著者
Shinya Suzuki Takayuki Otsuka Koichi Sagara Hiroaki Semba Hiroto Kano Shunsuke Matsuno Hideaki Takai Yuko Kato Tokuhisa Uejima Yuji Oikawa Kazuyuki Nagashima Hajime Kirigaya Takashi Kunihara Junji Yajima Hitoshi Sawada Tadanori Aizawa Takeshi Yamashita
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-15-1237, (Released:2016-01-21)
参考文献数
43
被引用文献数
43

Background:Trends of oral anticoagulant (OAC) prescription and incidence of thromboembolism (TE) and/or major bleeding (MB) in patients with non-valvular atrial fibrillation (NVAF) in Japan are still unclear.Methods and Results:We used data from Shinken Database 2004–2012, which included all new patients attending the Cardiovascular Institute between June 2004 and March 2013. Of them, 2,434 patients were diagnosed with NVAF. Patients were divided into 3 time periods according to the year of initial visit: 2004–2006 (n=681), 2007–2009 (n=833), and 2010–2012 (n=920). OAC prescription rate steadily increased from 2004–2006 to 2010–2012. Between 2004–2006 and 2007–2009, irrespective of increased warfarin usage, MB tended to decrease, presumably due to low-intensity therapy and avoidance of concomitant use of dual antiplatelets, but TE did not improve. In 2010–2012, direct OACs (DOAC), preferred in low-risk patients, may have contributed to not only decrease TE, but also increase MB, especially extracranial bleeds. In high-risk patients in that time period, mostly treated with warfarin, incidence of TE and MB did not improve.Conclusions:The 9-year trend of stroke prevention indicated a steady increase of OAC prescription and a partial improvement of TE and MB. Even in the era of DOAC, TE prevention was insufficient in high-risk patients, and DOAC were associated with increased extracranial bleeding.
著者
Masato Nakamura Satoru Otsuji Yoshihisa Nakagawa Yuji Oikawa Nobuo Shiode Masatoshi Miyahara Toshihito Furukawa Gaku Nakazawa Hiroyoshi Yokoi on behalf of the PROPEL Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-0011, (Released:2018-07-03)
参考文献数
31
被引用文献数
2

Background:The Resolute Integrity coronary drug-eluting stent (DES), the next evolution of the Resolute DES, is designed with thinner stent struts and continuous sinusoidal technology to further enhance performance. This study evaluated the performance of the Resolute Integrity DES compared with the historical performance of Xience V.Methods and Results:We assessed the safety, efficacy, and deliverability of Resolute Integrity compared with the Xience DES, the prespecified historical control, in PROPEL, a large, real-world prospective, single-arm, open-label study. A total of 1,204 subjects were enrolled in PROPEL and treated with the Resolute Integrity DES at 76 sites in Japan. Lesion and procedural success rates were 100% and 99%, respectively. Patients were equally complex in the Resolute Integrity and Xience cohorts. At 1 year in the clinical-only cohort, the primary endpoint target lesion failure was 4.3% (34/800) in the Resolute Integrity cohort compared with 8.5% (97/1,142) in the Xience historical controls (P<0.001 for non-inferiority). Target vessel failure, major adverse cardiac events, target vessel myocardial infarction, and the composite cardiac death and target vessel myocardial infarction were all lower with Resolute Integrity compared with Xience, including in “high risk” patients.Conclusions:In the large, prospective, multicenter PROPEL trial, the performance of the Resolute Integrity DES was non-inferior to that of the benchmark Xience DES used as a historical comparator.
著者
Shinya Suzuki Takeshi Yamashita Takayuki Ohtsuka Koichi Sagara Tokuhisa Uejima Yuji Oikawa Junji Yajima Akira Koike Kazuyuki Nagashima Hajime Kirigaya Ken Ogasawara Hitoshi Sawada Tsutomu Yamazaki Tadanori Aizawa
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.74, no.1, pp.66-70, 2010 (Released:2009-12-25)
参考文献数
45
被引用文献数
12 22

Background: Although recent studies have suggested that height and body mass index (BMI) independently affect the prevalence of atrial fibrillation (AF), their combined effects have not been fully examined in Japanese patients. Methods and Results: Patients without organic cardiac diseases, hypertension and diabetes mellitus were screened from a prospective, single hospital-based cohort of the Shinken Database 2004-2007 (n=4,719). Both height and BMI significantly increased the crude rate of AF prevalence and the effects were significant even after adjustment by age, sex and left atrial dimension. The relative risks (RRs) for AF in the height and BMI categories were 2.07 (95% confidence interval [CI] 1.70-2.52) and 1.78 (95%CI 1.46-2.17), respectively, in the highest tertile compared with the lowest tertile. The RRs in the highest combined tertile was high to 2.98 (95%CI 2.07-4.28) compared with the lowest combined tertile, an unignorable figure for AF prevalence in the future. Conclusions: Height and BMI synergistically affected the prevalence of AF in Japanese patients. With respect to the recent increase in body size of the Japanese population, the present study predicts that there will be more occurrences of AF than previously predicted. (Circ J 2010; 74: 66 - 70)