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.

著者

Hidehiro Matsuoka

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.73, no.8, pp.1399-1400, 2009 (Released:2009-07-24)

参考文献数

7

著者

Kiyoshi Hibi Shinjo Sonoda Masanori Kawasaki Yutaka Otsuji Toyoaki Murohara Hideki Ishii Katsuhiko Sato Ryoji Koshida Yukio Ozaki Masataka Sata Yoshihiro Morino Tadashi Miyamoto Tetsuya Amano Satoshi Morita Ken Kozuma Kazuo Kimura Hisayoshi Fujiwara for the Ezetimibe-ACS Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0598, (Released:2017-12-07)

参考文献数

34

被引用文献数

31

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Background:The results of previous clinical trials on the effects of ezetimibe-statin combination therapy on atherosclerosis are inconsistent, and the anti-atherosclerotic effect of ezetimibe remains controversial.

著者

Masayoshi Yamamoto Yoshihiro Seo Tomoko Ishizu Isao Nishi Yoshie Hamada-Harimura Tomoko Machino-Ohtsuka Kimi Sato Seika Sai Akinori Sugano Kenichi Obara Kazutaka Aonuma

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.81, no.11, pp.1662-1669, 2017-10-25 (Released:2017-10-25)

参考文献数

27

被引用文献数

9

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Background:Although experimental animal studies report many pleiotropic effects of dipeptidyl peptidase-4 inhibitors (DPP-4i), their prognostic value has not been demonstrated in clinical trials.Methods and Results:Among 838 prospectively enrolled heart failure (HF) patients hospitalized for acute decompensated HF, 79 treated with DPP-4i were compared with 79 propensity score-matched non-DPP-4i diabetes mellitus (DM) patients. The primary endpoint was all-cause mortality; the secondary endpoint was a composite of cardiovascular death and hospitalization. During follow-up (423±260 days), 8 patients (10.1%) in the DPP-4i group and 13 (16.5%) in the non-DPP-4i group died (log-rank, P=0.283). The DPP-4i group did not have a significantly higher rate of all-cause mortality (log-rank, P=0.283), or cardiovascular death or hospitalization (log-rank, P=0.425). In a subgroup analysis of HF with preserved ejection fraction (HFpEF; n=75), the DPP-4i group had a significantly better prognosis than the non-DPP-4i group regarding the primary endpoint (log-rank, P=0.021) and a tendency to have better prognosis regarding the secondary endpoint (log-rank, P=0.119). In patients with HF with reduced EF (n=83), DPP-4i did not result in better prognosis.Conclusions:DPP-4i did not increase the risk of adverse clinical outcomes in patients with DM and HF. DPP-4i may be beneficial in HFpEF.

著者

Hee Tae Yu Pil-Sung Yang Hancheol Lee Seng Chan You Tae-Hoon Kim Jae-Sun Uhm Jong-Youn Kim Hui-Nam Pak Moon-Hyoung Lee Boyoung Joung

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0669, (Released:2017-11-14)

参考文献数

34

被引用文献数

13

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Background:Rate control is now a front-line therapy in the management of atrial fibrillation (AF). However, the survival benefits of different rate-control medications remain controversial, so we assessed the efficacy of rate-control medications in AF patients with concomitant heart failure (HF).Methods and Results:From January 2002 to December 2008, a total of 7,034 AF patients with a single type of rate-control drug or without rate-control treatment were enrolled from the Korea National Health Insurance Service database. The death rates over a mean follow-up of 4.5±1.2 years were 12.6% (580 of 4,593) and 29.0% (709 of 2,441) in non-HF and HF patients, respectively. Among the total subjects, the risk of death was lower in patients receiving β-blockers (adjusted hazard ratio (HR) 0.75, 95% confidence interval (CI) 0.64–0.88) and calcium-channel blockers (adjusted HR 0.74, 95% CI 0.55–0.98) compared with those who did not receive rate-control medications. In patients without HF, use of rate-control medications did not affect the risk of death. In patients with HF, β-blockers significantly decreased the mortality risk (adjusted HR 0.63, 95% CI 0.50–0.79), whereas use of calcium-channel blockers or digoxin was not associated with death. The results were observed consistently among the cohorts after propensity matching.Conclusions:Use of β-blockers was associated with a reduced mortality rate for AF patient with HF but not for those without HF. These findings should be examined in a large randomized trial.

著者

Daisuke Sueta Koichi Kaikita Nobukazu Okamoto Soichiro Yamabe Masanobu Ishii Yuichiro Arima Miwa Ito Yu Oimatsu Tatsuro Mitsuse Satomi Iwashita Eiichi Nakamura Seiji Hokimoto Hiroshi Mizuta Hisao Ogawa Kenichi Tsujita for the ESCORT-TKA Study Investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0612, (Released:2017-09-16)

参考文献数

50

被引用文献数

4

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Background:The pharmacological advantage of combining physiotherapy with anticoagulants for the prevention of venous thromboembolism (VTE) after total knee arthroplasty (TKA) is not fully known. Herein we investigated the potential benefit of this combination therapy in patients undergoing TKA.Methods and Results:The 38 patients were randomly assigned to a physiotherapy group (n=19) or a physiotherapy plus 30 mg/day edoxaban group (n=19). The occurrence of VTE was evaluated, as were serial changes in parameters measured by the Total Thrombus-formation Analysis System, a novel system for quantitatively analyzing thrombus formation using microchips with thrombogenic surfaces (collagen plus tissue factor, atheroma [AR]-chip). Combination therapy significantly reduced the incidence of VTE after TKA compared with monotherapy (P=0.038). The area under the curve (AUC) of thrombus formation for the AR-chip (AR10-AUC30) was significantly lower in the combination group (P=0.001) on Day 7 after TKA than before TKA, but no significant change was observed with monotherapy (P=0.809). In 13 VTE-positive patients, AR10-AUC30was significantly lower in the combination group (n=3) than in the monotherapy group (n=10) on Day 7 (P=0.045).Conclusions:The combination of physiotherapy and edoxaban significantly reduced the incidence of VTE after TKA compared with physiotherapy alone. However, it is possible that VTE occurrence after TKA is not only associated with thrombogenicity, but also rheological factors.

著者

Kimio Satoh Jun Takahashi Yasuharu Matsumoto Shunsuke Tatebe Tatsuo Aoki Yoku Kikuchi Kiyotaka Hao Kazuma Ohyama Masamichi Nogi Akira Suda Shintaro Kasahara Koichi Sato Sadamitsu Ichijo Hiroaki Shimokawa

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1103, (Released:2017-11-02)

参考文献数

17

被引用文献数

3

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From August 26th to 30th, the 2017 Annual Congress of the European Society of Cardiology (ESC 2017) was held in Barcelona, Spain. Despite the terrorism tradegy just before the ESC congress, the congress attracted many medical professionals from all over the world to discuss the recent topics in cardiovascular medicine in more than 500 sessions, including COMPASS (Cardiovascular OutcoMes for People using Anticoagulation StrategieS Trial), CANTOS (Canakinumab Anti-Inflammatory Thrombosis Outcomes Study), and ORION (which assessed the effect of a novel siRNA inhibitor to PCSK9 on reductions in low-density lipoprotein cholesterol). Japanese cardiologists and the Japanese Circulation Society greatly contributed to the congress. This report briefly introduces some late-breaking registry results, late-breaking clinical trials, and ESC Guidelines from the ESC 2017 Congress.

著者

Genjiro Kimura

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.81, no.6, pp.898, 2017-05-25 (Released:2017-05-25)

参考文献数

8

被引用文献数

7

著者

Tadatsugu Gamou Kenji Sakata Hayato Tada Tetsuo Konno Kenshi Hayashi Hidekazu Ino Masakazu Yamagishi Masa-aki Kawashiri on behalf of the MILLION Study Group

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.81, no.10, pp.1490-1495, 2017-09-25 (Released:2017-09-25)

参考文献数

31

被引用文献数

4

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Background:The MILLION study, a prospective randomized multicenter study, revealed that lipid and blood pressure (BP)-lowering therapy resulted in regression of coronary plaque as determined by intravascular ultrasound (IVUS). In the present study we performed additional analysis to investigate the associated factors with regression of coronary plaque.Methods and Results:We investigated serial 3D IVUS images from 68 patients in the MILLION study. Standard IVUS parameters were assessed at both baseline and follow-up (18–24 months). Volumetric data were standardized by length as normalized volume. In patients with plaque regression (n=52), plaque volumenormalizedsignificantly decreased from 64.8 to 55.8 mm3(P<0.0001) and vessel volumenormalizedsignificantly decreased from 135.0 to 127.5 mm3(P=0.0008). There was no difference in lumen volumenormalizedfrom 70.1 to 71.8 mm3(P=0.27). There were no correlations between % changes in vessel volume and cholesterol or BP. On the other hand, negative correlations between % change in vessel volume and vessel volumenormalizedat baseline (r=−0.352, P=0.009) or plaque volumenormalizedat baseline (r=−0.336, P=0.01) were observed.Conclusions:The current data demonstrated that in patients with plaque regression treated by aggressive lipid and BP-lowering therapy, the plaque regression was derived from reverse vessel remodeling determined by vessel volume and plaque burden at baseline irrespective of decreases in lipids and BP.

著者

Fumihiko Hara Junko Tatebe Ippei Watanabe Junichi Yamazaki Takanori Ikeda Toshisuke Morita

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.80, no.9, pp.2037-2046, 2016-08-25 (Released:2016-08-25)

参考文献数

35

被引用文献数

1 27

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Background:Substantial evidence indicates that molecular hydrogen (H2) has beneficial vascular effects because of its antioxidant and/or anti-inflammatory effects. Thus, hydrogen-rich water may prove to be an effective anti-aging drink. This study examined the effects of H2on endothelial senescence and clarified the mechanisms involved.Methods and Results:Hydrogen-rich medium was produced by a high-purity hydrogen gas generator. Human umbilical vein endothelial cells (HUVECs) were incubated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) for various time periods in normal or hydrogen-rich medium. The baseline H2concentration in hydrogen-rich medium was 0.55±0.07 mmol/L. This concentration gradually decreased, and H2was almost undetectable in medium after 12 h. At 24 h after TCDD exposure, HUVECs treated with TCDD exhibited increased 8OHdG and acetyl-p53 expression, decreased nicotinamide adenine dinucleotide (NAD+)/NADH ratio, impaired Sirt1 activity, and enhanced senescence-associated β-galactosidase. However, HUVECs incubated in hydrogen-rich medium did not exhibit these TCDD-induced changes accompanying Nrf2 activation, which was observed even after H2was undetectable in the medium. Chrysin, an inhibitor of Nrf2, abolished the protective effects of H2on HUVECs.Conclusions:H2has long-lasting antioxidant and anti-aging effects on vascular endothelial cells through the Nrf2 pathway, even after transient exposure to H2. Hydrogen-rich water may thus be a functional drink that increases longevity. (Circ J 2016; 80: 2037–2046)

著者

Park Seong-Mi Seo Hong-Seog Lim Hong-Euy Shin Sung-Hee Park Chang-Gyu Oh Dong-Joo Ro Young-Moo

出版者

社団法人日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.69, no.10, pp.1218-1222, 2005

被引用文献数

9 31

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<b>Background</b> The aim of the present study was to assess the feasibility and usefulness of the arterial stiffness index (ASI) measured non-invasively by computerized oscillometry and by comparing it with the pulse wave velocity (PWV). <b>Methods and Results</b> The study group comprised 60 consutive patients who underwent coronary angiography and whose aorto-femoral PWV were obtained with a Judkins catheter. The ASI was obtained using Cardio Vision ^® MS-2000 (IMDP, Las Vegas, NV, USA): (i) baseline (ASI-B); (ii) hyperemia induced by compression of the arm with cuff pressure for 5 min (ASI-H); and (iii) sublingual nitroglycerin (ASI-N). In total, 34 patients had significant coronary artery disease (CAD). The PWV and all ASI were higher in patients with CAD than in those without CAD (ASI-B, 85.9±57.8 vs 48.2±24.5, p=0.001; ASI-H, 98.1±49.8 vs 48.1±21.3, p<0.01; ASI-N, 66.7±55.7 vs 33.2±27.9, p=0.002). However, only ASI-B and ASI-H were positively correlated to the PWV (ASI-B, r=0.27, p=0.03; ASI-H, r=0.49, p=0.001; ASI-N, r=0.19, p=0.16). The ASI was increased after hyperemia in patients with CAD (ASI-H, 85.9±57.8 to 98.1±49.8, p=0.01), but not in patients without CAD (ASI-H, 48.2±24.5 to 48.1±21.3, p>0.01). After adjusting their age, only ASI-H was correlated to the presence of CAD (r=0.33, p<0.01). <b>Conclusions</b> It is feasible and useful to use the ASI for detection of atherosclerotic coronary disease. The findings of ASI-H suggests that in addition to stiffening of the arterial wall itself, the impairment of flow mediated vasodilation, because of endothelial dysfunction, further increases the arterial stiffness. (<i>Circ J</i> 2005; <b>69:</b> 1218 - 1222)<br>

著者

Nobuaki Kobayashi Noritake Hata Noriaki Kume Takuro Shinada Kazunori Tomita Akihiro Shirakabe Mitsunobu Kitamura Ayaka Nozaki Toru Inami Yoshihiko Seino Kyoichi Mizuno

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.75, no.12, pp.2862-2871, 2011 (Released:2011-11-25)

参考文献数

41

被引用文献数

12 24

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Background: Although highly sensitive assays for troponin T (hs-TnT) have been developed, the sensitivity and specificity of hs-TnT for diagnosing acute coronary syndrome (ACS) remains imperfect. We evaluated the diagnostic value of a new biomarker of plaque vulnerability (soluble lectin-like oxidized low-density lipoprotein receptor-1, sLOX-1) as compared with hs-TnT in the emergency room (ER). Methods and Results: Plasma sLOX-1 and serum hs-TnT levels were measured in 200 consecutive patients presenting with chest symptoms and ECG abnormalities in the ER (116 ST elevation ACS [STEACS], 44 non-ST elevation ACS [NSTEACS], 40 non-ACS). The non-ACS group consisted of patients with cardiovascular diseases such as coronary spastic angina pectoris, pulmonary thromboembolism, perimyocarditis and takotsubo cardiomyopathy. Levels of sLOX-1 and hs-TnT were significantly higher in STEACS and NSTEACS than in non-ACS patients. The receiver-operating characteristic (ROC) curves of sLOX-1 and hs-TnT for detecting ACS, using the non-ACS patients as negative references, showed that the area under the curve (AUC) values of sLOX-1 and hs-TnT were 0.769 and 0.739, respectively. In the lower hs-TnT (<0.0205ng/ml) subgroup, the AUC value of the ROC curve of sLOX-1 for detecting ACS was 0.869. Conclusions: The diagnostic value for ACS was comparable between sLOX-1 and hs-TnT, and the accuracy of ACS diagnosis appeared to improve when sLOX-1 and hs-TnT were measured in combination. (Circ J 2011; 75: 2862-2871)

著者

Xiaofan Guo Eric Vittinghoff Vasanth Vedantham Mark J. Pletcher Byron K. Lee

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0701, (Released:2017-09-13)

参考文献数

8

被引用文献数

5

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Background:Cardiac sarcoidosis (CS) is a life-threatening disease that is frequently under-diagnosed.Methods and Results:We used a nationwide inpatient sample to identify CS patients from 2005 to 2011 in the USA. The annual admissions of CS increased from 1,108 in 2005 to 2,182 in 2011, representing a 2-fold rise over a short time. The proportions of CS patients with severe comorbidities, ventricular tachycardia, ventricular fibrillation and heart failure all increased from 2005 to 2011. However, the in-hospital mortality rate declined.Conclusions:An increasing trend of CS was observed. Cardiologists should notice that CS is not as rare as thought.

著者

Antonio Tello-Montoliu José Rivera Diana Hernández Ana Silvente Eva Jover Ana I Rodriguez Miriam Quintana Ana Romero Esteban Orenes-Piñero José Miguel Rivera-Caravaca Francisco Marín Andrea Veliz Mariano Valdés

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0471, (Released:2017-09-06)

参考文献数

30

被引用文献数

5

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Background:Prasugrel has been shown to provide more potency and less variability than clopidogrel, but its potential temporal variability has not been described.Methods and Results:We conducted a prospective open-label study, evaluating platelet reactivity overtime in acute coronary syndrome (ACS) patients on aspirin and clopidogrel (n=60) or prasugrel (n=61), after a percutaneous coronary intervention (PCI). Blood samples were taken at discharge and at 3 and 6 months. Platelet function tests included VerifyNow (VN-P2Y12), and Multiplate Aggregometry (MEA). By means of VN-P2Y12, prasugrel patients displayed significantly (P<0.001) higher platelet inhibition than clopidogrel patients over time, although there were not significant differences using MEA. Prasugrel patients showed higher platelet inhibition at baseline than at 3 months (59.3±8.1 vs. 105.0±49.2; P<0.001), without significant change at 6 months (107.9±72.0; P=0.919 vs. 3 months). Clopidogrel patients showed a similar trend (160.1±65.1, 184.8±62.7 and 185.0±53.3; baseline vs. 3 months P=0.060; 3 months vs. 6 months P=0.974). High platelet reactivity (HPR) was shown in 16.3% prasugrel patients, with no patient consistently remaining in HPR over time. HPR was detected in 36.6% of the clopidogrel patients, being consistently observed in 15.0% of them. Low platelet reactivity (LPR) was detected in 60.5% prasugrel and 9.8% clopidogrel patients.Conclusions:Prasugrel patients showed less temporal variation than patients on clopidogrel in terms of HPR. In contrast, higher variability in LPR was detected in prasugrel patients for up to 6 months’ follow-up.

著者

Akira Sezai Mitsumasa Hata Shinji Wakui Motomi Shiono Nanao Negishi Yuji Kasamaki Satoshi Saito Jitsu Kato Kazutomo Minami

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.70, no.11, pp.1426-1431, 2006 (Released:2006-10-25)

参考文献数

21

被引用文献数

22 31

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Background The aim of the present study was to evaluate the efficacy of α-human atrial natriuretic peptide (hANP) in cardiac surgery under cardiopulmonary bypass (CPB). Methods and Results A prospective randomized study was conducted with 150 patients who underwent scheduled coronary artery bypass grafting to compare a group of patients receiving 0.02 μg · kg-1 · min-1 of hANP from the initiation of CPB with a group not receiving hANP. Hemodynamics, levels of atrial and brain natriuretic peptides (BNP), angiotensin-II and aldosterone, renin activity, and left ventricular (LV) function were examined. The hANP group showed significantly lower renin activity and lower levels of angiotensin-II and aldosterone during the early postoperative period, compared with the non-hANP group. The incidence of postoperative ventricular arrhythmia and the postoperative peak level of creatine kinase-MB were significantly lower in the hANP group. BNP at 1 month after surgery and measures of LV function were also significantly lower in the hANP group. Conclusions Low-dose continuous infusion of hANP during cardiac surgery not only had a compensatory effect for the imperfections of CPB during the early postoperative period but also an inhibitory effect on postoperative LV remodeling and a reduction in ischemia/reperfusion injury. hANP should be part of the postoperative care for cardiac surgery. (Circ J 2006; 70: 1426 - 1431)

著者

Barak Zafrir Ayman Jubran Gil Lavie David A. Halon Moshe Y. Flugelman Chen Shapira

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0392, (Released:2017-07-12)

参考文献数

26

被引用文献数

8

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Background:Familial hypercholesterolemia (FH) is associated with premature atherosclerotic cardiovascular disease (ASCVD). The introduction of potent therapeutic agents underlies the importance of improving clinical diagnosis and treatment gaps in FH.Methods and Results:A regional database of 1,690 adult patients with high-probability FH based on age-dependent peak-low-density lipoprotein cholesterol (LDL-C) cut-offs and exclusion of secondary causes of severe hypercholesterolemia, was examined to explore the clinical manifestations and current needs in the management of ASCVD, which was present in 248 patients (15%), of whom 83% had coronary artery disease (CAD); 19%, stroke; and 13%, peripheral artery disease. ASCVD was associated with male gender, higher peak LDL-C, lower high-density lipoprotein cholesterol (HDL-C), and traditional risk factor burden. Despite high-intensity statin (prescribed in 83% and combined with ezetimibe in 42%), attainment of LDL-C treatment goals was low, and associated with treatment intensity and drug adherence. Multivessel CAD (adjusted hazard ratios (HR), 3.05; 95% CI: 1.65–5.64), myocardial infarction, and the presence of ≥1 traditional risk factor (HR, 2.59; 95% CI: 1.42–4.71), were associated with repeat coronary revascularizations, in contrast with peak LDL-C >300 mg/dL (HR, 1.13; 95% CI: 0.66–1.91).Conclusions:Main manifestations of ASCVD in FH patients were premature, multivessel CAD with need for recurrent revascularization, associated with classical cardiovascular risk factors but not with peak LDL-C. In spite of intensive therapy with lipid-lowering agents, treatment gaps were significant, with low attainment of LDL-C treatment goals.