pp.2084-2184, 2019-09-25 (Released:2019-09-25)

参考文献数

608

被引用文献数

425

著者

Takeshi Yamauchi Yasuhiko Sakata Masanobu Miura Takeo Onose Kanako Tsuji Ruri Abe Takuya Oikawa Shintaro Kasahara Masayuki Sato Kotaro Nochioka Takashi Shiroto Jun Takahashi Satoshi Miyata Hiroaki Shimokawa on behalf of the CHART-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-16-0759, (Released:2017-01-14)

参考文献数

52

被引用文献数

19

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Background:The prognostic impact of atrial fibrillation (AF) among patients at high risk for heart failure (HF) remains unclear. In addition, there is no risk estimation model for AF development in these patients.Methods and Results:The present study included 5,382 consecutive patients at high risk of HF enrolled in the CHART-2 Study (n=10,219). At enrollment, 1,217 (22.6%) had AF, and were characterized, as compared with non-AF patients, by higher age, lower estimated glomerular filtration rate, higher B-type natriuretic peptide (BNP) level and lower left ventricular ejection fraction. A total of 116 non-AF patients (2.8%) newly developed AF (new AF) during the median 3.1-year follow-up. AF at enrollment was associated with worse prognosis for both all-cause death and HF hospitalization (adjusted hazard ratio (aHR) 1.31, P=0.027 and aHR 1.74, P=0.001, for all-cause death and HF hospitalization, respectively) and new AF was associated with HF hospitalization (aHR 4.54, P<0.001). We developed a risk score with higher age, smoking, pulse pressure, lower eGFR, higher BNP, aortic valvular regurgitation, LV hypertrophy, and left atrial and ventricular dilatation on echocardiography, which effectively stratified the risk of AF development with excellent accuracy (AUC 0.76).Conclusions:These results indicated that AF is associated with worse prognosis in patients at high risk of HF, and our new risk score may be useful to identify patients at high risk for AF onset.

著者

Masato Takase Mitsuhiro Yamada Tomohiro Nakamura Naoki Nakaya Mana Kogure Rieko Hatanaka Kumi Nakaya Ippei Chiba Ikumi Kanno Kotaro Nochioka Naho Tsuchiya Takumi Hirata Yohei Hamanaka Junichi Sugawara Tomoko Kobayashi Nobuo Fuse Akira Uruno Eiichi N Kodama Shinichi Kuriyama Ichiro Tsuji Atsushi Hozawa

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220355, (Released:2023-04-08)

参考文献数

44

被引用文献数

1

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Background: Although fat mass index (FMI) and fat-free mass index (FFMI) affect lung function, FMI and FFMI are not independent of each other since FMI and FFMI were calculated as fat mass and fat-free mass divided by height squared, respectively. We aimed to examine the association of combined FMI and FFMI with lung function.Methods: In this cross-sectional study, lung function was evaluated using forced expiratory volume at 1 s and forced vital capacity was measured using spirometry. Both FMI and FFMI were classified into sex-specific quartiles (16 groups). Analysis of covariance was used to assess the associations of combined FMI and FFMI with lung function. The trend test was conducted by stratifying the FMI and FFMI, scoring the categories from 1–4 (lowest–highest), and entering the number as a continuous term in the regression model.Results: This study included 3,736 men and 8,821 women aged ≥20 years living in Miyagi Prefecture, Japan. The mean FEV1 (standard deviation) was 3.0 (0.7) L for men and 2.3 (0.5) L for women. The mean FVC was 3.8 (0.7) L for men and 2.8 (0.5) L for women. The FMI was inversely associated with lung function among all FFMI subgroups in both sexes. Conversely, FFMI was positively associated with lung function in all FMI subgroups in both sexes.Conclusions: Higher FMI was associated with lower lung function independent of FFMI; higher FFMI was associated with higher lung function independent of FMI. Reducing FMI and maintaining FFMI might be important for respiratory health.

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

Kotaro Nochioka Yasuhiko Sakata Satoshi Miyata Masanobu Miura Tsuyoshi Takada Soichiro Tadaki Ryoichi Ushigome Takeshi Yamauchi Jun Takahashi Hiroaki Shimokawa on behalf of the CHART-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-14-0865, (Released:2015-01-08)

参考文献数

41

被引用文献数

12 52

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Background:The effectiveness of statins remains to be examined in patients with heart failure (HF) with preserved ejection fraction (EF).Methods and Results:Among 4,544 consecutive HF patients registered in the Chronic Heart Failure Registry and Analysis in the Tohoku district-2 (CHART-2) between 2006 and 2010, 3,124 had EF ≥50% (HFpEF; mean age 69 years; male 65%) and 1,420 had EF <50% (HF with reduced EF (HFrEF); mean age 67 years; male 75%). The median follow-up was 3.4 years. The 3-year mortality in HFpEF patients was lower in patients receiving statins [8.7% vs. 14.5%, adjusted hazard ratio (HR) 0.74; 95% confidence interval (CI), 0.58–0.94; P<0.001], which was confirmed in the propensity score-matched cohort (HR, 0.72; 95% CI, 0.49–0.99; P=0.044). The inverse probability of treatment weighted further confirmed that statin use was associated with reduced incidence of all-cause death (HR, 0.71; 95% CI, 0.62–0.82, P<0.001) and noncardiovascular death (HR, 0.53; 95% CI, 0.43–0.66, P<0.001), specifically reduction of sudden death (HR, 0.59; 95% CI, 0.36–0.98, P=0.041) and infection death (HR, 0.53; 95% CI, 0.35–0.77, P=0.001) in HFpEF. In the HFrEF cohort, statin use was not associated with mortality (HR, 0.87; 95% CI, 0.73–1.04, P=0.12), suggesting a lack of statin benefit in HFrEF patients.Conclusions:These results suggest that statin use is associated with improved mortality rates in HFpEF patients, mainly attributable to reductions in sudden death and noncardiovascular death.

著者

Masato Takase Naoki Nakaya Tomohiro Nakamura Mana Kogure Rieko Hatanaka Kumi Nakaya Ippei Chiba Ikumi Kanno Kotaro Nochioka Naho Tsuchiya Takumi Hirata Akira Narita Taku Obara Mami Ishikuro Akira Uruno Tomoko Kobayashi Eiichi N Kodama Yohei Hamanaka Masatsugu Orui Soichi Ogishima Satoshi Nagaie Nobuo Fuse Junichi Sugawara Shinichi Kuriyama Ichiro Tsuji Gen Tamiya Atsushi Hozawa Masayuki Yamamoto the ToMMo investigators

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.64425, (Released:2023-10-06)

参考文献数

42

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Aim: The influence of family history of diabetes, probably reflecting genetic and lifestyle factors, on the association of combined genetic and lifestyle risks with diabetes is unknown. We examined these associations. Methods: This cross-sectional study included 9,681 participants in the Tohoku Medical Megabank Community-based Cohort Study. A lifestyle score, which was categorized into ideal, intermediate, and poor lifestyles, was given. Family history was obtained through a self-reported questionnaire. A polygenic risk score (PRS) was constructed in the target data (n=1,936) using publicly available genome-wide association study summary statistics from BioBank Japan. For test data (n=7,745), we evaluated PRS performance and examined the associations of combined family history and genetic and lifestyle risks with diabetes. Diabetes was defined as non-fasting blood glucose ≥ 200 mmHg, HbA1c ≥ 6.5%, and/or self-reported diabetes treatment. Results: In test data, 467 (6.0%) participants had diabetes. Compared with a low genetic risk and an ideal lifestyle without a family history, the odds ratio (OR) was 3.73 (95% confidence interval [CI], 1.92–7.00) for a lower genetic risk and a poor lifestyle without a family history. Family history was significantly associated with diabetes (OR, 3.58 [95% CI, 1.73–6.98]), even in those with a low genetic risk and an ideal lifestyle. Even among participants who had an ideal lifestyle without a family history, a high genetic risk was associated with diabetes (OR, 2.49 [95% CI, 1.65–3.85]). Adding PRS to family history and conventional lifestyle risk factors improved the prediction ability for diabetes. Conclusions: Our findings support the notion that a healthy lifestyle is important to prevent diabetes regardless of genetic risk.

著者

Atsushi Hozawa Kozo Tanno Naoki Nakaya Tomohiro Nakamura Naho Tsuchiya Takumi Hirata Akira Narita Mana Kogure Kotaro Nochioka Ryohei Sasaki Nobuyuki Takanashi Kotaro Otsuka Kiyomi Sakata Shinichi Kuriyama Masahiro Kikuya Osamu Tanabe Junichi Sugawara Kichiya Suzuki Yoichi Suzuki Eiichi N Kodama Nobuo Fuse Hideyasu Kiyomoto Hiroaki Tomita Akira Uruno Yohei Hamanaka Hirohito Metoki Mami Ishikuro Taku Obara Tomoko Kobayashi Kazuyuki Kitatani Takako Takai-Igarashi Soichi Ogishima Mamoru Satoh Hideki Ohmomo Akito Tsuboi Shinichi Egawa Tadashi Ishii Kiyoshi Ito Sadayoshi Ito Yasuyuki Taki Naoko Minegishi Naoto Ishii Masao Nagasaki Kazuhiko Igarashi Seizo Koshiba Ritsuko Shimizu Gen Tamiya Keiko Nakayama Hozumi Motohashi Jun Yasuda Atsushi Shimizu Tsuyoshi Hachiya Yuh Shiwa Teiji Tominaga Hiroshi Tanaka Kotaro Oyama Ryoichi Tanaka Hiroshi Kawame Akimune Fukushima Yasushi Ishigaki Tomoharu Tokutomi Noriko Osumi Tadao Kobayashi Fuji Nagami Hiroaki Hashizume Tomohiko Arai Yoshio Kawaguchi Shinichi Higuchi Masaki Sakaida Ryujin Endo Satoshi Nishizuka Ichiro Tsuji Jiro Hitomi Motoyuki Nakamura Kuniaki Ogasawara Nobuo Yaegashi Kengo Kinoshita Shigeo Kure Akio Sakai Seiichiro Kobayashi Kenji Sobue Makoto Sasaki Masayuki Yamamoto

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.1, pp.65-76, 2021-01-05 (Released:2021-01-05)

参考文献数

34

被引用文献数

54 66

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Background: We established a community-based cohort study to assess the long-term impact of the Great East Japan Earthquake on disaster victims and gene-environment interactions on the incidence of major diseases, such as cancer and cardiovascular diseases.Methods: We asked participants to join our cohort in the health check-up settings and assessment center based settings. Inclusion criteria were aged 20 years or over and living in Miyagi or Iwate Prefecture. We obtained information on lifestyle, effect of disaster, blood, and urine information (Type 1 survey), and some detailed measurements (Type 2 survey), such as carotid echography and calcaneal ultrasound bone mineral density. All participants agreed to measure genome information and to distribute their information widely.Results: As a result, 87,865 gave their informed consent to join our study. Participation rate at health check-up site was about 70%. The participants in the Type 1 survey were more likely to have psychological distress than those in the Type 2 survey, and women were more likely to have psychological distress than men. Additionally, coastal residents were more likely to have higher degrees of psychological distress than inland residents, regardless of sex.Conclusion: This cohort comprised a large sample size and it contains information on the natural disaster, genome information, and metabolome information. This cohort also had several detailed measurements. Using this cohort enabled us to clarify the long-term effect of the disaster and also to establish personalized prevention based on genome, metabolome, and other omics information.

著者

Masato Takase Naoki Nakaya Tomohiro Nakamura Mana Kogure Rieko Hatanaka Kumi Nakaya Ippei Chiba Ikumi Kanno Kotaro Nochioka Naho Tsuchiya Takumi Hirata Yohei Hamanaka Junichi Sugawara Tomoko Kobayashi Nobuo Fuse Akira Uruno Eiichi N Kodama Shinichi Kuriyama Ichiro Tsuji Atsushi Hozawa

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.64039, (Released:2023-02-11)

参考文献数

56

被引用文献数

2

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Aim: We examined the association between the carotid intima medica thickness (cIMT) and risk factors for atherosclerosis based on the Japan Atherosclerosis Society 2022 Atherosclerosis Prevention Guideline. Methods: Using data from the Tohoku Medical Megabank Community-based Cohort Study, we performed a cross-sectional study that enrolled 13,366 participants (age ≥ 20 years) with an analysis of covariance to assess associations between cIMT and risk factors for atherosclerosis. The maximum common carotid artery was measured using high-resolution B-mode ultrasound. Analysis was conducted in the model adjusted for age, sex, smoking status, drinking status, body mass index (BMI), systolic blood pressure (SBP), glycated hemoglobin (HbA1c), high-density lipoprotein-cholesterol (HDL-C), non-high-density lipoprotein-cholesterol (non-HDL-C), and height. Results: In this study cohort, the average age and cIMT were 57.3 (13.8) years and 0.61 (0.13) mm, respectively, which included 3,988 males (29.8%). Males had a higher cIMT than did the females. Age, height, BMI, SBP, HbA1c, and non-HDL-C were positively associated with cIMT. HDL-C was inversely associated with cIMT. Compared with never drinkers, current drinkers (≥ 46.0 g/day) had a significantly decreased cIMT. Conclusions: The cIMT was associated with atherosclerosis risk factors including age, sex, BMI, SBP, HbA1c, non-HDL-C, and HDL-C, and adequate control of risks in high-risk individuals might be required to prevent atherosclerotic cardiovascular diseases.

著者

Masato Takase Mitsuhiro Yamada Tomohiro Nakamura Naoki Nakaya Mana Kogure Rieko Hatanaka Kumi Nakaya Ikumi Kanno Kotaro Nochioka Naho Tsuchiya Takumi Hirata Yohei Hamanaka Junichi Sugawara Tomoko Kobayashi Nobuo Fuse Akira Uruno Eiichi N Kodama Shinichi Kuriyama Ichiro Tsuji Atsushi Hozawa

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.63826, (Released:2022-11-04)

参考文献数

54

被引用文献数

1

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Aim: Impaired lung function is associated with atherosclerotic vascular events. Carotid intima-media thickness (cIMT) is a marker for subclinical atherosclerosis. However, few studies have examined the association between lung function and cIMT among never smokers or individuals stratified by age. We investigated the association between lung function and cIMT in the Japanese population. Methods: We conducted a cross-sectional study of 3,716 men and 8,765 women aged 20 years or older living in Miyagi Prefecture, Japan. Lung function was evaluated using forced expiratory volume at 1 s (FEV1) and forced vital capacity (FVC) was measured using spirometry. The maximum common carotid artery was measured using high-resolution B-mode ultrasound. An analysis of covariance was used to assess associations between lung function and cIMT and adjusted for potential confounders. A linear trend test was conducted by scoring the categories from 1 (lowest) to 4 (highest) and entering the score as a continuous term in the regression model. Results: After adjusting for potential confounders including passive smoking, lower FEV1 and FVC were associated with higher cIMT in both men and women (P<0.001 for linear trend). This association was confirmed even when we restricted our study to never smokers. Furthermore, even when we stratified by age, an inverse association between lung function and cIMT was confirmed in middle-aged (40-64 years) and elderly participants (65-74 years). Conclusions: Lower lung function was associated with higher cIMT in the Japanese population independent of age and smoking. Assessment of atherosclerosis or lung function may be required for individuals with lower lung function or atherosclerosis.

著者

Saori Yamamoto Tasuku Nagasawa Koichiro Sugimura Atuhiro Kanno Shunsuke Tatebe Tatsuo Aoki Haruka Sato Katsuya Kozu Ryo Konno Kotaro Nochioka Kimio Sato Hiroaki Shimokawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0959-18, (Released:2018-10-17)

参考文献数

16

被引用文献数

7

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Anderson-Fabry disease (AFD) is a rare X-linked disorder caused by deficient activity of the lysosomal enzyme α-galactosidase A (α-GAL A). We herein report 10 cases of AFD in 5 families (3 men and 7 women) that were found to have a specific common mutation in R301Q (G-to-A transition in exon 6 [codon 301] resulting in the replacement of a glutamine with an arginine residue). We evaluated their clinical characteristics, residual enzymatic activity, and plasma concentrations of globotriaosylsphingosine (Lyso-Gb3). Although all 10 cases had cardiac and renal manifestations in common, their clinical manifestations were markedly divergent despite the same genetic abnormality.

著者

Kotaro Nochioka Yasuhiko Sakata Satoshi Miyata Masanobu Miura Tsuyoshi Takada Soichiro Tadaki Ryoichi Ushigome Takeshi Yamauchi Jun Takahashi Hiroaki Shimokawa on behalf of the CHART-2 Investigators’

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.79, no.3, pp.574-582, 2015-02-25 (Released:2015-02-25)

参考文献数

41

被引用文献数

15 52

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Background:The effectiveness of statins remains to be examined in patients with heart failure (HF) with preserved ejection fraction (EF).Methods and Results:Among 4,544 consecutive HF patients registered in the Chronic Heart Failure Registry and Analysis in the Tohoku district-2 (CHART-2) between 2006 and 2010, 3,124 had EF ≥50% (HFpEF; mean age 69 years; male 65%) and 1,420 had EF <50% (HF with reduced EF (HFrEF); mean age 67 years; male 75%). The median follow-up was 3.4 years. The 3-year mortality in HFpEF patients was lower in patients receiving statins [8.7% vs. 14.5%, adjusted hazard ratio (HR) 0.74; 95% confidence interval (CI), 0.58–0.94; P<0.001], which was confirmed in the propensity score-matched cohort (HR, 0.72; 95% CI, 0.49–0.99; P=0.044). The inverse probability of treatment weighted further confirmed that statin use was associated with reduced incidence of all-cause death (HR, 0.71; 95% CI, 0.62–0.82, P<0.001) and noncardiovascular death (HR, 0.53; 95% CI, 0.43–0.66, P<0.001), specifically reduction of sudden death (HR, 0.59; 95% CI, 0.36–0.98, P=0.041) and infection death (HR, 0.53; 95% CI, 0.35–0.77, P=0.001) in HFpEF. In the HFrEF cohort, statin use was not associated with mortality (HR, 0.87; 95% CI, 0.73–1.04, P=0.12), suggesting a lack of statin benefit in HFrEF patients.Conclusions:These results suggest that statin use is associated with improved mortality rates in HFpEF patients, mainly attributable to reductions in sudden death and noncardiovascular death. (Circ J 2015; 79: 574–582)

著者

Takeshi Yamauchi Yasuhiko Sakata Masanobu Miura Soichiro Tadaki Ryoichi Ushigome Kenjiro Sato Takeo Onose Kanako Tsuji Ruri Abe Takuya Oikawa Shintaro Kasahara Kotaro Nochioka Jun Takahashi Satoshi Miyata Hiroaki Shimokawa on behalf of the CHART-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-15-0783, (Released:2015-12-07)

参考文献数

44

被引用文献数

6 25

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Background:The prognostic impact of new-onset atrial fibrillation (AF) is not fully elucidated.Methods and Results:We examined 4,818 consecutive stage C/D chronic heart failure (CHF) patients in the Chronic Heart Failure Analysis and Registry in the Tohoku District-2 (CHART-2) Study (n=10,219). At enrollment, 1,859 (38.6%) of them had AF. Compared with the 2,953 patients without AF, AF patients were characterized by higher age (71 vs. 68 years), lower estimated glomerular filtration rate (58.9 vs. 61.9 ml/min/1.73 m2), higher brain natriuretic peptide (152 vs. 74.5 pg/ml), similar left ventricular ejection fraction (56.8 vs. 56.5%), and a similar prescription rate of β-blockers (48.1 vs. 50.6%) and renin-angiotensin system (RAS) inhibitors (72.9 vs. 71.6%). Among the patients without AF at enrollment, 106 (3.6%) developed new AF during the median 3.2-year follow-up, which was associated with increased mortality (adjusted hazard ratio, 1.72; P=0.013). In contrast, neither paroxysmal nor chronic AF at enrollment was associated with increased mortality. The mortality rate was significantly high in the first year after the onset of new AF. On inverse probability of treatment weighting analysis using propensity score, RAS inhibitors and statins were associated with reduced incidence of new AF, and diuretics were associated with increase of new AF.Conclusions:Onset of new AF, but not a history of AF, is associated with increased mortality in CHF patients, especially in the first year.