著者
Jiro Sakamoto Yugo Yamashita Takeshi Morimoto Hidewo Amano Toru Takase Seiichi Hiramori Kitae Kim Maki Oi Masaharu Akao Yohei Kobayashi Mamoru Toyofuku Toshiaki Izumi Tomohisa Tada Po-Min Chen Koichiro Murata Yoshiaki Tsuyuki Syunsuke Saga Yuji Nishimoto Tomoki Sasa Minako Kinoshita Kiyonori Togi Hiroshi Mabuchi Kensuke Takabayashi Yusuke Yoshikawa Hiroki Shiomi Takao Kato Takeru Makiyama Koh Ono Toshihiro Tamura Yoshihisa Nakagawa Takeshi Kimura on behalf of the COMMAND VTE Registry Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-19-0515, (Released:2019-09-20)
参考文献数
28

Background:There is a paucity of data on the management and prognosis of cancer-associated venous thromboembolism (VTE), leading to uncertainty about optimal management strategies.Methods and Results:The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive acute symptomatic VTE patients in Japan between 2010 and 2014. We divided the entire cohort into 3 groups: active cancer (n=695, 23%), history of cancer (n=243, 8%), and no history of cancer (n=2089, 69%). The rate of anticoagulation discontinuation was higher in patients with active cancer (43.5%, 27.0%, and 27.0%, respectively, at 1 year, P<0.001). The cumulative 5-year incidences of recurrent VTE, major bleeding, and all-cause death were higher in patients with active cancer (recurrent VTE: 17.7%, 10.2%, and 8.6%, P<0.001; major bleeding: 26.6%, 8.8%, and 9.3%, P<0.001; all-cause death: 73.1%, 28.6%, 14.6%, P<0.001). Among the 4 groups classified according to active cancer status, the cumulative 1-year incidence of recurrent VTE was higher in the metastasis group (terminal stage group: 6.4%, metastasis group: 22.1%, under chemotherapy group: 10.8%, and other group: 5.8%, P<0.001).Conclusions:In a current real-world VTE registry, patients with active cancer had higher risk for VTE recurrence, bleeding, and death, with variations according to cancer status, than patients without active cancer. Anticoagulation therapy was frequently discontinued prematurely in patients with active cancer in discordance with current guideline recommendations.
著者
Yasuaki Takeji Tomohiko Taniguchi Takeshi Morimoto Naritatsu Saito Kenji Ando Shinichi Shirai Genichi Sakaguchi Yoshio Arai Yasushi Fuku Yuichi Kawase Tatsuhiko Komiya Natsuhiko Ehara Takeshi Kitai Tadaaki Koyama Shin Watanabe Hirotoshi Watanabe Hiroki Shiomi Eri Minamino-Muta Shintaro Matsuda Hidenori Yaku Yusuke Yoshikawa Kazuhiro Yamazaki Masahide Kawatou Kazuhisa Sakamoto Toshihiro Tamura Makoto Miyake Hisashi Sakaguchi Koichiro Murata Masanao Nakai Norio Kanamori Chisato Izumi Hirokazu Mitsuoka Masashi Kato Yutaka Hirano Tsukasa Inada Kazuya Nagao Hiroshi Mabuchi Yasuyo Takeuchi Keiichiro Yamane Takashi Tamura Mamoru Toyofuku Mitsuru Ishii Moriaki Inoko Tomoyuki Ikeda Katsuhisa Ishii Kozo Hotta Toshikazu Jinnai Nobuya Higashitani Yoshihiro Kato Yasutaka Inuzuka Yuko Morikami Kenji Minatoya Takeshi Kimura on befalf of the CURRENT AS Registry Investigators and K-TAVI Registry Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-19-0951, (Released:2020-02-01)
参考文献数
35

Background:There are no data comparing transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) outcomes in real clinical practice in Japan.Methods and Results:We combined 2 independent registries, the K-TAVI Registry (a 6-center prospective registry of consecutive patients who underwent TAVI) and the CURRENT AS Registry (a large, 27-center registry of 3,815 consecutive patients with severe aortic stenosis [AS]). In the K-TAVI Registry, 338 patients underwent TAVI with SAPIEN XT balloon-expandable valves from October 2013 to January 2016, whereas in the CURRENT AS Registry 237 patients with severe AS underwent SAVR from January 2003 to December 2011. Propensity score matching was conducted, with final cohort comprising 306 patients. The cumulative 2-year incidence of all-cause death and heart failure (HF) hospitalization did not differ significantly between the TAVI and SAVR groups (13.7% vs. 12.4% [P=0.81] and 7.9% vs 3.9% [P=0.13], respectively). After adjusting for residual confounders, there were no significant differences between the TAVI and SAVR groups in the risk for all-cause death (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.35–1.58; P=0.43) or HF hospitalization (HR 1.27; 95% CI 0.40–4.59; P=0.69).Conclusions:These findings from 2 independent Japanese registries suggest that the 2-year risk of all-cause mortality and HF does not differ significantly between TAVI and SAVR groups in real-world practice in Japan.