著者

Yasushi Yoshikawa Yukikatsu Okada Yutaka Okita Hitoshi Yaku Junjiro Kobayashi Hideyuki Uesugi Shuichiro Takanashi Toshiaki Ito Tatsuya Nakao Tadaaki Koyama Taichi Sakaguchi Kouji Yamamoto Yoshiki Sawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.86, no.3, pp.449-457, 2022-02-25 (Released:2022-02-25)

参考文献数

24

被引用文献数

5

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Background:This study retrospectively evaluated the long-term patient outcomes and durability of the Mosaic mitral porcine bioprosthesis in the Japan Mosaic valve long-term multicenter study.Methods and Results:The medical records of 390 patients who underwent mitral valve replacement with the Mosaic bioprosthesis at 10 centers in Japan (1999–2014) were reviewed. Patient data were collected using the Research Electronic Data Capture software. Patient survival was determined using the Kaplan-Meier method. Freedom from structural valve deterioration (SVD) and valve-related reoperation and death were determined using actuarial methods. The median (interquartile range [IQR]) age of the cohort was 73 (69–77) years. The median (IQR) follow-up period was 4.83 (1.84–8.26) years. The longest follow-up period was 15.8 years. The 30-day mortality rate was 5.4%. The 12-year actuarial survival rate was 54.1±4.5%, and the freedom from valve-related death was 85.3±3.4%. The freedom from reoperation at 12 years was 74.3±5.7%. The freedom from SVD at 12 years was 81.4±6.6% for patients aged ≥65 years and 71.6±11.1% for those aged <65 years. The median (IQR) mean pressure gradient was 4.1 (3.0–6.0) and 5.6 (4.0–6.7) mmHg at 1 and 10 years, respectively. The median (IQR) effective orifice area was 1.7 (1.4–2.0) and 1.4 (1.2–1.6) cm2at 1 and 10 years, respectively.Conclusions:The Mosaic porcine bioprosthesis offered satisfactory long-term outcomes for up to 12 years.

著者

Ayumi KONO Naomi FUKUSHIMA Takuma ISHIHARA Noriko YOSHIYUKI Kouji YAMAMOTO

出版者

Japanese Society of Public Health

雑誌

日本公衆衛生雑誌 (ISSN:05461766)

巻号頁・発行日

vol.68, no.4, pp.267-275, 2021-04-15 (Released:2021-04-23)

参考文献数

34

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Objectives We investigated the 5-year disease-related mortality risk, including that associated with neoplasms, mental/behavioral/neurodevelopmental disorders, and diseases of the circulatory system and respiratory system,in ambulatory frail Japanese older adults.Methods We retrospectively analyzed long-term care and health insurance claims data in this cohort study performed between April 2012 and March 2017. The primary outcome was mortality, and the secondary outcome was care-need level decline. Risk factors were determined based on the International Statistical Classification of Disease and Related Health Problems, 10th Revision codes, hospitalization, and institutionalization. The study included 1,239 ambulatory frail older adults newly certified as needing Support-Level care at baseline (April 2012-March 2013) across three Japanese municipalities.Results Of the 1,239 participants, 454 (36.6%) died. Neoplasms (hazard ratio [HR] 2.69, 95% confidence interval [CI] 1.97-3.68) or respiratory system diseases (HR 1.62, 95%CI 1.26-2.08) were independently associated with mortality. Mental/behavioral/neurodevelopmental disorders (HR 1.39, 95%CI 1.17-1.66) or diseases of the respiratory system(HR 86, 95%CI 75-99) were independently associated with care-need level decline.Conclusions This study suggests that neoplasms or respiratory system diseases were associated with a high mortality risk and that mental/behavioral/neurodevelopmental disorders were associated with care-need level decline among ambulatory frail older adults. Optimal disease management and effective long-term care are important to delay the onset of these events in older adults certified as needing Support-Level care.

著者

Tetsuo Minamino Shuichiro Higo Ryo Araki Shungo Hikoso Daisaku Nakatani Hiroshi Suzuki Takahisa Yamada Masaaki Okutsu Kouji Yamamoto Yasushi Fujio Yoshio Ishida Takuya Ozawa Kiminori Kato Ken Toba Yoshifusa Aizawa Issei Komuro EPO-AMI-II Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0889, (Released:2018-02-02)

参考文献数

21

被引用文献数

15

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Background:Erythropoietin (EPO) has antiapoptotic and tissue-protective effects, but previous clinical studies using high-dose EPO have not shown cardioprotective effects, probably because of platelet activation and a lack of knowledge regarding the optimal dose. In contrast, a small pilot study using low-dose EPO has shown improvement in left ventricular function without adverse cardiovascular events.Methods and Results:We performed a multicenter (25 hospitals), prospective, randomized, double-blind, placebo-controlled, dose-finding study to clarify the efficacy and safety of low-dose EPO in patients with ST-segment elevation myocardial infarction (STEMI) under the Evaluation System of Investigational Medical Care of the Ministry of Health, Labor and Welfare of Japan. In total, 198 STEMI patients with low left ventricular ejection fraction (LVEF <50%) were randomly assigned to receive intravenous administration of EPO (6,000 or 12,000 IU) or placebo within 6 h of successful percutaneous coronary intervention. At 6 months, there was no significant dose-response relationship in LVEF improvement among the 3 groups tested (EPO 12,000 IU: 5.4±9.3%, EPO 6,000 IU: 7.3±7.7%, Placebo: 8.1±8.3%, P=0.862). Low-dose EPO also did not improve cardiac function, as evaluated by 99 mTc-MIBI SPECT or NT-proBNP at 6 months and did not increase adverse events.Conclusions:Administration of low-dose EPO did not improve LVEF at 6 months in STEMI patients (UMIN000005721).

著者

山本 浩二 中井 聖 ヤマモト コウジ ナカイ アキラ Kouji Yamamoto Akira Nakai

雑誌

近畿医療福祉大学紀要 = Journal of the Kinki Health Welfare University

巻号頁・発行日

vol.13, no.2, pp.49-56, 2012-12-01