著者

Satomi Ishihara Shinya Hiramitsu Koshiro Kanaoka Mizuri Taki Hitoshi Nakagawa Tomoya Ueda Ayako Seno Taku Nishida Kenji Onoue Tsunenari Soeda Tomohito Ohtani Makoto Watanabe Rika Kawakami Yasushi Sakata Kazuomi Kario Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0032, (Released:2022-05-25)

参考文献数

33

被引用文献数

4

---

Background: Although B-type natriuretic peptide (BNP) and N-terminal (NT)-proBNP are commonly used markers of heart failure, a simple conversion formula between these peptides has not yet been developed for clinical use.Methods and Results: A total of 9,394 samples were obtained from Nara Medical University, Jichi Medical University, and Osaka University. We randomly selected 70% for a derivation set to investigate a conversion formula from BNP to NT-proBNP using estimated glomerular filtration rate (eGFR) and body mass index (BMI); the remaining 30% was used as the internal validation set and we used a cohort study from Nara Medical University as an external validation set. Multivariate linear regression analysis revealed a new conversion formula: log NT-proBNP = 1.21 + 1.03 × log BNP − 0.009 × BMI − 0.007 × eGFR (r2=0.900, P<0.0001). The correlation coefficients between the actual and converted values of log NT-proBNP in the internal and external validation sets were 0.942 (P<0.0001) and 0.891 (P<0.0001), respectively. We applied this formula to samples obtained from patients administered with sacubitril/valsartan. After treatment initiation, NT-proBNP levels decreased and actual BNP levels increased. However, the calculated BNP levels decreased roughly parallel to the NT-proBNP levels.Conclusions: This new and simple conversion formula of BNP and NT-proBNP with eGFR and BMI is potentially useful in clinical practice.

著者

Kaeko Hirai Rika Kawakami Maki Nogi Satomi Ishihara Yukihiro Hashimoto Yasuki Nakada Hitoshi Nakagawa Tomoya Ueda Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Hiroyuki Okura Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.3, no.7, pp.388-395, 2021-07-09 (Released:2021-07-09)

参考文献数

28

被引用文献数

1

---

Background:Atrial fibrillation (AF) and mitral regurgitation (MR) are frequently combined in patients with heart failure (HF). However, the effect of AF on the prognosis of patients with HF and MR remains unknown.Methods and Results:We studied 867 patients (mean age 73 years; 42.7% female) with acute decompensated HF (ADHF) in the NARA-HF registry. Patients were divided into 4 groups based on the presence or absence of AF and MR at discharge. Patients with severe MR were excluded. The primary endpoint was the composite of cardiovascular (CV) death and HF-related readmission. During the median follow-up of 621 days, 398 patients (45.9%) reached the primary endpoint. In patients with MR, AF was associated with a higher incidence of the primary endpoint regardless of left ventricular function; however, in patients without MR, AF was not associated with CV events. Cox multivariate analyses showed that the incidence of CV events was significantly higher in patients with AF and MR than in patients with MR but without AF (hazard ratio 1.381, P=0.036). Similar findings were obtained in subgroup analysis of patients with AF and only mild MR.Conclusions:The present study demonstrated that AF is associated with poor prognosis in patients with ADHF with mild to moderate MR, but not in those without MR.

著者

Koshiro Kanaoka Yoshitaka Iwanaga Katsuki Okada Satoshi Terasaki Yuichi Nishioka Michikazu Nakai Daisuke Kamon Tomoya Myojin Tsunenari Soeda Tatsuya Noda Manabu Horii Yasushi Sakata Yoshihiro Miyamoto Yoshihiko Saito Tomoaki Imamura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.87, no.4, pp.536-542, 2023-03-24 (Released:2023-03-24)

参考文献数

22

被引用文献数

6

---

Background: We aimed to validate a claims-based diagnostic algorithm to identify hospitalized patients with acute major cardiovascular diseases (CVDs) from health insurance claims in Japan.Methods and Results: This retrospective multicenter validation study was conducted at 4 institutes, including Japanese Circulation Society-certified and uncertified hospitals in Japan. Data on patients with CVDs in departmental lists or with International Classification of Diseases, 10th Revision (ICD-10) codes for CVDs hospitalized between April 2018 and March 2019 were extracted. We examined the sensitivity and positive predictive value of a diagnostic algorithm using ICD-10 codes, medical examinations, and treatments for acute coronary syndrome (ACS), acute heart failure (HF), and acute aortic disease (AAD). We identified 409 patients with ACS (mean age 70.6 years; 24.7% female), 615 patients with acute HF (mean age 77.3 years; 46.2% female), and 122 patients with AAD (mean age 73.4 years; 36.1% female). The respective sensitivity and positive predictive value for the algorithm were 0.86 (95% confidence interval [CI] 0.82–0.89) and 0.95 (95% CI 0.92–0.97) for ACS; 0.74 (95% CI 0.70–0.77) and 0.79 (95% CI 0.76–0.83) for acute HF; and 0.86 (95% CI 0.79–0.92) and 0.83 (95% CI 0.76–0.89) for AAD.Conclusions: The validity of the diagnostic algorithm for Japanese claims data was acceptable. Our results serve as a foundation for future studies on CVDs using nationwide administrative data.

著者

Yukihiro Hashimoto Tsunenari Soeda Ayako Seno Satoshi Okayama Nozomi Fukuda Hiroki Yano Atsushi Iwai Kazutaka Nogi Kaeko Hirai Hajime Fujimoto Megumi Suzuki Hajime Iwama Takehito Nakai Naofumi Doi Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.86, no.12, pp.1968-1979, 2022-11-25 (Released:2022-11-25)

参考文献数

25

被引用文献数

1 2

---

Background: Non-contrast T1 hypointense infarct cores (ICs) within infarcted myocardium detected using cardiac magnetic resonance imaging (CMR) T1 mapping may help assess the severity of left ventricular (LV) injury. However, because the relationship of ICs with chronic LV reverse remodeling (LVRR) is unknown, this study aimed to clarify it.Methods and Results: We enrolled patients with reperfused AMI who underwent baseline CMR on day-7 post-primary percutaneous coronary intervention (n=109) and 12-month follow-up CMR (n=94). Correlations between ICs and chronic LVRR (end-systolic volume decrease ≥15% at 12-month follow-up from baseline CMR) were investigated. We detected 52 (47.7%) ICs on baseline CMR by non-contrast-T1 mapping. LVRR was found in 52.1% of patients with reperfused AMI at 12-month follow-up. Patients with ICs demonstrated higher peak creatine kinase levels, higher B-type natriuretic peptide levels at discharge, lower LV ejection fraction at discharge, and lower incidence of LVRR than those without ICs (26.5% vs. 73.3%, P<0.001) at follow-up. Multivariate logistic regression analysis showed that the presence of ICs was an independent and the strongest negative predictor for LVRR at 12-month follow-up (hazard ratio: 0.087, 95% confidence interval: 0.017–0.459, P=0.004). Peak creatine kinase levels, native T1 values at myocardial edema, and myocardial salvaged indices also correlated with ICs.Conclusions: ICs detected by non-contrast-T1 mapping with 3.0-T CMR were an independent negative predictor of LVRR in patients with reperfused AMI.

著者

Koshiro Kanaoka Tsunenari Soeda Satoshi Terasaki Yuichi Nishioka Tomoya Myojin Shinichiro Kubo Katsuki Okada Tatsuya Noda Makoto Watanabe Rika Kawakami Yasushi Sakata Tomoaki Imamura Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.3, no.3, pp.122-130, 2021-03-10 (Released:2021-03-10)

参考文献数

25

被引用文献数

15

---

Background:Although cardiac rehabilitation (CR) has been reported to be associated with better clinical outcomes in patients with cardiovascular diseases, there are few nationwide studies about CR participation by patients with coronary artery disease in Japan.Methods and Results:We performed a nationwide retrospective cohort study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan between April 2014 and March 2018. Patients were divided into 2 groups (acute coronary syndrome [ACS] and stable coronary artery disease [sCAD]), and the rates of participation in in- and outpatient CR after percutaneous coronary intervention (PCI) were investigated. Propensity score-matched analysis was performed and the association between outpatient CR participation and all-cause mortality 3 months after PCI was examined. Overall, 616,664 patients (ACS, n=202,853; sCAD, n=413,811) were analyzed. The participation rates of CR increased annually. The participation rate was higher for inpatient than outpatient CR in both the ACS (52% vs. 9%, respectively) and sCAD (15% vs. 3%, respectively) groups. Prognosis was better for patients with than without outpatient CR in both the ACS (hazard ratio [HR] 0.52; 95% confidence interval [CI] 0.47–0.59) and sCAD (HR 0.72; 95% CI 0.65–0.80) groups.Conclusions:Outpatient CR was associated with a better prognosis in patients with ACS or sCAD. The participation rates of outpatient CR following PCI were extremely low in Japan.

著者

Koshiro Kanaoka Yoshitaka Iwanaga Katsuki Okada Satoshi Terasaki Yuichi Nishioka Michikazu Nakai Daisuke Kamon Tomoya Myojin Tsunenari Soeda Tatsuya Noda Manabu Horii Yasushi Sakata Yoshihiro Miyamoto Yoshihiko Saito Tomoaki Imamura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0566, (Released:2023-01-28)

参考文献数

22

被引用文献数

6

---

Background: We aimed to validate a claims-based diagnostic algorithm to identify hospitalized patients with acute major cardiovascular diseases (CVDs) from health insurance claims in Japan.Methods and Results: This retrospective multicenter validation study was conducted at 4 institutes, including Japanese Circulation Society-certified and uncertified hospitals in Japan. Data on patients with CVDs in departmental lists or with International Classification of Diseases, 10th Revision (ICD-10) codes for CVDs hospitalized between April 2018 and March 2019 were extracted. We examined the sensitivity and positive predictive value of a diagnostic algorithm using ICD-10 codes, medical examinations, and treatments for acute coronary syndrome (ACS), acute heart failure (HF), and acute aortic disease (AAD). We identified 409 patients with ACS (mean age 70.6 years; 24.7% female), 615 patients with acute HF (mean age 77.3 years; 46.2% female), and 122 patients with AAD (mean age 73.4 years; 36.1% female). The respective sensitivity and positive predictive value for the algorithm were 0.86 (95% confidence interval [CI] 0.82–0.89) and 0.95 (95% CI 0.92–0.97) for ACS; 0.74 (95% CI 0.70–0.77) and 0.79 (95% CI 0.76–0.83) for acute HF; and 0.86 (95% CI 0.79–0.92) and 0.83 (95% CI 0.76–0.89) for AAD.Conclusions: The validity of the diagnostic algorithm for Japanese claims data was acceptable. Our results serve as a foundation for future studies on CVDs using nationwide administrative data.

著者

Makoto Watanabe Kazutaka Aonuma Toyoaki Murohara Yasuo Okumura Takeshi Morimoto Sadanori Okada Sunao Nakamura Shiro Uemura Koichiro Kuwahara Tadateru Takayama Naofumi Doi Tamio Nakajima Manabu Horii Kenichi Ishigami Kazumiki Nomoto Daisuke Abe Koji Oiwa Kentaro Tanaka Terumasa Koyama Akira Sato Tomoya Ueda Tsunenari Soeda Yoshihiko Saito PREVENT CINC-J Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0869, (Released:2022-04-22)

参考文献数

37

被引用文献数

2

---

Background: Previous studies have reported that high-dose strong statin therapy reduces the incidence of contrast-induced nephropathy (CIN) in statin naïve patients; however, the efficacy of high-dose strong statins for preventing CIN in real-world clinical practice remains unclear. The aim of this study was to evaluate the efficacy of strong statin therapy in addition to fluid hydration for preventing CIN after cardiovascular catheterization.Methods and Results: This prospective, multicenter, randomized controlled trial included 420 patients with chronic kidney disease who underwent cardiovascular catheterization. They were assigned to receive high-dose pitavastatin (4 mg/day × 4 days) on the day before and of the procedure and 2 days after the procedure (Statin group, n=213) or no pitavastatin (Control group, n=207). Isotonic saline hydration combined with a single bolus of sodium bicarbonate (20 mEq) was scheduled for administration to all patients. In the control group, statin therapy was continued at the same dose as that before randomization. CIN was defined as a ≥0.5 mg/dL increase in serum creatinine or ≥25% above baseline at 48 h after contrast exposure. Before randomization, 83% of study participants were receiving statin treatment. The statin group had a higher incidence of CIN than the control group (3.0% vs. 0%, P=0.01). The 12-month rate of major adverse cardiovascular events was similar between the 2 groups.Conclusions: High-dose pitavastatin increases the incidence of CIN in this study population.

著者

Kenji Onoue Hitoshi Nakagawa Ayaka Keshi Junichi Sugiura Akihiko Okamura Koshiro Kanaoka Atsushi Kyodo Satoshi Terasaki Takuya Nakamura Hiroki Yano Kazutaka Nogi Satomi Ishihara Yukihiro Hashimoto Tomoya Ueda Ayako Seno Taku Nishida Tsunenari Soeda Makoto Watanabe Rika Kawakami Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0735, (Released:2021-10-06)

参考文献数

9

被引用文献数

2

著者

Satomi Ishihara Rika Kawakami Maki Nogi Kaeko Hirai Yukihiro Hashimoto Yasuki Nakada Hitoshi Nakagawa Tomoya Ueda Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0620, (Released:2019-12-26)

参考文献数

30

被引用文献数

8

---

Background:Countermeasure development for early rehospitalization for heart failure (re-HHF) is an urgent and important issue in Western countries and Japan.Methods and Results:Of 1,074 consecutive NARA-HF study participants with acute decompensated HF admitted to hospital as an emergency between January 2007 and December 2016, we excluded 291 without follow-up data, who died in hospital, or who had previous HF-related hospitalizations, leaving 783 in the analysis. During the median follow-up period of 895 days, 241 patients were re-admitted for HF. The incidence of re-HHF was the highest within the first 30 days of discharge (3.3% [26 patients]) and remained high until 90 days, after which it decreased sharply. Within 90 days of discharge, 63 (8.0%) patients were re-admitted. Kaplan-Meier analysis revealed that patients with 90-day re-HHF had worse prognoses than those without 90-day re-HHF in terms of all-cause death (hazard ratio [HR] 2.321, 95% confidence interval [CI] 1.654–3.174; P<0.001) and cardiovascular death (HR 3.396, 95% CI 2.153–5.145; P<0.001). Multivariate analysis indicated that only male sex was an independent predictor of 90-day re-HHF.Conclusions:The incidence of early re-HHF was lower in Japan than in Western countries. Its predictors are not related to the clinical factors of HF, indicating that a new comprehensive approach might be needed to prevent early re-HHF.

著者

Yasuki Nakada Rika Kawakami Shouji Matsushima Tomomi Ide Koshiro Kanaoka Tomoya Ueda Satomi Ishihara Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Hiroyuki Okura Miyuki Tsuchihashi-Makaya Hiroyuki Tsutsui Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.5, pp.1019-1024, 2019-04-25 (Released:2019-04-25)

参考文献数

22

被引用文献数

8 13

---

Background: Prognosis after acute decompensated heart failure (ADHF) is poor. An appropriate risk score that would allow for improved care and treatment of ADHF patients after discharge, however, is lacking. Methods and Results: We used 2 HF cohorts, the NARA-HF study and JCARE-CARD, as derivation and validation cohorts, respectively. The primary endpoint was all-cause death during the 2-year follow-up, excluding in-hospital death. Age, hemoglobin (Hb), and brain natriuretic peptide (BNP) at discharge were identified as independent risk factors. We determined 3 categorizations on the basis of these parameters, termed A2B score: age (<65 years, 0; 65–74 years, 1; ≥75 years, 2), anemia (Hb <10 g/dL, 2; 10–11.9 g/dL, 1; ≥12 g/dL, 0) and BNP (<200 pg/mL, 0; 200–499 pg/mL, 1; ≥500 pg/mL, 2). We divided patients into 4 groups according to A2B score (extremely low, 0; low, 1–2; medium, 3–4; high, 5–6). For the extremely low-risk group, the 2-year survival rate was 97.8%, compared with 84.5%, 66.1%, and 45.2% for the low-, medium-, and high-risk groups, respectively. Using the JCARE-CARD as a validation model, for the extremely low-risk group, the 2-year survival was 95.4%, compared with 90.2%, 75.0%, and 55.6% for the low-, medium-, and high-risk groups, respectively. Conclusions: The user-friendly A2B score is useful for estimating survival rate in ADHF patients at discharge.

著者

Tomoya Ueda Rika Kawakami Manabu Horii Yu Sugawara Takaki Matsumoto Sadanori Okada Taku Nishida Tsunenari Soeda Satoshi Okayama Satoshi Somekawa Yukiji Takeda Makoto Watanabe Hiroyuki Kawata Shiro Uemura Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.77, no.11, pp.2766-2771, 2013 (Released:2013-10-25)

参考文献数

29

被引用文献数

35 43

---

Background: Accumulating evidence suggests that hematopoiesis, especially erythropoiesis, is disturbed in heart failure (HF) for many reasons. Low hemoglobin and red blood cell distribution width have emerged as prognostic indicators of HF independent of classic predictors. The prognostic implication of mean corpuscular volume (MCV) in HF, however, is unknown. In this context, we investigated the relationship between MCV and prognosis of acute decompensated HF (ADHF). Methods and Results: This retrospective cohort study consisted of 458 consecutive patients with ADHF who had emergency admission to hospital. Patients were divided into 2 groups: MCV ≤100fl (non-macrocytic group, n=400); and MCV >100fl (macrocytic group, n=58). The relationship between MCV and all-cause death was tested using Cox proportional hazard models, adjusting for other predictors. Mean patient age was 72.4 years and mean MCV was 93.0±7.1fl. Hemoglobin was significantly lower in the macrocytic group than the non-macrocytic group. During the mean follow-up of 20.8 months, a total of 173 deaths (37.9%) occurred. Kaplan-Meier analysis showed that all-cause death was significantly higher in the macrocytic group (log-rank P<0.0001). Cox proportional hazards analysis indicated that macrocytosis was an independent predictor of all-cause death (hazard ratio, 2.288; 95% confidence interval: 1.390–3.643; P=0.0015) after adjustment in the multivariate model. Conclusions: It is proposed for the first time that MCV is an independent predictor of all-cause death in patients with ADHF.  (Circ J 2013; 77: 2766–2771)

著者

Atsushi Kyodo Makoto Watanabe Akihiko Okamura Saki Iwai Azusa Sakagami Kazutaka Nogi Daisuke Kamon Yukihiro Hashimoto Tomoya Ueda Tsunenari Soeda Hiroyuki Okura Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0759, (Released:2021-01-27)

参考文献数

33

被引用文献数

4

---

Background:The association between unfavorable post-stent optical coherence tomography (OCT) findings and subsequent stent thrombosis (ST) remains unclear. This study investigated the ST-related characteristics of post-stent OCT findings at index percutaneous coronary intervention (PCI).Methods and Results:Fifteen patients with ST onset after OCT-guided PCI (ST group) were retrospectively enrolled. Post-stent OCT findings in the ST group were compared with those in 70 consecutive patients (reference group) without acute coronary syndrome onset for at least 5 years after OCT-guided PCI. The incidence of acute myocardial infarction (AMI) was higher in the ST than reference group (60.0% vs. 17.1%, respectively; P=0.0005). The incidence of incomplete stent apposition (93.3% vs. 55.7%; P=0.0064), irregular protrusion (IP; 93.3% vs. 62.8%; P=0.0214), and thrombus (93.3% vs. 51.4%; P=0.0028) was significantly higher in the ST than reference group. The maximum median (interquartile range) IP arc was significantly larger in the ST than reference group (265° [217°–360°] vs. 128° [81.4°–212°], respectively; P<0.0001). In AMI patients, the incidence of a maximum IP arc >180° was significantly higher in the ST than reference group (100% vs. 58.3%, respectively; P=0.0265).Conclusions:IP with a large arc was a significant feature on post-stent OCT in patients with ST.