著者

Mashio Nakamura Satoshi Tamaru Shigeki Hirooka Atsushi Hirayama Akihiro Tsuji Mitsuhiro Hirata Mitsuru Munemasa Izumi Nakagawa Masahiro Toshima Hiroaki Shimokawa Yuki Nishimura Toru Ogura Takeshi Yamamoto Hirono Satokawa Toru Obayashi Norikazu Yamada on behalf of the AKAFUJI Study Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0158, (Released:2023-06-30)

参考文献数

16

被引用文献数

1

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Background: A large-scale prospective study of the efficacy and safety of warfarin for the treatment of venous thromboembolism (VTE) has not been conducted in Japan. Therefore, we conducted a real-world prospective multicenter observational cohort study (AKAFUJI Study; UMIN000014132) to investigate the efficacy and safety of warfarin for VTE.Methods and Results: Between May 2014 and March 2017, 352 patients (mean [±SD] age 67.7±14.8 years; 57% female) with acute symptomatic/asymptomatic VTE were enrolled; 284 were treated with warfarin. The cumulative incidence of recurrent symptomatic VTE was higher in patients without warfarin than in those treated with warfarin (8.7 vs. 2.2 per 100 person-years, respectively; P=0.018). The cumulative incidence of bleeding complications was not significantly different between the 2 groups. The mean prothrombin time-international normalized ratio (PT-INR) during warfarin on-treatment was <1.5 in 180 patients, 1.5–2.5 in 97 patients, and >2.5 in 6 patients. The incidence of bleeding complications was significantly higher in patients with PT-INR >2.5, whereas the incidence of recurrent VTE was not significantly different between the 3 PT-INR groups. The cumulative incidence of recurrent VTE and bleeding complications did not differ significantly among those in whom VTE was provoked by a transient risk factor, was unprovoked, or was associated with cancer.Conclusions: Warfarin therapy with an appropriate PT-INR according to Japanese guidelines is effective without increasing bleeding complications, regardless of patient characteristics.

著者

Nobuhiro Hara Takamichi Miyamoto Junji Yamaguchi Takamasa Iwai Sadahiro Hijikata Keita Watanabe Yuichiro Sagawa Ryo Masuda Ryoichi Miyazaki Naoyuki Miwa Masahiro Sekigawa Tetsuo Yamaguchi Yasutoshi Nagata Toshihiro Nozato Orie Kobayashi Satoshi Umezawa Toru Obayashi

出版者

The Editorial Committee of Annals of Vascular Diseases

雑誌

Annals of Vascular Diseases (ISSN:1881641X)

巻号頁・発行日

vol.11, no.1, pp.106-111, 2018-03-25 (Released:2018-03-25)

参考文献数

27

被引用文献数

3

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Objective: Although deep vein thrombosis (DVT) followed by pulmonary thromboembolism (PE) is a critical complication during pregnancy, there have been few reports about its intrapartum management. We evaluated intrapartum management by using a temporary inferior vena cava filter (IVCF) in pregnant women with PE/DVT.Materials and Methods: Eleven women with PE/DVT during pregnancy between January 2004 and December 2016 were included. The patients were hospitalized for intravenous unfractionated heparin infusion after acute PE/DVT onset. Seven patients were discharged and continued treatment with subcutaneous injection of heparin at the outpatient unit. IVCF was implanted 1–3 days before delivery in 10 patients. Anticoagulant therapy was discontinued 6–12 h before delivery. We retrospectively analyzed rates of maternal or perinatal death, and recurrence of symptomatic PE/DVT.Results: One patient was diagnosed as having PE/DVT and 10 had DVT alone. One patient suffered hemorrhagic shock during delivery; however, maternal or perinatal death and recurrence of symptomatic PE/DVT did not occur in any patient.Conclusion: Maternal or perinatal death and recurrence of symptomatic PE/DVT was not seen in women diagnosed as having PE/DVT during pregnancy and treated with anticoagulant therapy and IVCF.

著者

Tetsuo Yamaguchi Masahiro Terashima Chisato Takamura Hironobu Sakurai Kiyotoshi Ooishi Tomoya Yoshizaki Junji Yamaguchi Sadahiro Hijikata Takamasa Iwai Yuichiro Sagawa Keita Watanabe Ryoichi Miyazaki Ryo Masuda Naoyuki Miwa Masahiro Sekigawa Nobuhiro Hara Yasutoshi Nagata Takamichi Miyamoto Toru Obayashi Toshihiro Nozato

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9605-17, (Released:2017-12-21)

参考文献数

11

被引用文献数

3

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A 55-year-old man presented with dyspnea, edema, and appetite loss. He had undergone coronary artery bypass grafting 8 years previously. He had jugular venous distention and Kussmaul's sign. Contrast-enhanced cardiac magnetic resonance imaging (CMRI) demonstrated an intrapericardial mass compressing the right ventricular (RV) cavity. T1- and T2-weighted black-blood images showed a mass with heterogeneous high signal intensity and a thick and dark rim. The mass was considered to be a chronic hematoma. After pericardiotomy with surgical removal of the hematoma, CMRI showed the marked improvement of the RV function. Late intrapericardial hematoma is rare and CMRI is useful for making a differential diagnosis.

著者

Atsushi Mizuno Takeshi Yamamoto Yasuhiro Tanabe Toru Obayashi Morimasa Takayama Ken Nagao Tokyo CCU Network Scientific Committee

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.79, no.4, pp.889-891, 2015-03-25 (Released:2015-03-25)

参考文献数

11

被引用文献数

4 8

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Background:The Pulmonary Embolism Severity Index (PESI) and simplified PESI (sPESI) have not been fully evaluated in Japan, so the present study aimed to evaluate these risk stratification models in the prediction of mortality of affected patients in Japan.Methods and Results:We retrospectively analysed 302 PE patients (63.9±17.2 years of age; 42.4% male) from January 2011 to December 2012 using data from the Tokyo CCU Network. The areas under the receiver-operating characteristic curves were 0.92 (95% confidence interval (CI): 0.88–0.97) for the PESI and 0.88 (95% CI: 0.77–0.98) for the sPESI.Conclusions:Both scores can be used to predict PE mortality in Japan. (Circ J 2015; 79: 889–891)