著者

Tetsuya Matoba Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0645, (Released:2021-08-18)

参考文献数

12

著者

Noriaki Iwahashi Jin Kirigaya Masaomi Gohbara Takeru Abe Mutsuo Horii Yohei Hanajima Noriko Toya Hironori Takahashi Yugo Minamimoto Yuichiro Kimura Eiichi Akiyama Kozo Okada Yasushi Matsuzawa Nobuhiko Maejima Kiyoshi Hibi Masami Kosuge Toshiaki Ebina Kouichi Tamura Kazuo Kimura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0183, (Released:2021-06-01)

参考文献数

19

被引用文献数

9

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Background:Three-dimensional (3D) speckle tracking echocardiography (STE) after ST-elevation acute myocardial infarction (STEMI) is associated with left ventricular (LV) remodeling and 1-year prognosis. This study investigated the clinical significance of 3D-STE in predicting the long-term prognosis of patients with STEMI.Methods and Results:A total of 270 patients (mean age 64.6 years) with first-time STEMI treated with reperfusion therapy were enrolled. At 24 h after admission, standard 2D echocardiography and 3D full-volume imaging were performed, and 2D-STE and 3D-STE were calculated. Patients were followed up for a median of 119 months (interquartile range: 96–129 months). The primary endpoint was occurrence of a major adverse cardiac event (MACE: cardiac death, heart failure with hospitalization), and 64 patients experienced MACEs. Receiver operating characteristic curves and Cox hazard multivariate analysis showed that the 3D-STE indices were stronger predictors of MACE compared with those of 2D-STE. Additionally, 3D-global longitudinal strain (GLS) was the strongest predictor for MACE followed by 3D-global circumferential strain (GCS). The Kaplan-Meier curve demonstrated that 3D-GLS >−11.0 was an independent predictor for MACE (log-rank χ2=132.2, P<0.0001). When combined with 3D-GCS >−18.3, patients with higher values of 3D-GLS and 3D-GCS were found to be at extremely high risk for MACE.Conclusions:Global strain measured by 3D-STE immediately after the onset of STEMI is a clinically significant predictor of 10-year prognosis.

著者

Kosuke Kiyohara Junya Sado Tetsuhisa Kitamura Mamoru Ayusawa Masahiko Nitta Taku Iwami Ken Nakata Yasuto Sato Noriko Kojimahara Naohito Yamaguchi Tomotaka Sobue Yuri Kitamura for the SPIRITS Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1237, (Released:2018-02-15)

参考文献数

34

被引用文献数

1 19

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Background:A better understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring in school settings is important to establish an evidence-based strategy for prevention and better prognosis.Methods and Results:The Stop and Prevent cardIac aRrest, Injury, and Trauma in Schools (SPIRITS) is a nationwide prospective observational study linking databases from 2 nationally representative registries, the Injury and the Accident Mutual Aid Benefit System of The Japan Sport Council and the All-Japan Utstein Registry of the Fire and Disaster Management Agency. Using these databases, we described the detailed characteristics and outcomes of pediatric OHCAs that occurred in school settings in Japan between 2009 and 2014. During the 6-year study period, 295 OHCA cases were confirmed. Overall incidence rate was 0.4 per 100,000 students per year. The majority of OHCA cases had a cardiac origin (71%), occurred during exercise (65%), were witnessed by bystanders (70%), and received bystander-initiated cardiopulmonary resuscitation (73%). In approximately one-third of cases the student was defibrillated by public-access automated external defibrillator (38%). The proportion of patients with 1-month survival and a favorable neurological outcome was 34% among all OHCAs and 43% among OHCAs of cardiac origin.Conclusions:In Japan, approximately 50 pediatric cases of OHCA consistently occur yearly in school settings. The majority of students received basic life support from bystanders, and patients with OHCA of cardiac origin had a relatively good prognosis.

著者

Valentina Carubelli Marco Metra Ugo Corrà Damiano Magrì Claudio Passino Carlo Lombardi Domenico Scrutinio Michele Correale Gaia Cattadori Massimo F. Piepoli Elisabetta Salvioni Marta Giovannardi Rosa Raimondo Mariantonietta Cicoira Romualdo Belardinelli Marco Guazzi Giuseppe Limongelli Francesco Clemenza Gianfranco Parati Angela B. Scardovi Andrea Di Lenarda Maurizio Bussotti Rocco La Gioia Piergiuseppe Agostoni on behalf of the MECKI score research group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.79, no.12, pp.2608-2615, 2015-11-25 (Released:2015-11-25)

参考文献数

33

被引用文献数

17 18

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Background:In patients with chronic heart failure (HF) the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score, is a predictor of cardiovascular death and urgent heart transplantation. We investigated the relationship between age, exercise tolerance and the prognostic value of the MECKI score.Methods and Results:We analyzed data from 3,794 patients with chronic systolic HF. The primary endpoint was a composite of cardiovascular death and urgent heart transplantation. Older patients had higher prevalence of comorbidities and lower exercise performance compared with younger subjects (peak V̇O2, 925 vs. 1,351 L/min; P<0.0001; V̇E/V̇CO2slope, 33.2 vs. 28.3; P>0.0001). The rate of the primary endpoint was 19% in the highest age quartile and 14% in the lowest quartile. At multivariable analysis, the independent predictors of the primary endpoint were left ventricular ejection fraction (LVEF), eGFR, peak V̇O2, serum Na+and the use of β-blockers in patients aged ≥70 years, and LVEF, eGFR and peak V̇O2in younger subjects. The MECKI risk score increased across age subgroups, but on receiver operating characteristic curve analysis its prognostic power was similar in both patients aged ≥70 and <70 years.Conclusions:Older patients with HF are a high-risk population with lower exercise performance. The MECKI score increased according to age and maintained its prognostic value also in older patients. (Circ J 2015; 79: 2608–2615)

著者

Lusha W. Liang Yuichi J. Shimada

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0349, (Released:2021-06-08)

参考文献数

51

被引用文献数

3

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Endotyping is an emerging concept in which diseases are classified into distinct subtypes based on underlying molecular mechanisms. Heart failure (HF) is a complex clinical syndrome that encompasses multiple endotypes with differential risks of adverse events, and varying responses to treatment. Identifying these distinct endotypes requires molecular-level investigation involving multi-“omics” approaches, including genomics, transcriptomics, proteomics, and metabolomics. The derivation of these HF endotypes has important implications in promoting individualized treatment and facilitating more targeted selection of patients for clinical trials, as well as in potentially revealing new pathways of disease that may serve as therapeutic targets. One challenge in the integrated analysis of high-throughput omics and detailed clinical data is that it requires the ability to handle “big data”, a task for which machine learning is well suited. In particular, unsupervised machine learning has the ability to uncover novel endotypes of disease in an unbiased approach. In this review, we will discuss recent efforts to identify HF endotypes and cover approaches involving proteomics, transcriptomics, and genomics, with a focus on machine-learning methods.

著者

Yugo Yamashita Yuuki Maruyama Hirono Satokawa Yuji Nishimoto Ichizo Tsujino Hideki Sakashita Hiroko Nakata Yoshinori Okuno Yoshito Ogihara Sen Yachi Naoki Toya Masami Shingaki Satoshi Ikeda Naoto Yamamoto Shizu Aikawa Nobutaka Ikeda Hiroya Hayashi Shingo Ishiguro Eriko Iwata Michihisa Umetsu Akane Kondo Takehisa Iwai Takao Kobayashi Makoto Mo Norikazu Yamada on behalf of the Taskforce of VTE and COVID-19 in Japan Study

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0169, (Released:2021-05-20)

参考文献数

33

被引用文献数

30

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Background:Coronavirus disease 2019 (COVID-19) reportedly causes venous thromboembolism (VTE), but the status of this complication in Japan was unclear.Methods and Results:The VTE and COVID-19 in Japan Study is a retrospective, multicenter cohort study enrolling hospitalized patients with COVID-19 who were evaluated with contrast-enhanced computed tomography (CT) examination at 22 centers in Japan between March 2020 and October 2020. Among 1,236 patients with COVID-19, 45 (3.6%) were evaluated with contrast-enhanced CT examination. VTE events occurred in 10 patients (22.2%), and the incidence of VTE in mild, moderate, and severe COVID-19 was 0%, 11.8%, and 40.0%, respectively. COVID-19 patients with VTE showed a higher body weight (81.6 vs. 64.0 kg, P=0.005) and body mass index (26.9 vs. 23.2 kg/m2, P=0.04), and a higher proportion had a severe status for COVID-19 compared with those without. There was no significant difference in the proportion of patients alive at discharge between patients with and without VTE (80.0% vs. 88.6%, P=0.48). Among 8 pulmonary embolism (PE) patients, all were low-risk PE.Conclusions:Among a relatively small number of patients undergoing contrast-enhanced CT examination in Japanese real-world clinical practice, there were no VTE patients among those with mild COVID-19, but the incidence of VTE seemed to be relatively high among severe COVID-19 patients, although all PE events were low-risk without significant effect on mortality risk.

著者

Yousuke Hashimoto Yukio Ozaki Shino Kan Koichi Nakao Kazuo Kimura Junya Ako Teruo Noguchi Satoru Suwa Kazuteru Fujimoto Kazuoki Dai Takashi Morita Wataru Shimizu Yoshihiko Saito Atsushi Hirohata Yasuhiro Morita Teruo Inoue Atsunori Okamura Toshiaki Mano Minoru Wake Kengo Tanabe Yoshisato Shibata Mafumi Owa Kenichi Tsujita Hiroshi Funayama Nobuaki Kokubu Ken Kozuma Shiro Uemura Tetsuya Tobaru Keijiro Saku Shigeru Oshima Satoshi Yasuda Tevfik F Ismail Takashi Muramatsu Hideo Izawa Hiroshi Takahashi Kunihiro Nishimura Yoshihiko Miyamoto Hisao Ogawa Masaharu Ishihara on behalf of J-MINUET Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1115, (Released:2021-06-03)

参考文献数

31

被引用文献数

19

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Background:The impact of chronic kidney disease (CKD) on long-term outcomes following acute myocardial infarction (AMI) in the era of modern primary PCI with optimal medical therapy is still in debate.Methods and Results:A total of 3,281 patients with AMI were enrolled in the J-MINUET registry, with primary PCI of 93.1% in STEMI. CKD stage on admission was classified into: no CKD (eGFR ≥60 mL/min/1.73 m2); moderate CKD (60>eGFR≥30 mL/min/1.73 m2); and severe CKD (eGFR <30 mL/min/1.73 m2). While the primary endpoint was all-cause mortality, the secondary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause death, cardiac failure, myocardial infarction (MI) and stroke. Of the 3,281 patients, 1,878 had no CKD, 1,073 had moderate CKD and 330 had severe CKD. Pre-person-days age- and sex-adjusted in-hospital mortality significantly increased from 0.014% in no CKD through 0.042% in moderate CKD to 0.084% in severe CKD (P<0.0001). Three-year mortality and MACE significantly deteriorated from 5.09% and 15.8% in no CKD through 16.3% and 38.2% in moderate CKD to 36.7% and 57.9% in severe CKD, respectively (P<0.0001). C-index significantly increased from the basic model of 0.815 (0.788–0.841) to 0.831 (0.806–0.857), as well as 0.731 (0.708–0.755) to 0.740 (0.717–0.764) when adding CKD stage to the basic model in predicting 3-year mortality (P=0.013; net reclassification improvement [NRI] 0.486, P<0.0001) and MACE (P=0.046; NRI 0.331, P<0.0001) respectively.Conclusions:CKD remains a useful predictor of in-hospital and 3-year mortality as well as MACE after AMI in the modern PCI and optimal medical therapy era.

著者

Yuma Hamanaka Yohei Sotomi Akio Hirata Tomoaki Kobayashi Yasuhiro Ichibori Nobuhiko Makino Takaharu Hayashi Yasushi Sakata Atsushi Hirayama Yoshiharu Higuchi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-1006, (Released:2020-02-11)

参考文献数

21

被引用文献数

8 17

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Background:This study investigated the impact of systemic inflammation on bleeding risk in non-valvular atrial fibrillation (NVAF) patients treated with direct oral anticoagulants (DOAC).Methods and Results:We conducted a single-center prospective registry of 2,216 NVAF patients treated with DOAC: the DIRECT registry (UMIN000033283). High-sensitivity C-reactive protein (hsCRP) was measured ≤3 months before (pre-DOAC hsCRP) and 6±3 months after initiation of DOAC (post-DOAC hsCRP). Multivariate logistic regression model was used to assess the influence of systemic inflammation and conventional bleeding risk factors on major bleeding according to International Society on Thrombosis and Haemostasis criteria. Based on the findings, we created a new bleeding risk assessment score: the ORBIT-i score, which included post-DOAC hsCRP >0.100 mg/dL and all components of the ORBIT score. A total of 1,848 patients had both pre- and post-DOAC hsCRP data (follow-up duration, 460±388 days). Post-DOAC hsCRP was associated with major bleeding (OR, 2.770; 95% CI: 1.687–4.548, P<0.001). Patients with post-DOAC hsCRP >0.100 mg/dL more frequently had major bleeding than those without (log-rank test, P<0.001). ORBIT-i score had the highest C-index of 0.711 (95% CI, 0.654–0.769) compared with the ORBIT and HAS-BLED scores.Conclusions:Persistent systemic inflammation was associated with major bleeding risk. ORBIT-i score had a higher discriminative performance compared with the conventional bleeding risk scores.

著者

Takahiro Komori Satoshi Hoshide Kazuomi Kario

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0972, (Released:2021-04-14)

参考文献数

26

被引用文献数

7

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Background:Rising blood pressure (BP) in the morning, known as the morning BP surge (MBPS), is known to pose a risk for cardiovascular events in hypertensive individuals. It was not known whether the MBPS was associated with a worse prognosis in patients with heart failure (HF) with a reduced (HFrEF) or preserved (HFpEF) ejection fraction.Methods and Results:We performed a prospective, observational cohort study of hospitalized HF patients who underwent ambulatory BP monitoring (ABPM). The MBPS was calculated by subtracting the mean systolic BP (SBP) during the 1 h that included the lowest sleep BP from the mean SBP during the 2 h after waking. The MBPS group was defined as the top decile of MBPS (>40 mmHg). In all, 456 hospitalized HF patients (mean [±SD] age 68±13 years, 63.9% male) were followed-up for a median of 1.67 years. There were 90 events (16.3 per 100 person-years) of the composite outcome (all-cause mortality and worsening HF) in the HFrEF group, compared with 53 events (19.6 per 100 person-years) in the HFpEF group. Multivariate Cox regression analysis showed that MBPS was a significant predictor of outcome (hazard ratio 2.84, 95% confidence interval 1.58–5.10, P<0.01) in the HFrEF but not HFpEF group.Conclusions:MBPS was found to be a novel predictor of worsening HF in patients with HFrEF.

著者

Kyung-Duk Min Masafumi Kitakaze

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.10, pp.2479-2480, 2018-09-25 (Released:2018-09-25)

参考文献数

8

被引用文献数

1

著者

Hirokazu Komoriyama Kiwamu Kamiya Yuta Kobayashi Satonori Tsuneta Takao Konishi Takuma Sato Hiroyuki Iwano Toshiyuki Nagai Satoru Wakasa Kohsuke Kudo Toshihisa Anzai

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1248, (Released:2021-04-03)

著者

Ayako Sekine Takatomo Watanabe Genki Naruse Ayae Takada Shingo Fujimoto Noriko Ozawa Koichi Shinoda Yuzuru Nohisa Hiroyuki Okura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.85, no.1, pp.78, 2020-12-25 (Released:2020-12-25)

参考文献数

1

著者

Hitoshi Goto Michihisa Umetsu Daijirou Akamatsu Hirofumi Sugawara Ken Tsuchida Yoshitaro Yoshida Shunya Suzuki Takashi Kamei

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0713, (Released:2021-03-09)

参考文献数

28

被引用文献数

1

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Background:Because anticoagulant drugs for ambulatory patients with cancer-associated venous thromboembolism (CAT) are limited to warfarin and direct oral anticoagulants (DOACs) in Japan, it is important to assess the outcomes of both drugs.Methods and Results:We retrospectively assessed the outcomes of CAT patients who were treated with warfarin or edoxaban between 2011 and 2017. The assessment was limited to the duration of anticoagulant administration. CAT patients who did not receive anticoagulation therapy were also compared with the warfarin and edoxaban groups. We enrolled 111 CAT patients treated with warfarin (n=58, mean age 62.6 years, mean time in therapeutic range [TTR] % 61.1) or edoxaban (n=53, mean age 64.6 years). Although venous thromboembolism (VTE) recurred in 2 warfarin-treated patients, the 2 treatment groups were not significantly different (P=0.18). Bleeding during anticoagulation therapy occurred in 6 warfarin-treated patients (2 with major bleeding) and in 5 edoxaban-treated patients (no major bleeding) (P=1.0). The non-anticoagulation group (n=37) showed a high recurrence rate (P<0.01) compared with the anticoagulant group.Conclusions:This study showed that warfarin and edoxaban are equally effective in preventing VTE recurrence and bleeding. However, warfarin control in CAT patients presented some difficulties. This study also demonstrated the efficacy of anticoagulant drugs, compared with no anticoagulation, for CAT patients to prevent VTE recurrence.

著者

JCS Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.78, no.11, pp.2779-2801, 2014-10-24 (Released:2014-10-24)

参考文献数

292

被引用文献数

211 363

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(Circ J 2014; 78: 2779–2801)

著者

Nobunaga Okada Tasuku Matsuyama Sachiko Morita Naoki Ehara Nobuhiro Miyamae Yohei Okada Takaaki Jo Yasuyuki Sumida Makoto Watanabe Masahiro Nozawa Ayumu Tsuruoka Yoshihiro Fujimoto Yoshiki Okumura Kunio Hamanaka Tetsuhisa Kitamura Kei Nishiyama Bon Ohta

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.84, no.3, pp.445-455, 2020-02-25 (Released:2020-02-25)

参考文献数

21

被引用文献数

3

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Background: The Osborn wave (OW) is often observed in hypothermic patients; however, whether OW in hypothermic patients is related to the development of fatal ventricular arrhythmia, including ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT), remains undetermined. This study aimed to estimate the association between OW and the incidence of fatal ventricular arrhythmias.Methods and Results: This retrospective study used the Japanese Accidental Hypothermia Network registry database and included 572 hypothermic patients. Patients were divided into the OW group (those with OW) and non-OW group (those without OW). The relationship between the development of fatal arrhythmias and presence of OW was assessed using the chi-squared test. All patients who developed VF/VT (n=10) had OW on electrocardiogram upon hospital arrival. The presence of OW had a sensitivity of 100%, specificity of 47.8%, positive predictive value of 4.0%, and negative predictive value of 100% for VF/VT development. The in-hospital mortality rate was 22.3% in the OW group and 21.2% in the non-OW group (P=0.781).Conclusions: OW was observed in all hypothermic patients with VF/VT. The occurrence of ventricular arrhythmias is highly unlikely in the absence of OW on the electrocardiogram. Although the presence of OW might be used to predict these fatal arrhythmias in hypothermic patients, there was no association between the presence of OW and in-hospital mortality.

著者

Toshihisa Anzai

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.85, no.1, pp.1, 2020-12-25 (Released:2020-12-25)

著者

Kenichi Kurosaki Masataka Kitano Heima Sakaguchi Isao Shiraishi Naoko Iwanaga Jun Yoshimatsu Takaya Hoashi Hajime Ichikawa Satoshi Yasuda

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.84, no.12, pp.2275-2285, 2020-11-25 (Released:2020-11-25)

参考文献数

30

被引用文献数

3

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Background:Congenital heart disease (CHD) is often diagnosed prenatally using fetal echocardiography, but few studies have evaluated the accuracy of these fetal cardiac diagnoses in detail. We investigated the discrepancy between pre- and postnatal diagnoses of CHD and the impact of discrepant diagnoses.Methods and Results:This retrospective study at a tertiary institution included data from the medical records of 207 neonates with prenatally diagnosed CHD admitted to the cardiac neonatal intensive care unit between January 2011 and December 2016. Pre- and postnatal diagnoses of CHD differed in 12% of neonates. Coarctation of the aorta and ventricular septal defects were the most frequent causes of discrepant diagnosis. Unexpected treatments were added to 38% of discrepant diagnostic cases. However, discrepant diagnoses did not adversely affect the clinical course. The 9% of the 207 neonates who required invasive intervention within 24 h of delivery were accurately diagnosed prenatally.Conclusions:Pre- and postnatal diagnoses differed in only a few neonates, with differences not adversely affecting the clinical course. Neonates who required invasive intervention immediately after delivery were accurately diagnosed prenatally. Prenatal diagnosis thus seems to contribute to improved prognosis in neonates with CHD.

著者

Hiroshi Kadowaki Hiroshi Akazawa Junichi Ishida Issei Komuro

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.84, no.9, pp.1446-1453, 2020-08-25 (Released:2020-08-25)

参考文献数

58

被引用文献数

10

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Improvements in the long-term survival of cancer patients have led to growing awareness of the clinical importance of cancer therapeutics-related cardiac dysfunction (CTRCD), which can have a considerable effect on the prognosis and quality of life of cancer patients and survivors. Under such circumstances, onco-cardiology/cardio-oncology has emerged as a new discipline, with the aim of best managing cardiovascular complications, including CTRCD. Despite the recent accumulation of epidemiological and clinical information regarding CTRCD, the molecular mechanisms underlying the pathogenesis of CTRCD by individual drugs remain to be determined. To achieve the goal of preventing cardiovascular complications in cancer patients and survivors, it is important to elucidate the pathogenic mechanisms and to establish diagnostic strategies with risk prediction and mechanism- and evidence-based therapies against CTRCD.

著者

Yuji Nishimoto Yugo Yamashita Kitae Kim Takeshi Morimoto Syunsuke Saga Hidewo Amano Toru Takase Seiichi Hiramori Maki Oi Masaharu Akao Yohei Kobayashi Mamoru Toyofuku Toshiaki Izumi Tomohisa Tada Po-Min Chen Koichiro Murata Yoshiaki Tsuyuki Tomoki Sasa Jiro Sakamoto Minako Kinoshita Kiyonori Togi Hiroshi Mabuchi Kensuke Takabayashi Yusuke Yoshikawa Hiroki Shiomi Takao Kato Takeru Makiyama Koh Ono Yukihito Sato 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

vol.84, no.11, pp.2006-2014, 2020-10-23 (Released:2020-10-23)

参考文献数

33

被引用文献数

21

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Background:Patients with cancer-associated venous thromboembolism (VTE) are at high risk for recurrent VTE and are recommended to receive prolonged anticoagulation therapy if they are at a low risk for bleeding. However, there are no established risk factors for bleeding during anticoagulation therapy.Methods and Results:The COMMAND VTE Registry is a multicenter retrospective registry enrolling 3,027 consecutive patients with acute symptomatic VTE among 29 Japanese centers. The present study population consisted of 592 cancer-associated VTE patients with anticoagulation therapy. We constructed a multivariable Cox proportional hazard model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the potential risk factors for major bleeding. During a median follow-up period of 199 days, major bleeding occurred in 72 patients. The cumulative incidence of major bleeding was 5.8% at 3 months, 13.8% at 1 year, 17.5% at 2 years, and 28.1% at 5 years. The most frequent major bleeding site was gastrointestinal tract (47%). Terminal cancer (adjusted HR, 4.17; 95% CI, 2.22–7.85, P<0.001), chronic kidney disease (adjusted HR, 1.89; 95% CI 1.06–3.37, P=0.031), and gastrointestinal cancer (adjusted HR, 1.78; 95% CI, 1.04–3.04, P=0.037) were independently associated with an increased risk of major bleeding.Conclusions:Major bleeding events were common during anticoagulation therapy in real-world cancer-associated VTE patients. Terminal cancer, chronic kidney disease, and gastrointestinal cancer were the independent risk factors for major bleeding.

著者

Sylwia Sławek-Szmyt Aleksander Araszkiewicz Marek Grygier Krzysztof Szmyt Lidia Chmielewska-Michalak Wojciech Seniuk Michał Waśniewski Tomasz Smukowski Maciej Lesiak Przemysław Mitkowski

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0305, (Released:2020-09-05)

参考文献数

30

被引用文献数

7

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Background:Cardiac implantable electronic device-related infections (CDI) are of increasing importance and involve substantial healthcare resources. This study aimed to evaluate potential CDI risk factors and the utility of the novel PADIT and PACE DRAP scores to predict CDI.Methods and Results:The study group included 1,000 consecutive patients undergoing implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy (CRT) surgery. Patients’ and procedural characteristics were collected. CDI occurrence was assessed during 1-year follow-up. Moreover, if periprocedural significant pocket hematoma (SPH) occurred, the maximal volume was calculated based on ultrasonographic measurements and ABC/2 formula. The overall incidence of CDI was 1.8%. In the multivariable regression analysis independent CDI risk factors were: age >75 years (odds ratio [OR]: 5.93; 95% confidence interval [CI]: 1.77–19.84), system upgrade procedure (OR: 6.46; CI: 1.94–21.44), procedure duration >1 h (OR: 13.96; CI: 4.40–44.25), presence of SPH (OR: 4.95; CI: 1.62–15.13) and reintervention within 1 month (OR: 16.29; CI: 3.14–84.50). The PACE DRAP score had higher discrimination of CDI incidence (area under curve [AUC] 0.72) as compared with the PADIT score (AUC 0.63).Conclusions:We identified 5 independent risk factors of CDI development. Our study also showed that the PACE DRAP score was better able to identify patients at high risk of CDI than the PADIT score.