著者

Sohei Yoshimura Masatoshi Koga Shoichiro Sato Kenichi Todo Hiroshi Yamagami Masaya Kumamoto Ryo Itabashi Tadashi Terasaki Kazumi Kimura Yoshiki Yagita Yoshiaki Shiokawa Kenji Kamiyama Satoshi Okuda Yasushi Okada Shunya Takizawa Yasuhiro Hasegawa Tomoaki Kameda Satoshi Shibuya Yoshinari Nagakane Yasuhiro Ito Hideki Matsuoka Kazuhiro Takamatsu Kazutoshi Nishiyama Kyohei Fujita Teppei Kamimura Daisuke Ando Toshihiro Ide Takeshi Yoshimoto Masayuki Shiozawa Soichiro Matsubara Yoshitaka Yamaguchi Naoto Kinoshita Takayuki Matsuki Junji Takasugi Keisuke Tokunaga Kyoko Higashida Kazunari Homma Kazuomi Kario Shoji Arihiro Kazunori Toyoda for the SAMURAI Study Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-0067, (Released:2018-06-01)

参考文献数

27

被引用文献数

34

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Background:We determined the 2-year long-term risk-benefit profile in patients with stroke or transient ischemic attack (TIA) receiving warfarin or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry in Japan.Methods and Results:NVAF patients within 7 days after onset of ischemic stroke/TIA were enrolled in 18 stroke centers. Outcome measures included ischemic and bleeding events and death in the 2-year follow-up period. We enrolled 1,116 patients taking either warfarin (650 patients) or DOACs (466 patients) at acute hospital discharge. DOAC users were younger and had lower National Institutes of Health Stroke Scale, CHADS2and discharge modified Rankin Scale scores than warfarin users (P<0.0001 each). Incidences of stroke/systemic embolism (adjusted hazard ratio, 1.07; 95% CI, 0.66–1.72), all ischemic events (1.13; 0.72–1.75), and ischemic stroke/TIA (1.58; 0.95–2.62) were similar between groups. Risks of intracranial hemorrhage (0.32; 0.09–0.97) and death (0.41; 0.26–0.63) were significantly lower for DOAC users. Infection was the leading cause of death, accounting for 40% of deaths among warfarin users.Conclusions:Stroke/TIA patients receiving DOACs for secondary prevention were younger and had lower stroke severity and risk indices than those receiving warfarin. Estimated cumulative incidences of stroke and systemic embolism within 2 years were similar between warfarin and DOACs users, but those of death and intracranial hemorrhage were significantly lower among DOAC users.

著者

Keishi Moriwaki Tetsushiro Takeuchi Naoki Fujimoto Toshiki Sawai Yuichi Sato Naoto Kumagai Jun Masuda Shiro Nakamori Masaki Ishida Norikazu Yamada Mashio Nakamura Hajime Sakuma Masaaki Ito Kaoru Dohi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-0083, (Released:2018-05-12)

参考文献数

36

被引用文献数

5

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Background:The present study was conducted to assess the cardiovascular effects of dipeptidyl peptidase-4 inhibitors (DPP4i) on coronary flow reserve (CFR), left ventricular (LV) function and endothelial function of the peripheral artery by comparison with those of α-glucosidase inhibitors (αGI) in patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD).Methods and Results:We randomly assigned 30 patients with T2DM and CAD to receive either sitagliptin or voglibose, and 28 patients (age 69±9 years, 75% male, hemoglobin A1c [HbA1c] 6.62±0.48%) completed the study (14 in each group). CFR and LV function, assessed by cardiac magnetic resonance imaging, and endothelial function, assessed by reactive hyperemia peripheral arterial tonometry (RH-PAT), were measured at baseline and 24 weeks after treatment. Clinical and laboratory parameters, including HbA1c level, plasma active glucagon-like peptide-1 concentrations, and biomarkers of inflammation, were unchanged in both groups after 24 weeks of treatment. CFR were unchanged in both the αGI group (3.01±0.98 at baseline and 3.06±0.8 after treatment, P=NS) and the DPP4i group (4.29±2.04 at baseline and 3.63±1.31 after treatment, P=NS), with no interaction effect. LV functional parameters and the reactive hyperemia index also remained unchanged after the 24-week treatment.Conclusions:DPP4i did not improve CFR, LV function or endothelial function of the peripheral artery in patients with relatively well-controlled T2DM and CAD.

著者

Tolga Aksu Tümer Erdem Guler Serdar Bozyel Kazım Serhan Ozcan Kivanc Yalin

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-1314, (Released:2018-05-12)

参考文献数

5

著者

Francesco Liotta Francesco Annunziato Sergio Castellani Maria Boddi Brunetto Alterini Giovanni Castellini Benedetta Mazzanti Lorenzo Cosmi Manlio Acquafresca Filippo Bartalesi Beatrice Dilaghi Walter Dorigo Gabriele Graziani Benedetta Bartolozzi Guido Bellandi Giulia Carli Alessandro Bartoloni Aaron Fargion Filippo Fassio Paolo Fontanari Giancarlo Landini Eleonora A.M. Lucente Stefano Michelagnoli Carolina Orsi Battaglini Grazia Panigada Clara Pigozzi Valentina Querci Veronica Santarlasci Paola Parronchi Nicola Troisi Cristiana Baggiore Paola Romagnani Edoardo Mannucci Riccardo Saccardi Carlo Pratesi Gianfranco Gensini Sergio Romagnani Enrico Maggi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0720, (Released:2018-03-23)

参考文献数

47

被引用文献数

19

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Background:The therapeutic efficacy of bone marrow mononuclear cells (BM-MNC) autotransplantation in critical limb ischemia (CLI) has been reported. Variable proportions of circulating monocytes express low levels of CD34 (CD14+CD34lowcells) and behave in vitro as endothelial progenitor cells (EPCs). The aim of the present randomized clinical trial was to compare the safety and therapeutic effects of enriched circulating EPCs (ECEPCs) with BM-MNC administration.Methods and Results:ECEPCs (obtained from non-mobilized peripheral blood by immunomagnetic selection of CD14+and CD34+cells) or BM-MNC were injected into the gastrocnemius of the affected limb in 23 and 17 patients, respectively. After a mean of 25.2±18.6-month follow-up, both groups showed significant and progressive improvement in muscle perfusion (primary endpoint), rest pain, consumption of analgesics, pain-free walking distance, wound healing, quality of life, ankle-brachial index, toe-brachial index, and transcutaneous PO2. In ECEPC-treated patients, there was a positive correlation between injected CD14+CD34lowcell counts and the increase in muscle perfusion. The safety profile was comparable between the ECEPC and BM-MNC treatment arms. In both groups, the number of deaths and major amputations was lower compared with eligible untreated patients and historical reference patients.Conclusions:This study supports previous trials showing the efficacy of BM-MNC autotransplantation in CLI patients and demonstrates comparable therapeutic efficacy between BM-MNC and EPEPCs.

著者

Michiaki Higashitani Yukari Uemura Atsushi Mizuno Makoto Utsunomiya Tetsuo Yamaguchi Akihiro Matsui Shunsuke Ozaki Kazuki Tobita Atsushi Tosaka Akitsugu Oida Kenji Suzuki Takahide Kodama Kentaro Jujo Tatsuki Doijiri Yasuhiro Takahashi Shunsuke Matsuno Nobuhito Kaneko Akira Moriguchi Shohei Kishi Hitoshi Anzai on behalf of Toma-Code Registry Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-0105, (Released:2018-05-11)

参考文献数

27

被引用文献数

21

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Background:The present study was performed to clarify whether the preoperative clinical symptoms for endovascular therapy (EVT) can predict post-EVT death and cardiovascular prognosis in Japanese patients with peripheral artery disease (PAD), including acute disease.Methods and Results:The TOkyo taMA peripheral vascular intervention research COmraDE (Toma-Code) Registry is a Japanese prospective cohort of 2,321 consecutive patients with PAD treated with EVT, in 34 hospitals in the Kanto and Kōshin’etsu regions, from August 2014 to August 2016. In total, 2,173 symptomatic patients were followed up for a median of 10.4 months, including 1,370 with claudication, 719 with critical limb ischemia (CLI), and 84 with acute limb ischemia (ALI) for EVT. The all-cause death rates per 100 person-years for claudication, CLI and ALI were 3.5, 26.2, and 24.5, respectively. Similarly, major adverse cardiac and cerebrovascular events (MACCE) rates per 100 person-years for claudication, CLI, ALI, and others were 5.2, 31.2, and 29.7, respectively. After adjusting for the predictors of all-cause death and MACCE, namely, age, body mass index <18, diabetes mellitus, dialysis, cerebrovascular disease, and low left ventricular ejection fraction, it was determined that the preoperative indication for EVT was strongly associated with all-cause death and MACCE.Conclusions:The preoperative clinical symptoms for EVT can predict the prognosis in patients with PAD undergoing EVT.

著者

Saurabh P. Nagar Pratik P. Rane Kathleen M. Fox Juliana Meyers Keith Davis Anne Beaubrun Hyoe Inomata Yi Qian Kouji Kajinami

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.4, pp.1008-1016, 2018-03-23 (Released:2018-03-23)

参考文献数

29

被引用文献数

23

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Background:This study examined treatment patterns, possible statin intolerance, and incidence of cardiovascular events (CVEs) in 2 cohorts of patients with high cardiovascular risk (i.e., patients with atherosclerotic cardiovascular disease [ASCVD] and patients with diabetes mellitus).Methods and Results:A retrospective cohort study examined adults initiating either a statin or ezetimibe from 1 January 2006 to 31 May 2014 in the Japan Medical Data Center database. The first observed statin or ezetimibe prescription defined the index date. Patients had ≥12 months of pre- and post-index date plan enrollment. Two high-risk cohorts, the ASCVD cohort and diabetes cohort, were created based on diagnoses observed during the 12 months’ pre-index date. Treatment patterns, possible statin intolerance, and incidence of CVEs were reported. In the ASCVD cohort (n=5,302), 32.9% discontinued therapy, 7.7% switched to a non-index statin or non-statin lipid-lowering therapy, and 11.2% augmented index therapy in the 12 months’ post-index date; only 0.3% were using high-intensity statins and 10% had possible statin intolerance. Also, 8.1% had any new CVE during the follow-up period. Treatment patterns and incidence of CVEs among the diabetes cohort were similar to those of the ASCVD cohort.Conclusions:High cardiovascular risk Japanese patients had frequent treatment modifications, although use of high-intensity statin doses was rare. These patterns may indicate that alternative therapies for lipid lowering are needed.

著者

Takuya Hashimoto Junya Ako

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-0405, (Released:2018-04-28)

参考文献数

13

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The 67thAnnual Scientific Session and Expo of the American College of Cardiology (ACC) were held at the Orange County Convention Center, Orlando, from March 10–12, 2018. This meeting offered 2,700 accepted abstracts presented in oral and poster sessions by 2,100 experts and 37 Late-Breaking Clinical Trials and Featured Clinical Research presentations. This report introduces the key presentations and highlights from the ACC 2018 Scientific Session.

著者

Toshiya Kojima Katsuhito Fujiu Nobuaki Fukuma Hiroshi Matsunaga Tsukasa Oshima Jun Matsuda Takumi Matsubara Yu Shimizu Gaku Oguri Eriko Hasumi Hiroyuki Morita Issei Komuro

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1114, (Released:2018-04-13)

参考文献数

20

被引用文献数

7

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Background:Periprocedural anticoagulation is important in catheter ablation (CA) of atrial fibrillation (AF) and there is increasing evidence that uninterrupted vitamin K antagonist (VKA) therapy is superior to interrupted anticoagulation strategies. Since the emergence of direct oral anticoagulants (DOACs), numerous studies have shown promising results for their use in uninterrupted strategies. However, further studies are needed to further define the efficacy and safety of performing AF ablation with uninterrupted factor XA inhibitors or direct thrombin inhibitors.Methods and Results:We have performed CA of AF without discontinuation of either VKA or DOAC therapy since April 2014. A total of 376 patients with AF underwent CA including pulmonary vein isolation. All of the patients were divided into 2 groups (uninterrupted VKA or uninterrupted DOACs). Anticoagulation with DOACs was associated with fewer complications than uninterrupted VKA therapy (P=0.04). There were significant differences between groups in the rates of congestive heart failure, left ventricular ejection fraction, body weight, and estimated glomerular filtration rate and of the CHADS2, CHA2DS2-VASc and HAS-BLED scores. Therefore, we also analyzed the results using the propensity score-matching method. We found no significant difference in periprocedural complications between uninterrupted VKA or DOACs therapy (P=0.65).Conclusions:CA of AF without discontinuation of DOACs is not inferior to CA without discontinuation of a VKA, with regard to ischemic or hemorrhagic complications.

著者

Kotaro Nochioka Yasuhiko Sakata Satoshi Miyata Masanobu Miura Tsuyoshi Takada Soichiro Tadaki Ryoichi Ushigome Takeshi Yamauchi Jun Takahashi Hiroaki Shimokawa on behalf of the CHART-2 Investigators’

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.79, no.3, pp.574-582, 2015-02-25 (Released:2015-02-25)

参考文献数

41

被引用文献数

15 53

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Background:The effectiveness of statins remains to be examined in patients with heart failure (HF) with preserved ejection fraction (EF).Methods and Results:Among 4,544 consecutive HF patients registered in the Chronic Heart Failure Registry and Analysis in the Tohoku district-2 (CHART-2) between 2006 and 2010, 3,124 had EF ≥50% (HFpEF; mean age 69 years; male 65%) and 1,420 had EF <50% (HF with reduced EF (HFrEF); mean age 67 years; male 75%). The median follow-up was 3.4 years. The 3-year mortality in HFpEF patients was lower in patients receiving statins [8.7% vs. 14.5%, adjusted hazard ratio (HR) 0.74; 95% confidence interval (CI), 0.58–0.94; P<0.001], which was confirmed in the propensity score-matched cohort (HR, 0.72; 95% CI, 0.49–0.99; P=0.044). The inverse probability of treatment weighted further confirmed that statin use was associated with reduced incidence of all-cause death (HR, 0.71; 95% CI, 0.62–0.82, P<0.001) and noncardiovascular death (HR, 0.53; 95% CI, 0.43–0.66, P<0.001), specifically reduction of sudden death (HR, 0.59; 95% CI, 0.36–0.98, P=0.041) and infection death (HR, 0.53; 95% CI, 0.35–0.77, P=0.001) in HFpEF. In the HFrEF cohort, statin use was not associated with mortality (HR, 0.87; 95% CI, 0.73–1.04, P=0.12), suggesting a lack of statin benefit in HFrEF patients.Conclusions:These results suggest that statin use is associated with improved mortality rates in HFpEF patients, mainly attributable to reductions in sudden death and noncardiovascular death. (Circ J 2015; 79: 574–582)

著者

Rei Shibata Noriyuki Ouchi Toyoaki Murohara

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.73, no.4, pp.608-614, 2009 (Released:2009-03-25)

参考文献数

97

被引用文献数

90 163

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Obesity is strongly associated with metabolic and cardiovascular disorders. Adiponectin is an adipose-derived plasma protein that is downregulated in subjects with obesity-related disorders. Low levels of adiponectin are associated with the increased prevalence of obesity-linked cardiovascular diseases, including ischemic heart disease and peripheral artery disease. Experimental findings have shown that adiponectin has beneficial effects in the cardiovascular system by directly acting on the component cells of the heart and blood vessels. Adiponectin protects cardiovascular tissues under conditions of stress through a number of mechanisms: inhibition of pro-inflammatory and hypertrophic responses, and stimulation of endothelial cell responses. These effects of adiponectin are mainly attributed to the modulation of signaling molecules, including AMP-activated protein kinase. Thus, adiponectin could be a promising therapeutic target for cardiovascular diseases. (Circ J 2009; 73: 608 - 614)

著者

Yu Natsume Kasumi Oaku Kentaro Takahashi Wakana Nakamura Ai Oono Satomi Hamada Masahiro Yamazoe Kensuke Ihara Takeshi Sasaki Masahiko Goya Kenzo Hirao Tetsushi Furukawa Tetsuo Sasano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1194, (Released:2018-02-05)

参考文献数

44

被引用文献数

33

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Background:Recent experimental studies have demonstrated that several microRNAs (miRNAs) expressed in atrial tissue promote a substrate of atrial fibrillation (AF). However, because it has not been fully elucidated whether these experimental data contribute to identifying circulating miRNAs as biomarkers for AF, we used a combined analysis of human serum and murine atrial samples with the aim of identifying these biomarkers for predicting AF.Methods and Results:Comprehensive analyses were performed to screen 733 miRNAs in serum from 10 AF patients and 5 controls, and 672 miRNAs in atrial tissue from 6 inducible atrial tachycardia model mice and 3 controls. We selected miRNAs for which expression was detected in both analyses, and their expression levels were changed in the human analyses, the murine analyses, or both. This screening identified 11 candidate miRNAs. Next, we quantified the selected miRNAs using a quantitative RT-PCR in 50 AF and 50 non-AF subjects. The individual assessment revealed that 4 miRNAs (miR-99a-5p, miR-192-5p, miR-214-3p, and miR-342-5p) were significantly upregulated in AF patients. A receiver-operating characteristics curve indicated that miR-214-3p and miR-342-5p had the highest accuracy. The combination of the 4 miRNAs modestly improved the predictive accuracy for AF (76% sensitivity, 80% specificity).Conclusions:Novel circulating miRNAs were upregulated in the serum of AF patients and might be potential biomarkers of AF.

著者

Ming-Shyan Lin Chang-Min Chung Ming-Ling Chang Mei-Yen Chen Shih-Tai Chang Pao-Hsien Chu Tien-Hsing Chen Wey-Yil Lin Tung-Jung Huang Yu-Sheng Lin

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1118, (Released:2018-03-02)

参考文献数

39

被引用文献数

9

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Background:Although hepatitis C virus (HCV) is a known risk factor for cardiovascular disease, whether antiviral therapy (AVT) can reduce heart failure (HF) hospitalizations is unknown.Methods and Results:In this population-based cohort study, we used data from the Taiwan National Health Insurance Research Database to evaluate the effect of interferon-based therapy (IBT) on cardiovascular events in patients with chronic HCV infection. Clinical outcomes evaluated included HF hospitalizations; a composite of acute myocardial infarction, ischemic stroke, and peripheral artery disease; all-cause death; and cardiovascular death. Of 83,229 eligible patients with chronic HCV infection, we compared 16,284 patients who received IBT with untreated subjects after propensity score matching. Patients who received IBT were less likely to be hospitalized for HF compared with untreated subjects (incidence density.ID, 0.9 vs. 1.5 events per 103person-years; hazard ratio.HR, 0.58; 95% confidence interval.CI, 0.42–0.79; P=0.001). Compared with untreated subjects, the treated group had significantly lower risk of composite vascular events (ID, 3.7 vs. 5.0 events per 103person-years; P<0.001), all-cause death (ID, 5.6 vs. 17.2 events per 103person-years; P<0.001), and cardiovascular death (ID, 0.2 vs. 0.6 events per 103person-years; P=0.001).Conclusions:AVT for chronic HCV infection might offer protection against HF hospitalizations, critical vascular events, and cardiovascular death beyond known beneficial effects.

著者

Ryuji Fukazawa Tohru Kobayashi Masashi Mikami Tsutomu Saji Kenji Hamaoka Hitoshi Kato Hiroyuki Suzuki Etsuko Tsuda Mamoru Ayusawa Masaru Miura Ryota Ebata Tomio Kobayashi Mayumi Yashiro Shunichi Ogawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.1, pp.239-246, 2017-12-25 (Released:2017-12-25)

参考文献数

22

被引用文献数

38

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Background:Giant coronary aneurysm is the most severe sequela in Kawasaki disease, occurring in approximately 0.2% of patients in Japan. Regression is rare, while myocardial infarction (MI) and sudden death are relatively common. Herein, we reviewed patients with giant coronary aneurysm in a 10-year period.Methods and Results:A nationwide questionnaire survey was conducted based on a national epidemiological database from 1999 to 2010. We identified 355 giant coronary aneurysm patients, of whom 209 were analyzed. The 5- and 10-year total cardiac event-free rates were 0.72 and 0.68, respectively. Twelve patients died, and MI was observed in 32 patients (18.1%). Five and 6 deaths were due to coronary rupture and MI, respectively. All ruptures occurred within 1 month of onset, while most MI occurred within 18 months. There was no death beyond 2 years. Aneurysm size was significantly related to the occurrence of MI in both the right and left coronary arteries. At the time of writing, 55% of patients had no exercise limitations. And including patients who cannot perform strenuous exercises, 81% of patients were leading ordinary lives.Conclusions:Severe cardiac events are likely to occur within 2 years from onset of Kawasaki disease, while no deaths occurred beyond this time. Hence, careful monitoring is needed especially for the first 2 years. Most patients with giant coronary aneurysms can lead ordinary lives with appropriate management.

著者

Tetsuo Minamino Shuichiro Higo Ryo Araki Shungo Hikoso Daisaku Nakatani Hiroshi Suzuki Takahisa Yamada Masaaki Okutsu Kouji Yamamoto Yasushi Fujio Yoshio Ishida Takuya Ozawa Kiminori Kato Ken Toba Yoshifusa Aizawa Issei Komuro EPO-AMI-II Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0889, (Released:2018-02-02)

参考文献数

21

被引用文献数

15

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Background:Erythropoietin (EPO) has antiapoptotic and tissue-protective effects, but previous clinical studies using high-dose EPO have not shown cardioprotective effects, probably because of platelet activation and a lack of knowledge regarding the optimal dose. In contrast, a small pilot study using low-dose EPO has shown improvement in left ventricular function without adverse cardiovascular events.Methods and Results:We performed a multicenter (25 hospitals), prospective, randomized, double-blind, placebo-controlled, dose-finding study to clarify the efficacy and safety of low-dose EPO in patients with ST-segment elevation myocardial infarction (STEMI) under the Evaluation System of Investigational Medical Care of the Ministry of Health, Labor and Welfare of Japan. In total, 198 STEMI patients with low left ventricular ejection fraction (LVEF <50%) were randomly assigned to receive intravenous administration of EPO (6,000 or 12,000 IU) or placebo within 6 h of successful percutaneous coronary intervention. At 6 months, there was no significant dose-response relationship in LVEF improvement among the 3 groups tested (EPO 12,000 IU: 5.4±9.3%, EPO 6,000 IU: 7.3±7.7%, Placebo: 8.1±8.3%, P=0.862). Low-dose EPO also did not improve cardiac function, as evaluated by 99 mTc-MIBI SPECT or NT-proBNP at 6 months and did not increase adverse events.Conclusions:Administration of low-dose EPO did not improve LVEF at 6 months in STEMI patients (UMIN000005721).

著者

Satoshi Kodera Hiroyuki Morita Arihiro Kiyosue Jiro Ando Issei Komuro

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0995, (Released:2018-01-23)

参考文献数

33

被引用文献数

15

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Background:The addition of eicosapentaenoic acid (EPA) to statin therapy has been shown to reduce cardiovascular events. This study examined the cost-effectiveness of EPA plus statin (EPA+statin) combination therapy compared with statin monotherapy for primary and secondary prevention of cardiovascular disease (CVD) in Japan.Methods and Results:A Markov model was applied to assess the costs and benefits associated with EPA+statin combination therapy over a projected 30-year period from the perspective of a public healthcare funder in Japan. The incremental cost-effectiveness ratio (ICER), expressed as quality-adjusted life-years (QALY), was estimated for primary prevention and secondary prevention of CVD in patients with hypercholesterolemia. Impact on survival and number of events were based on the Japan EPA Lipid Intervention Study. Sensitivity analyses examined the influence of various input parameters on costs and outcomes of treatment. ICER was ¥29.6 million per QALY gained in primary prevention and ¥5.5 million per QALY gained in secondary prevention. The probabilities that EPA+statin combination therapy would be cost-effective compared with statin monotherapy were 39% in primary prevention and 49% in secondary prevention at a cost-effectiveness threshold of ¥5 million per QALY gained. Sensitivity analyses showed that EPA was cost-effective in secondary prevention.Conclusions:EPA+statin combination therapy showed acceptable cost-effectiveness for secondary prevention, but not primary prevention, of CVD in patients with hypercholesterolemia in Japan.

著者

Noriko Inoue Ryo Maeda Hideshi Kawakami Tomoki Shokawa Hideya Yamamoto Chikako Ito Hideo Sasaki

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.73, no.3, pp.549-553, 2009 (Released:2009-02-25)

参考文献数

31

被引用文献数

33 66

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Background: Aortic pulse wave velocity (PWV) is widely used as a noninvasive index of arterial stiffness and was used in the present study to investigate the relationship between PWV and cardiovascular mortality in the middle-aged and elderly Japanese population using a longitudinal study design. Methods and Results: From 1988 to 2003, a total of 3,960 men (50-69 years old at baseline) who underwent medical check-ups and measurement of PWV, which was standardized for diastolic blood pressure, were recruited and divided into 4 groups according to the PWV values. The average follow-up period was 8.2 years. Mortality from all-causes and from cardiovascular disease significantly increased as PWV increased in the entire follow-up period. Multivariate-adjusted relative risks of all-cause and cardiovascular disease mortality for the highest quartile of PWV (>9.0 m/s) were 1.28 (95% confidence interval (CI) 0.97-1.68) and 1.83 (95%CI 1.02-3.29), respectively, compared with the lowest quartile (<7.5 m/s). Conclusions: An increased PWV can predict cardiovascular mortality in middle-aged and elderly Japanese men. (Circ J 2009; 73: 549 - 553)

著者

Yoshihiro Seo

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1387, (Released:2018-01-11)

参考文献数

14

被引用文献数

2

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On November 11–15, the American Heart Association (AHA) Scientific Sessions 2017 were held in Anaheim, California, for the first time in 16 years. The annual sessions attracted nearly 18,000 attendees, with a global presence from more than 100 countries, and featured 5 days of programming for cardiovascular basic scientists, clinicians, and researchers. As usual, activities of participants from Japan were prominent. From the exciting sessions, I report the topics and key presentations including the late-breaking clinical trials.

著者

Toru Kubo Takayoshi Hirota Yuichi Baba Yuri Ochi Asa Takahashi Naohito Yamasaki Naohisa Hamashige Katsuhito Yamamoto Fumiaki Kondo Kanji Bando Eisuke Yamada Takashi Furuno Toshikazu Yabe Yoshinori L Doi Hiroaki Kitaoka

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0845, (Released:2018-01-13)

参考文献数

30

被引用文献数

21

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Background:There have been few studies on the clinical course of hypertrophic cardiomyopathy (HCM) in a community-based patient cohort in Japan.Methods and Results:In 2004, we established a cardiomyopathy registration network in Kochi Prefecture (the Kochi RYOMA study) that consisted of 9 hospitals, and finally, 293 patients with HCM were followed. The ages at registration and at diagnosis were 63±14 and 56±16 years, respectively, and 197 patients (67%) were male. HCM-related deaths occurred in 23 patients during a mean follow-up period of 6.1±3.2 years. The HCM-related 5-year survival rate was 94%. In addition, a total of 77 cardiovascular events that were clinically severe occurred in 70 patients, and the HCM-related 5-year event-free rate was 80%. Multivariate Cox proportional hazards model analysis showed that the presence of NYHA class III at registration was a significant predictor of HCM-related deaths and that the presence of atrial fibrillation, lower fractional shortening and presence of left ventricular outflow tract obstruction in addition to NYHA class III were significant predictors of cardiovascular events.Conclusions:In our unselected registry in an aged Japanese community, HCM mortality was favorable, but one-fifth of the patients commonly suffered from HCM-related adverse cardiovascular events during the 5-year follow-up period. Careful management of HCM patients is needed, particularly for those with the above-mentioned clinical determinants.

著者

Ryutaro Ikegami Ippei Shimizu Yohko Yoshida Tohru Minamino

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.1, pp.10-16, 2017-12-25 (Released:2017-12-25)

参考文献数

71

被引用文献数

30

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It is thought that at least 6,500 low-molecular-weight metabolites exist in humans, and these metabolites have various important roles in biological systems in addition to proteins and genes. Comprehensive assessment of endogenous metabolites is called metabolomics, and recent advances in this field have enabled us to understand the critical role of previously unknown metabolites or metabolic pathways in the cardiovascular system. In this review, we will focus on heart failure and how metabolomic analysis has contributed to improving our understanding of the pathogenesis of this critical condition.

著者

Keitaro Senoo Yusuke Kondo Yoshio Kobayashi Gregory YH Lip

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1164, (Released:2017-12-27)

参考文献数

45

被引用文献数

5

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Background:Atrial fibrillation (AF) is the most common arrhythmia in the ageing population in East Asia. Silent cerebral infarction (SCI) is defined as cerebral infarction in the absence of corresponding clinical symptoms, and is a highly prevalent and morbid condition in AF. SCI is increasingly being recognized as a risk factor for future stroke, which can lead to cognitive decline or dementia. The latter is an increasingly common health problem in East Asia.Methods and Results:We conducted a meta-analysis to compare the association of AF and SCI between East Asian and non-Asian patients. AF was associated with SCI in patients with no symptomatic stroke history (relative risk [RR], 2.24; 95% CI: 1.26–3.99, I2=83%; P=0.006) although the prevalence varied widely between studies (P for heterogeneity<0.001). In non-Asian patients, the prevalence of SCI in AF is higher than that in controls (RR, 1.85; 95% CI: 1.65–2.08, I2=17%; P<0.001). There was no significant racial difference between Asian and non-Asian studies (P=0.53).Conclusions:In East Asia, AF was significantly associated with SCI and no racial difference was seen between East Asian and non-Asian patients. The present findings offer clinicians new insights into the association between AF and SCI.