著者

Shun Kohsaka Kenji Fukushima Ippei Watanabe Susumu Manabe Nozomi Niimi Yodo Gatate Mitsuaki Sawano Shintaro Nakano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0345, (Released:2021-06-18)

参考文献数

68

被引用文献数

3

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Coronary artery disease (CAD) remains a leading cause of mortality and morbidity in developed countries. Although urgent revascularization is the cornerstone of management of acute coronary syndrome (ACS), for patients with stable CAD recent large-scale clinical trials indicate that a mechanical ‘fix’ of a narrowed artery is not obviously beneficial; ACS and stable CAD are increasingly recognized as different clinical entities. We review the perspectives on (1) modifying the diagnostic pathway of stable CAD with the incorporation of modern estimates of pretest probability, (2) non-imaging evaluations based on their availability, (3) the optimal timing of invasive coronary angiography and revascularization, and (4) the implementation of medical therapy during the work-up.

著者

Mitsuaki Sawano Shun Kohsaka Hideki Ishii Yohei Numasawa Kyohei Yamaji Taku Inohara Tetsuya Amano Yuji Ikari Masato Nakamura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0098, (Released:2021-06-24)

参考文献数

38

被引用文献数

24

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Background:Acute coronary syndrome (ACS) hospital survivors experience a wide array of late adverse cardiac events, despite considerable advances in the quality of care. We investigated 30-day and 1-year outcomes of ACS hospital survivors using a Japanese nationwide cohort.Methods and Results:We studied 20,042 ACS patients who underwent percutaneous coronary intervention (PCI) in 2017: 10,242 (51%) with ST-elevation myocardial infarction (STEMI), 3,027 (15%) with non-ST-elevation myocardial infarction (NSTEMI), and 6,773 (34%) with unstable angina (UA). The mean (±SD) age was 69.6±12.4 years, 77% of the patients were men, and 20% had a previous history of PCI. The overall 30-day all-cause, cardiac, and non-cardiac mortality rates were 3.0%, 2.4%, and 0.6%, respectively. The overall 1-year incidence of all-cause, cardiac, and non-cardiac death was 7.1%, 4.2%, and 2.8%, respectively. Compared with UA patients, STEMI patients had a higher risk of all fatal events, non-fatal ischemic stroke, and acute heart failure, and NSTEMI patients had a higher risk of heart failure.Conclusions:The results from our ACS hospital survivor PCI database suggest the need to improve care for the acute myocardial infarction population to lessen the burden of 30-day mortality due to ACS, heart failure, and sudden cardiac death, as well as 1-year ischemic stroke and heart failure events.

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

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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.

著者

Shintaro Nakano Shun Kohsaka Taishiro Chikamori Kenji Fukushima Yoshio Kobayashi Ken Kozuma Susumu Manabe Hitoshi Matsuo Masato Nakamura Takayuki Ohno Mitsuaki Sawano Koichi Toda Yasunori Ueda Hiroyoshi Yokoi Yodo Gatate Tokuo Kasai Yoshiaki Kawase Naoya Matsumoto Hitoshi Mori Ryo Nakazato Nozomi Niimi Yuichi Saito Ayumi Shintani Ippei Watanabe Yusuke Watanabe Yuji Ikari Masahiro Jinzaki Masami Kosuge Kenichi Nakajima Takeshi Kimura on behalf of the JCS Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-1041, (Released:2022-03-11)

参考文献数

245

被引用文献数

40

著者

Shintaro Nakano Shun Kohsaka Taishiro Chikamori Kenji Fukushima Yoshio Kobayashi Ken Kozuma Susumu Manabe Hitoshi Matsuo Masato Nakamura Takayuki Ohno Mitsuaki Sawano Koichi Toda Yasunori Ueda Hiroyoshi Yokoi Yodo Gatate Tokuo Kasai Yoshiaki Kawase Naoya Matsumoto Hitoshi Mori Ryo Nakazato Nozomi Niimi Yuichi Saito Ayumi Shintani Ippei Watanabe Yusuke Watanabe Yuji Ikari Masahiro Jinzaki Masami Kosuge Kenichi Nakajima Takeshi Kimura on behalf of the JCS Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.86, no.5, pp.882-915, 2022-04-25 (Released:2022-04-25)

参考文献数

245

被引用文献数

40

著者

Nobuhiro Ikemura Mitsuaki Sawano Yasuyuki Shiraishi Ikuko Ueda Hiroaki Miyata Yohei Numasawa Shigetaka Noma Masahiro Suzuki Yukihiko Momiyama Taku Inohara Kentaro Hayashida Shinsuke Yuasa Yuichiro Maekawa Keiichi Fukuda Shun Kohsaka

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.6, pp.815-822, 2017-05-25 (Released:2017-05-25)

参考文献数

37

被引用文献数

12

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Background:Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe.Methods and Results:We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min. Median DTB time was 90 min (IQR, 68–115 min) during the study period and there were no significant changes with year. Predictors for delay in DTB time included peripheral artery disease, prior revascularization, off-hour arrival, age >75 years, heart failure at arrival, and use of IABP or VA-ECMO. Notably, high-volume PCI-capable institutions (PCI ≥200/year) were more adept at achieving shorter DTB time compared with low-volume institutions (PCI <200/year).Conclusions:Half of the present STEMI patients did not achieve DTB time ≤90 min. Targeting the elderly and patients with multiple comorbidities, and PCI performed in off-hours may aid in its improvement.

著者

Sei Harada Miho Iida Naoko Miyagawa Aya Hirata Kazuyo Kuwabara Minako Matsumoto Tomonori Okamura Shun Edagawa Yoko Kawada Atsuko Miyake Ryota Toki Miki Akiyama Atsuki Kawai Daisuke Sugiyama Yasunori Sato Ryo Takemura Kota Fukai Yoshiki Ishibashi Suzuka Kato Ayako Kurihara Mizuki Sata Takuma Shibuki Ayano Takeuchi Shun Kohsaka Mitsuaki Sawano Satoshi Shoji Yoshikane Izawa Masahiro Katsumata Koichi Oki Shinichi Takahashi Tsubasa Takizawa Hiroshi Maruya Yuji Nishiwaki Ryo Kawasaki Akiyoshi Hirayama Takamasa Ishikawa Rintaro Saito Asako Sato Tomoyoshi Soga Masahiro Sugimoto Masaru Tomita Shohei Komaki Hideki Ohmomo Kanako Ono Yayoi Otsuka-Yamasaki Atsushi Shimizu Yoichi Sutoh Atsushi Hozawa Kengo Kinoshita Seizo Koshiba Kazuki Kumada Soichi Ogishima Mika Sakurai-Yageta Gen Tamiya Toru Takebayashi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20230192, (Released:2024-01-06)

参考文献数

40

被引用文献数

1

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The Tsuruoka Metabolomics Cohort Study (TMCS) is an ongoing population-based cohort study being conducted in the rural area of Yamagata Prefecture, Japan. This study aimed to enhance the precision prevention of multi-factorial, complex diseases, including non-communicable and aging-associated diseases, by improving risk stratification and prediction measures. At baseline, 11,002 participants aged 35–74 years were recruited in Tsuruoka City, Yamagata Prefecture, Japan, between 2012 and 2015, with an ongoing follow-up survey. Participants underwent various measurements, examinations, tests, and questionnaires on their health, lifestyle, and social factors. This study used an integrative approach with deep molecular profiling to identify potential biomarkers linked to phenotypes that underpin disease pathophysiology and provide better mechanistic insights into social health determinants. The TMCS incorporates multi-omics data, including genetic and metabolomic analyses of 10,933 participants and comprehensive data collection ranging from physical, psychological, behavioral, and social to biological data. The metabolome is used as a phenotypic probe because it is sensitive to changes in physiological and external conditions. The TMCS focuses on collecting outcomes for cardiovascular disease, cancer incidence and mortality, disability, functional decline due to aging and disease sequelae, and the variation in health status within the body represented by omics analysis that lies between exposure and disease. It contains several sub-studies on aging, heated tobacco products, and women's health. This study is notable for its robust design, high participation rate (89%), and long-term repeated surveys. Moreover, it contributes to precision prevention in Japan and East Asia as a well-established multi-omics platform.

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

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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.

著者

Yuji Yamada Yoshitaka Miyakawa Mitsuaki Sawano Yutaka Okano

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.53, no.10, pp.1083-1085, 2014 (Released:2014-05-15)

参考文献数

15

被引用文献数

2 10

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Acquired coagulation factor deficiency is a rare disorder that occurs in patients with drug reactions, malignancy and collagen diseases as well as during pregnancy. Most cases are caused by factor VIII inhibitors. We herein describe the case of a 61-year-old Japanese man with acquired factor V inhibitor who developed symptoms 11 days after lung surgery for empyema. The patient required mechanical ventilation to treat acute respiratory failure due to severe pulmonary hemorrhage. He responded poorly to steroid pulse therapy; however, treatment with rituximab was successful.