著者

Seiji Hokimoto Koichi Kaikita Satoshi Yasuda Kenichi Tsujita Masaharu Ishihara Tetsuya Matoba Yasushi Matsuzawa Yoshiaki Mitsutake Yoshihide Mitani Toyoaki Murohara Takashi Noda Koichi Node Teruo Noguchi Hiroshi Suzuki Jun Takahashi Yasuhiko Tanabe Atsushi Tanaka Nobuhiro Tanaka Hiroki Teragawa Takanori Yasu Michihiro Yoshimura Yasuhide Asaumi Shigeo Godo Hiroki Ikenaga Takahiro Imanaka Kohei Ishibashi Masanobu Ishii Takayuki Ishihara Yunosuke Matsuura Hiroyuki Miura Yasuhiro Nakano Takayuki Ogawa Takashi Shiroto Hirofumi Soejima Ryu Takagi Akihito Tanaka Atsushi Tanaka Akira Taruya Etsuko Tsuda Kohei Wakabayashi Kensuke Yokoi Toru Minamino Yoshihisa Nakagawa Shozo Sueda Hiroaki Shimokawa Hisao Ogawa on behalf of the Japanese Circulation Society and Japanese Association of Cardiovascular Intervention and Therapeutics and Japanese College of Cardiology Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0779, (Released:2023-03-10)

被引用文献数

39

著者

Takayuki Ishihara Isamu Mizote Daisuke Nakamura Naotaka Okamoto Tatsuya Shiraki Naoki Itaya Takuya Tsujimura Mitsuyoshi Takahara Takaharu Nakayoshi Osamu Iida Yosuke Hata Masami Nishino Takafumi Ueno Daisaku Nakatani Shungo Hikoso Shinsuke Nanto Toshiaki Mano Yasushi Sakata The COLLABORATION Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0098, (Released:2022-06-04)

参考文献数

31

被引用文献数

4

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Background: A polymer-free biolimus A9-coated stent (PF-BCS) may achieve better arterial healing than a durable polymer drug-eluting stent owing to its polymer-free feature.Methods and Results: This multicenter, prospective, observational study enrolled 105 patients (132 lesions) who underwent PF-BCS (51 patients, 71 lesions) or durable polymer everolimus-eluting stent (DP-EES, 54 patients, 61 lesions) implantation. Serial coronary angioscopy (CAS) and optical coherence tomography (OCT) examinations were performed at 1 and 12 months, and the serial vessel responses were compared between PF-BCS and DP-EES. The primary outcome measure was the incidence of subclinical intrastent thrombus on CAS. The secondary outcome measures were: adequate strut coverage (≥40 μm) on OCT and maximum yellow color grade on CAS. The incidence of thrombus was high at 1 month (100% vs. 93%, P=0.091), but decreased at 12 months (18% vs. 25%, P=0.56), without a significant difference between PF-BCS and DP-EES. The adequate strut coverage rate was significantly higher (84±14% vs. 69±22%, P<0.001) and yellow color was significantly less intense (P=0.012) at 12 months in PF-BCS than in DP-EES; however, they were not significantly different at 1 month (adequate strut coverage: 47±21% vs. 50±17%, P=0.40; yellow color: P=0.99).Conclusions: Although the thrombogenicity of PF-BCS was similar to that of DP-EES, the adequate coverage and plaque stabilization rates of PF-BCS were superior to those of DP-EES at 12 months.

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

Yasushi Ueki Shoichi Kuramitsu Tatsuya Saigusa Keisuke Senda Hitoshi Matsuo Kazunori Horie Hiroaki Takashima Hidenobu Terai Yuetsu Kikuta Takayuki Ishihara Tomohiro Sakamoto Nobuhiro Suematsu Yasutsugu Shiono Taku Asano Kenichi Tsujita Katsuhiko Masamura Tatsuki Doijiri Yohei Sasaki Manabu Ogita Tairo Kurita Akiko Matsuo Ken Harada Kenji Yaginuma Noriyoshi Kanemura Shinjo Sonoda Hiroyoshi Yokoi Nobuhiro Tanaka on behalf of the J-CONFIRM Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-1024, (Released:2022-03-12)

参考文献数

19

被引用文献数

1

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Background:Little evidence is available regarding the long-term outcome in elderly patients after deferral of revascularization based on fractional flow reserve (FFR).Methods and Results:From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicenter registry), 1,262 patients were divided into 2 groups according to age: elderly and younger patients (aged ≥75 or <75 years, respectively). The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TVMI), and clinically driven target vessel revascularization (CDTVR). Cumulative 5-year incidence of TVF was not significantly different between elderly and younger patients (14.3% vs. 10.8%, P=0.12). Cardiac death occurred more frequently in elderly patients than younger patients (4.4% vs. 0.8%, P<0.001), whereas TVMI and CDTVR did not differ between groups (1.3% vs. 0.9%, P=0.80; 10.7% vs. 10.1%, P=0.80, respectively). FFR values in lesions with diameter stenosis <50% were significantly higher in elderly patients than in younger patients (0.88±0.07 vs. 0.85±0.07, P=0.01), whereas this relationship was not observed in those with diameter stenosis ≥50%.Conclusions:Elderly patients had no excess risk of ischemic events related to the deferred coronary lesions by FFR, although FFR values in mild coronary artery stenosis were modestly different between elderly and younger patients.

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.