著者

Takeshi Tsuda Abdul M. Bhat Bradley W. Robinson Jeanne M. Baffa Wolfgang Radtke

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-15-0485, (Released:2015-08-19)

参考文献数

36

被引用文献数

9 38

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Background:The incidence of late coronary artery abnormalities after arterial switch operation (ASO) for d-loop transposition of the great arteries may be underestimated.Methods and Results:We retrospectively reviewed coronary artery morphology in 40 of 97 patients who survived the first year after ASO. Seven asymptomatic patients developed significant late coronary artery abnormalities. One patient died suddenly at home with severe left coronary artery (LCA) ostial stenosis at age 3.8 years. The second patient collapsed during exercise at age 9.6 years due to ventricular fibrillation and severe LCA ostial stenosis despite prior negative exercise stress test (EST) and myocardial perfusion imaging (MPI). The third patient was found to have moderate ostial stenosis of the LCA with negative EST and MPI. The fourth patient with exercise-induced ST-T depression and myocardial perfusion defect was shown to have complete LCA occlusion with collateral vessel formation. Three other patients had complete proximal obliteration of either of the coronary arteries with collateral supply. An additional 4 asymptomatic patients had trivial-mild narrowing of the LCA on routine selective coronary angiogram.Conclusions:Incidence of late coronary stenosis or occlusion was not infrequent after ASO (11.3%) and presented usually without preceding symptoms and often after negative non-invasive screening. We advocate routine coronary imaging in all patients after ASO before they participate in competitive sports.

著者

Shinya Goto Chien-Hua Huang Seung-Jung Park Håkan Emanuelsson Takeshi Kimura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.79, no.11, pp.2452-2460, 2015-10-23 (Released:2015-10-23)

参考文献数

37

被引用文献数

59 199

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Background:Few data on the relative efficacy and safety of new P2Y12inhibitors such as prasugrel and ticagrelor in Japanese, Taiwanese and South Korean patients with acute coronary syndromes (ACS) exist.Methods and Results:The multicenter, double-blind, randomized PHILO trial compared the safety and efficacy of ticagrelor vs. clopidogrel in 801 patients with ACS (Japanese, n=721; Taiwanese, n=35; South Korean, n=44; unknown ethnicity, n=1). All were planned to undergo percutaneous coronary intervention and randomized within 24 h of symptom onset. Primary safety and efficacy endpoints were time to first occurrence of any major bleeding event and to any event from the composite of myocardial infarction, stroke or death from vascular causes, respectively.At 12 months, overall major bleeding occurred in 10.3% of ticagrelor-treated patients and in 6.8% of clopidogrel-treated patients (hazard ratio (HR), 1.54; 95% confidence interval (CI): 0.94–2.53); the composite primary efficacy endpoint occurred in 9.0% and in 6.3% of ticagrelor- and clopidogrel-treated patients, respectively (HR, 1.47; 95% CI: 0.88–2.44). For both analyses, the difference between groups was not statistically significant.Conclusions:In ACS patients from Japan, Taiwan and South Korea, event rates of primary safety and efficacy endpoints were higher, albeit not significantly, in ticagrelor-treated patients compared with clopidogrel-treated patients. This observation could be explained by the small sample size, imbalance in clinical characteristics and low number of events in the PHILO population. (Circ J 2015; 79: 2452–2460)

著者

Nagako Okuda Aya Kadota Nobuo Nishi Katsuyuki Miura Takayoshi Ohkubo Naoko Miyagawa Atsushi Satoh Yoshikuni Kita Takehito Hayakawa Naoyuki Takashima Akira Fujiyoshi Akira Okayama Tomonori Okamura Hirotsugu Ueshima for the NIPPON DATA90 Research Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.7, pp.1506-1513, 2019-06-25 (Released:2019-06-25)

参考文献数

32

被引用文献数

7

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Background:Several cohort studies have demonstrated an association between socioeconomic status (SES) and health outcomes in Japan. As long-term employment is common in Japan, the size of the company may be related to cardiovascular disease (CVD) mortality risk. We examined the association of employment conditions with CVD mortality risk among working-age Japanese men (30–59 years, n=2,091).Methods and Results:We used 20-year follow-up data from NIPPON DATA90, for which baseline data were obtained from the 4th National Survey on Circulatory Disorders in 1990. Participants were classified into 4 groups: 3 strata for indefinite-term employees according to company size (large company/public office, moderate-sized, or small), and the self-employed/administrator group. Multivariable-adjusted hazard ratios (HRs) were adjusted for age, lifestyle, and CVD risk factors. Smokers were more common, habitual exercise was less common, and the average systolic blood pressure was higher among indefinite-term employees of small companies compared with employees at large companies/public offices. There was no significant difference in the total CVD mortality risk between indefinite-term employees and self-employed/administrator participants. The age-adjusted HR (95% confidence interval) for total CVD using indefinite-term employees of large companies/public office as a reference was 2.53 (1.12, 5.69) for employees of small companies.Conclusions:Working as an indefinite-term employee at a small company in Japan was significantly associated with elevated risk of CVD mortality among Japanese men.

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-19-0148, (Released:2019-06-05)

参考文献数

35

被引用文献数

11

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Background:The cost-effectiveness of percutaneous coronary intervention (PCI) for ischemic heart disease is undetermined in Japan. The aim of this study was to analyze the cost-effectiveness of PCI compared with medical therapy for ST-elevation myocardial infarction (STEMI) and angina pectoris (AP) in Japan.Methods and Results:We used Markov models for STEMI and AP to assess the costs and benefits associated with PCI or medical therapy from a health system perspective. We estimated the incremental cost-effectiveness ratio (ICER), expressed as quality-adjusted life-years (QALY), and ICER <¥5 m per QALY gained was judged to be cost-effective. The impact of PCI on cardiovascular events was based on previous publications. In STEMI patients, the ICER of PCI over medical treatment was ¥0.97 m per QALY gained. The cost-effectiveness probability of PCI was 99.9%. In AP patients, the ICER of fractional flow reserve (FFR)-guided PCI over medical treatment was ¥4.63 m per QALY gained. The cost-effectiveness probability of PCI was 50.4%. The ICER of FFR-guided PCI for asymptomatic patients was ¥23 m per QALY gained.Conclusions:In STEMI patients, PCI was cost-effective compared with medical therapy. In AP patients, FFR-guided PCI for symptomatic patients could be cost-effective compared with medical therapy. FFR-guided PCI for asymptomatic patients with myocardial ischemia was not cost-effective.

著者

Satoshi Yasuda Satoshi Honda Misa Takegami Kensaku Nishihira Sunao Kojima Yasuhide Asaumi Makoto Suzuki Masami Kosuge Jun Takahashi Yasuhiko Sakata Morimasa Takayama Tetsuya Sumiyoshi Hisao Ogawa Kazuo Kimura on behalf of the JAMIR Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0145, (Released:2019-06-14)

参考文献数

32

被引用文献数

17

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Background:Antiplatelet therapy is the corner stone of treatment following acute myocardial infarction (AMI). Prasugrel, a new and potent antiplatelet agent, was recently introduced to clinical practice. We compared the clinical outcomes of patients with AMI treated with prasugrel with those treated with clopidogrel in real-world clinical practice in Japan.Methods and Results:The Japan AMI Registry (JAMIR) is a multicenter, nationwide, prospective registry enrolling patients with AMI from 50 institutes. Between December 2015 and May 2017, a total of 3,411 patients were enrolled. Among them, 3,069 patients were treated with either prasugrel (n=2,607) or clopidogrel (n=462) during hospitalization. Median follow-up period was 12 months. Prasugrel-treated patients were predominantly male, younger, more often showed ST-elevation AMI, and had fewer comorbidities. After adjustment using inverse probability of treatment weighting, the primary endpoint, defined as a composite of cardiovascular death, non-fatal MI and non-fatal stroke, was comparable between the prasugrel and clopidogrel groups (adjusted hazard ratio [HR] 1.07, 95% confidence interval [CI] 0.67–1.72), whereas the risk of major bleeding (BARC type 3 or 5 bleeding) was significantly lower in the prasugrel group (adjusted HR 0.62, 95% CI 0.39–0.99).Conclusions:The present real-world database of the JAMIR demonstrated that the potent P2Y12-inhibitor prasugrel showed comparable rates of 1-year ischemic events to clopidogrel, but the risk of bleeding was lower with prasugrel than with clopidogrel.

著者

Koichiro Kinugawa Naoki Sato Takayuki Inomata Moriyoshi Yasuda Toshiyuki Shimakawa Yasuhiko Fukuta

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0158, (Released:2019-05-22)

参考文献数

26

被引用文献数

19

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Background:In Japan, tolvaptan is indicated for patients with heart failure and volume overload who have inadequate response to other diuretics. In contrast to the USA and Europe, tolvaptan can be used in Japan in patients with normal sodium levels.Methods and Results:In this multicenter, non-interventional, post-marketing surveillance study, prospective data from 3,349 patients treated with tolvaptan over a 5-year period were analyzed to identify benefits and risks. By Day 2 of treatment, 76.9% of evaluable patients had an increase in baseline 24-h urine volume (tolvaptan responders). Mean change in body weight was similar between 7.5 mg and 15 mg dosage groups (−3.6±3.9 kg and −3.7±4.0 kg, respectively). Improvement or disappearance rates for congestive symptoms from baseline to Day 14 ranged from 77.7% for lower limb edema to 51.1% for 3rd sound. Adverse drug reactions were reported in 18.1% of patients, most frequently thirst (8.4%). No case of central pontine myelinolysis was reported. All-cause mortality was significantly lower in patients with improved sodium concentration and increased 24-h urine volume.Conclusions:The effectiveness and safety of tolvaptan in real-world clinical settings was confirmed in this large-scale analysis. The 7.5-mg dose was equally as effective as the 15-mg dose and had a better safety profile. Improvements in all-cause mortality were suggested in tolvaptan responders.

著者

Keiko Kondo Katsuyuki Miura Sachiko Tanaka-Mizuno Aya Kadota Hisatomi Arima Nagako Okuda Akira Fujiyoshi Naoko Miyagawa Katsushi Yoshita Tomonori Okamura Akira Okayama Hirotsugu Ueshima for the NIPPON DATA80 Research Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-1002, (Released:2019-04-19)

参考文献数

47

被引用文献数

10

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Background:Many studies show that dietary factors such as vegetables, fruit, and salt are associated with cardiovascular disease (CVD) risk. However, a risk assessment chart for CVD mortality according to combinations of dietary factors has not been established.Methods and Results:Participants were 9,115 men and women aged 30–79 years enrolled in the National Nutritional Survey of Japan in 1980 with a 29-year follow-up. Dietary intake was assessed using a 3-day weighed dietary record at baseline. Cox regression models were used to estimate the hazard ratio (HR) of CVD mortality stratified by vegetables, fruit, fish, and salt consumption. HRs of CVD mortality according to combinations of dietary factors were color coded on an assessment chart. Higher intakes of vegetables, fruit, and fish, and lower salt intake were associated with lower CVD mortality risk. HRs calculated from combinations of dietary factors were displayed using 5 colors corresponding to the magnitude of the HR. People with the lowest intake of vegetables, fruit, and fish, and higher salt intake had a HR of 2.87 compared with those with the highest intake of vegetables, fruit, and fish, and lower salt intake.Conclusions:Vegetables, fruit, fish, and salt intake were independently associated with CVD mortality risk. The assessment chart generated could be used in Japan as an educational tool for CVD prevention.

著者

Jeong-Woo Lee Jong-Min Song Jong Pil Park Jae Won Lee Duk-Hyun Kang Jae-Kwan Song

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.74, no.2, pp.375-380, 2010 (Released:2010-01-25)

参考文献数

25

被引用文献数

52 138

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Background: The prognostic implications and surgical benefit of isolated significant tricuspid regurgitation (TR) and prognostic factors in patients with TR were investigated. Methods and Results: In 870 consecutive patients with significant isolated TR, all-cause mortality was analyzed over 4.9±2.9 years. It was found that the survival rate tended to be higher in the 57 patients who underwent tricuspid valve (TV) surgery than the 813 patients who did not by using propensity-score matching (P=0.068), although it was not significant. Of the 813 patients that did not undergo TV surgery, the 5-year survival rate was 74%. According to the Cox proportional hazards model, the initial TR jet area (hazard ratio [HR], 1.044; 95% confidence interval [CI], 1.016-1.073), pulmonary artery systolic pressure (HR, 1.024; 95%CI, 1.017-1.032) and presence of right ventricular (RV) dysfunction (HR, 2.256; 95% CI, 1.329-3.828) were predictors of mortality independent of patient age and presence of diabetes mellitus and renal failure in medically managed patients. Conclusions: In patients with isolated significant TR, there was a tendency, although not significant, towards a higher survival rate after TV surgery. The severity of TR and pulmonary hypertension, and the presence of RV dysfunction are independent prognostic factors in medically managed patients. Further prospective randomized studies are necessary to demonstrate the benefit of TV surgery in these poor prognostic populations. (Circ J 2010; 74: 375-380)

著者

Naoki Tamada Kazuhiko Nakayama Kenichi Yanaka Hiroyuki Onishi Yuto Shinkura Yu Taniguchi Hiroto Kinutani Yasunori Tsuboi Kazuhiro P. Izawa Seimi Satomi-Kobayashi Hiromasa Otake Hiroshi Tanaka Toshiro Shinke Yutaka Okita Noriaki Emoto Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.5, pp.228-234, 2019-05-10 (Released:2019-05-10)

参考文献数

27

被引用文献数

4

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Background:While hemodynamics and exercise capacity in patients with chronic thromboembolic pulmonary hypertension (CTEPH) can be improved by invasive therapy such as pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA), there has been little data on the health-related quality of life (HRQOL) in such patients.Methods and Results:This single-center and observational study compared the impact of invasive therapy on HRQOL. We utilized the Medical Outcome Study 36-Item Short Health Survey (SF-36) to measure HRQOL and compared HRQOL changes after PEA and BPA. A total of 48 patients were diagnosed with CTEPH. Of these, 39 patients completed questionnaires before and after invasive therapy. The PEA group (n=15) and the BPA group (n=24) had similar improvements in clinical parameters. With regard to HRQOL score, both groups had fairly low scores in physical functioning (PF), role physical (RP), general health (GH), social functioning (SF), role emotional (RE), and physical component summary (PCS) at baseline. PF, GH, vitality (VT), mental health (MH), and PCS had significant improvements in the PEA group while PCS and all subscales except for bodily pain (BP) had significant improvements in the BPA group. Furthermore, changes between baseline and follow-up were not significantly different between the 2 groups.Conclusions:BPA for patients who are ineligible for PEA can recover HRQOL to a similar level to that achieved by PEA.

著者

Koutaro Yokote Junya Ako Kazuo Kitagawa Hyoe Inomata Toshihiko Sugioka Keiko Asao Yasuhiko Shinmura Junichiro Shimauchi Tamio Teramoto

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.5, pp.219-227, 2019-05-10 (Released:2019-05-10)

参考文献数

15

被引用文献数

4

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Background:Evolocumab is the first monoclonal antibody against proprotein convertase subtilisin/kexin type 9 (PCSK9) approved in Japan for the treatment of patients with familial hypercholesterolemia (FH) and hypercholesterolemia (HC). This study assessed the 12-week effectiveness and safety of low-density lipoprotein cholesterol (LDL-C)-lowering therapy by PCSK9 inhibition in patients with FH (homozygous [HoFH] or heterozygous [HeFH]) and HC by analyzing evolocumab data collected in the real-world setting in Japan.Methods and Results:Overall, 427 patients (mean±SD age, 61.6±13.8 years; female, 38.4%; 28 HoFH, 320 HeFH, 79 HC), enrolled from 299 clinical sites, were included in the safety analysis set. The major cardiovascular risk factors were coronary artery disease (77.3%), diabetes mellitus/impaired glucose tolerance (38.6%), and hypertension (65.1%). Median follow-up duration was 85.0 days. After 12 weeks of evolocumab treatment, the mean±SD percent change from baseline in LDL-C was −45.5%±27.0% (n=23) in HoFH (P<0.001 vs. baseline; t-test), −54.2%±29.0% (n=280) in HeFH (P<0.001), and −64.6%±22.4% (n=72) in HC (P<0.001) patients. The incidence of adverse drug reactions was 5.4% (23/427).Conclusions:Results suggest that patients receiving evolocumab treatment in the real-world setting were predominantly those with FH and HC in the secondary prevention group. LDL-C-lowering effectiveness with evolocumab was observed in FH (both HoFH and HeFH) and HC patients.

著者

Shinsuke Mii Atsushi Guntani Eisuke Kawakubo Hirofumi Shimazoe Masaru Ishida

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0005, (Released:2019-04-25)

参考文献数

30

被引用文献数

17

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Background:Nutritional status has been reported to be a predictor of the outcomes of critical limb ischemia. However, there have been no reports of the association between nutritional status and the prognosis of patients with intermittent claudication (IC). The aim of this study was to examine whether or not the geriatric nutritional risk index (GNRI) is independently associated with the long-term outcomes of elderly patients following open bypass for IC.Methods and Results:The preoperative nutritional status of patients aged ≥65 years undergoing infrainguinal bypass for IC between 1991 and 2017 was retrospectively evaluated using the GNRI. Patients were divided into 3 groups based on the GNRI: Group I (normal nutritional risk), GNRI >98; Group II (low nutritional risk), GNRI 92 to ≤98; Group III (moderate to high nutritional risk), GNRI <92. The amputation-free survival (AFS), overall survival, and freedom from cardiovascular death up to 5 years were calculated by Kaplan-Meier method and a multivariate analysis was performed to detect independent predictors of each outcome. Group I showed superior outcomes to Group III for each of the 3 outcomes and the multivariate analysis showed that GNRI was an independent predictor of AFS.Conclusions:The GNRI was independently associated with the AFS of elderly patients who underwent open bypass for IC.

著者

Yasufumi Kijima Teiji Akagi Yoichi Takaya Satoshi Akagi Koji Nakagawa Kengo Kusano Shunji Sano Hiroshi Ito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.80, no.1, pp.227-234, 2015-12-25 (Released:2015-12-25)

参考文献数

29

被引用文献数

8 35

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Background:A therapeutic strategy in patients with atrial septal defect (ASD) and significant pulmonary arterial hypertension (PAH) remains controversial. This study aimed to assess the effect of PAH-specific medications and subsequent transcatheter shunt closure (ie, a treat and repair strategy) in these patients.Methods and Results:Among 646 patients with ASD, 22 patients (mean age of 56±20 years) who had PAH [mean pulmonary artery pressure ≥25 mmHg and pulmonary vascular resistance (PVR) ≥3 Wood units] underwent successful transcatheter ASD closure. Prior to the procedure, 8 patients received PAH-specific medications (PHM group) and 14 patients did not (non-PHM group). Initially, the PHM group had higher PVR compared with non-PHM group (9.6±3.8 vs. 4.2±1.0 Wood units, P<0.01). After treatment with PAH-specific medications, PVR in this group decreased to 4.0±0.8 Wood units (P<0.01). No adverse events were observed in either the PHM or non-PHM group during or after the transcatheter procedure. In the PHM group, during a treatment period of 52±48 months, the World Health Organization Functional Classification significantly improved (3.0±0.5 to 2.0±0.0, P<0.01), as well as in the non-PHM group (2.1±0.6 to 1.5±0.5, P<0.01).Conclusions:Treat and repair strategy provided substantial improvement and no worsening of the WHO-FC, even in patients with ASD and significant PAH. Long-term hemodynamic follow-up is mandatory to evaluate the ultimate efficacy and safety of this new strategy. (Circ J 2016; 80: 227–234)

著者

Teruhiko Imamura Koichiro Kinugawa Minoru Ono Osamu Kinoshita Norihide Fukushima Akira Shiose Yoshiro Matsui Kenji Yamazaki Yoshikatsu Saiki Akihiko Usui Hiroshi Niinami Goro Matsumiya Hirokuni Arai Yoshiki Sawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-1215, (Released:2019-04-24)

参考文献数

35

被引用文献数

7

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Background:Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain.Methods and Results:Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P<0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P>0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87–16.1, P=0.075). These trends still remained with propensity score-matched comparison.Conclusions:Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation.

著者

Shiro Uemura Hiroshi Okamoto Michikazu Nakai Kunihiro Nishimura Yoshihiro Miyamoto Satoshi Yasuda Nobuhiro Tanaka Shun Kohsaka Kazushige Kadota Yoshihiko Saito Hiroyuki Tsutsui Issei Komuro Yuji Ikari Hisao Ogawa Masato Nakamura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0004, (Released:2019-04-24)

参考文献数

33

被引用文献数

17

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Background:Primary percutaneous coronary intervention (pPCI) is strongly recommended by guidelines for patients presenting with acute myocardial infarction (AMI), but its applications in elderly patients are less clear.Methods and Results:The JROAD-DPC is a Japanese nationwide registry for patients with cardiovascular diseases combined with an administrative claim-based database. Among 2,369,165 records from 2012 to 2015, data for 115,407 AMI patients were extracted for this study. Elderly patients (≥75 years) comprised 45,645 subjects (39.6%), and received pPCI less frequently (62.2%) than younger patients (79.2%, P<0.001). Clinical variables such as higher age, female sex, higher Killip class, and renal dysfunction, but not functional status on admission, were predictors of non-application of pPCI. Endpoint 30-day mortality increased with aging, and was significantly higher in elderly patients (10.7%) than in younger patients (3.8%, P<0.001). Indeed, pPCI was independently associated with lower 30-day mortality only in subgroups of patients aged ≥60 years. Propensity score-matching analysis confirmed a similar reduction in endpoint 30-day mortality with pPCI in elderly patients. Duration of hospitalization was significantly shorter and functional ability on discharge was significantly better in elderly patients who underwent pPCI.Conclusions:Elderly patients with AMI underwent pPCI less frequently, but it was consistently associated with better clinical outcome in these patients. Our findings support the proactive application of pPCI for elderly AMI patients when they are eligible for an invasive strategy.

著者

Kayo Tanigawa-Sugihara Taku Iwami Chika Nishiyama Tetsuhisa Kitamura Masashi Goto Masahiko Ando Tatsuya Nishiuchi Yasuyuki Hayashi Takashi Kawamura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.77, no.8, pp.2073-2078, 2013 (Released:2013-07-25)

参考文献数

35

被引用文献数

11 24

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Background: Weather conditions affect the occurrence of cardiovascular disease. The aim of this study was to investigate the associations between atmospheric conditions including temperature, pressure, and humidity, and the occurrence of out-of-hospital cardiac arrests (OHCAs) with cardiac etiology. Methods and Results: This study was a cross-sectional analysis of a prospective cohort that included all persons aged ≥18 years with OHCA in Osaka, from 1998 through 2007. The association between the number of daily OHCA events with various atmospheric conditions was analyzed using Poisson regression. A total of 28,806 adult OHCAs were presumed to be of cardiac etiology. The number of OHCAs in 1 day was inversely correlated with the day’s mean atmospheric temperature. The regression coefficient was greater on the days under 18°C (r=–0.317, P<0.001) than on days over 18°C (r=–0.088, P<0.001). A positive linear relation was found between the number of OHCAs in 1 day and the day’s mean atmospheric pressure (r=0.321, P<0.001). Under 18°C, every 5°C decrease in the daily mean temperature was associated with an 11% (95% confidence interval [CI]: 8–13%) increase in OHCA occurrence in the non-elderly group, and a 16% increase in the elderly group (95% CI: 14–19%). Conclusions: The occurrence of adult OHCA with cardiac etiology increases with decreasing temperature of the day. Elderly people are more susceptible to severe weather conditions.  (Circ J 2013; 77: 2073–2078)

著者

Yi-Heng Li Yu-Wei Chiu Jun-Jack Cheng I-Chang Hsieh Ping-Han Lo Meng-Huan Lei Kwo-Chang Ueng Fu-Tien Chiang Shih-Hsien Sung Jen-Yuan Kuo Ching-Pei Chen Wen-Ter Lai Wen-Lieng Lee Jyh-Hong Chen Taiwan ACS STENT Registry Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-1283, (Released:2019-04-27)

参考文献数

23

被引用文献数

2

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Background:Little information is available in Asia about the real-world practice of dual antiplatelet therapy (DAPT) duration for acute coronary syndrome (ACS) and its influence on clinical outcomes.Methods and Results:The Taiwan ACS STENT Registry was a prospective, multicenter study to observe ACS patients using clopidogrel-based DAPT after percutaneous coronary intervention (PCI). The primary outcome was a composite of cardiovascular death, myocardial infarction, and stroke. Overall, 2,221 ACS patients (62 years, 83% men) were included. DAPT duration was ≤9 months in 935 (42.1%). The incidence of primary outcome was higher in patients receiving DAPT ≤9 months compared with those receiving DAPT >9 months at 1 year (3.5% vs. 1.6%, P=0.0026). The incidence of stent thrombosis (overall 0.5%) was similar between groups. Multivariable analysis showed that DAPT >9 months was associated with a significantly lower risk of primary outcome (odds ratio 0.725, 95% confidence interval 0.545–0.965).Conclusions:Our data showed that short duration of DAPT (≤9 months) was common (42.1%) in Taiwan for ACS patients undergoing PCI. DAPT ≤9 months increased the risk of the primary outcome.

著者

Jeff Z. Chen Hisashi Sawada Jessica J. Moorleghen Mackenzie Weiland Alan Daugherty Mary B. Sheppard

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-18-0012, (Released:2019-04-27)

参考文献数

32

被引用文献数

24

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Background:High-frequency ultrasound has facilitated in vivo measurement of murine ascending aorta, allowing aortic strain to be determined from 2-D imaging. Thoracic aortic aneurysms associated with mutations infibrillin-1(FBN1) display elastin fragmentation, which may affect aortic strain. In this study, we determined the relationship between elastin fragmentation and aortic circumferential strain in wild-type (WT) and fibrillin-1 hypomorphic (FBN1mgR/mgR) mice.Methods and Results:Luminal diameter of the ascending aorta from WT andFBN1mgR/mgRmice was measured in systole and diastole. Expansion of the ascending aorta during systole in male and female WT mice was 0.21±0.02 mm (16.3%) and 0.21±0.01 mm (17.0%), respectively, while expansion in male and femaleFBN1mgR/mgRmice was 0.11±0.04 mm (4.9%) and 0.07±0.02 mm (4.5%), respectively. Reduced circumferential strain was observed inFBN1mgR/mgRmice compared with WT littermates. Elastin fragmentation was inversely correlated to circumferential strain (R2=0.628, P=0.004) and significantly correlated with aortic diameter (systole, R2=0.397, P=0.038; diastole, R2=0.515, P=0.013).Conclusions:FBN1mgR/mgRmice had increased aortic diameter, reduced circumferential strain, and increased elastin fragmentation. Elastin fragmentation inFBN1mgR/mgRand their WT littermates was correlated with reduced circumferential strain.

著者

Haruhiko Sakurai Miyazaki Kei Kenichirou Matsubara Kazuhiko Yokouchi Kazuki Hattori Ryoichi Ichihashi Yoshihiro Hirakawa Hideto Tsukamoto Yoshihiro Saburi

出版者

The Japanese Circulation Society

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.64, no.11, pp.893-896, 2000 (Released:2001-05-31)

参考文献数

23

被引用文献数

6 8

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Cardiogenic shock developed in a 72-year-old Japanese woman during combination therapy with verapamil and atenolol for recurrent supraventricular arrhythmia. She had coronary atherosclerosis, liver cirrhosis and brady-cardia-tachycardia syndrome. Despite of the high-dose catecholamines and counterpulsation, she progressively deteriorated. Bolus administration of intravenous calcium chloride(CaCl2) immediately resolved her hemodynamic collapse.

著者

Akinori Higaki Katsuji Inoue Masaki Kinoshita Shuntaro Ikeda Osamu Yamaguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.4, pp.197, 2019-04-10 (Released:2019-04-10)

参考文献数

3

被引用文献数

5

著者

Yoichiro Hirakawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.4, pp.711-712, 2019-03-25 (Released:2019-03-25)

参考文献数

17

被引用文献数

1