201
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Yamaguchi J, Kawada-Watanabe E, Arashi H, Sekiguchi H, Ogawa H, Hagiwara N. Reply to: “Call for an ezetimibe effectivess test”. Atherosclerosis 2018; 278:335. [DOI: 10.1016/j.atherosclerosis.2018.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 09/20/2018] [Indexed: 10/28/2022]
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202
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Suzuki A, Matsui Y, Shiga T, Morio S, Hagiwara N. Electocardiographic Characteristics and Left Ventricular Ejection Fraction Improvement in Patients with Implantable Cardioverter Defibrillator. J Electrocardiol 2018. [DOI: 10.1016/j.jelectrocard.2018.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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203
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Minami Y, Kajimoto K, Sato N, Hagiwara N, Takano T. C-reactive protein level on admission and time to and cause of death in patients hospitalized for acute heart failure. Eur Heart J Qual Care Clin Outcomes 2018; 3:148-156. [PMID: 28927169 DOI: 10.1093/ehjqcco/qcw054] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/15/2016] [Indexed: 11/13/2022]
Abstract
Aims We analysed the association between C-reactive protein (CRP) levels measured on admission and timing and cause of death among patients hospitalized for acute heart failure (AHF). Methods and Results The ATTEND study prospectively registered 4777 hospitalized AHF patients with data on CRP levels on admission. Mortality risks were assessed by univariable and multivariable Cox proportional and non-proportional hazards models. The overall median CRP level was 5.8 mg/L (intertertile range: 2.9-11.8 mg/L). There were significant increases in all-cause, cardiac, and non-cardiac mortalities from the lowest to highest CRP tertiles throughout the follow-up periods. Within 120 days after admission, CRP levels in the highest tertile (>11.8 mg/L) were independently associated with higher all-cause (hazard ratio [HR], 2.21; 95% confidence interval [CI], 1.69-2.88; P < 0.001), cardiac (HR, 1.88; 95% CI, 1.37-2.58; P < 0.001), and non-cardiac (HR, 3.21; 95% CI, 1.94-5.32; P < 0.001) deaths, while levels in the second tertile (2.9-11.8 mg/L) were not associated with poorer survival, compared with levels in the first tertile (<2.9 mg/L). However, in terms of cardiac death, the hazard ratios for patients in the third tertile decreased markedly with time and only CRP levels in second tertile were independently associated with poorer cardiac survival after the follow-up period of 120 days (HR, 1.44; 95% CI, 1.09-1.89; P = 0.011). Conclusions Markedly elevated CRP levels at admission in patients with AHF may be associated with higher short-term cardiac and non-cardiac mortalities. In addition, modestly elevated CRP levels may be associated with higher mortality, especially cardiac mortality, after 120 days of long-term follow-up.
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Affiliation(s)
- Yuichiro Minami
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | | | - Naoki Sato
- Internal Medicine, Cardiology, and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kawasaki, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Teruo Takano
- Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
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204
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Jujo K, Hagiwara N. Alternative Exercise Intervention for Patients With Severe Peripheral Artery Disease ― Akt1-Induced Blood Flow Recovery ―. Circ J 2018; 82:2705-2706. [DOI: 10.1253/circj.cj-18-1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kentaro Jujo
- Department of Cardiology, Tokyo Women’s Medical University
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205
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Tanabe K, Popma JJ, Kozuma K, Saito S, Muramatsu T, Nakamura S, Namiki A, Morino Y, Hagiwara N, Uematsu M, Kawasaki T, Fujii K, Serruys PW, Onuma Y, Ying S, Kusano H, Stone GW, Kimura T. Multislice computed tomography assessment of everolimus-eluting Absorb bioresorbable scaffolds in comparison with metallic drug-eluting stents from the ABSORB Japan randomised trial. EUROINTERVENTION 2018; 14:e1020-e1028. [PMID: 29131799 DOI: 10.4244/eij-d-17-00716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Blooming artefacts limit accurate coronary assessment by multislice computed tomography (MSCT) in metallic stents. We sought to investigate whether bioresorbable vascular scaffolds (BVS) could be better assessed by MSCT. METHODS AND RESULTS Among 400 patients in the randomised ABSORB Japan trial, a pre-specified MSCT substudy was performed in 98 patients (103 lesions) in the BVS arm and 49 patients (49 lesions) in the cobalt-chromium everolimus-eluting stent (CoCr-EES) arm at 13 months prior to follow-up angiography. The assessability of BVS by MSCT was superior to that of CoCr-EES (94% versus 67%, p<0.001). Blooming artefacts were the main reason CoCr-EES could not be analysed (29%), while marker artefacts precluded analysis in 1.1% of BVS. In the CoCr-EES arm, non-assessable lesions were more prevalent in segments with 2.5 mm stents compared to 3.0 or 3.5 mm stents (75.0% versus 23.5%, p=0.01), while in the BVS arm image quality was good regardless of the diameter. The in-device minimal lumen diameter by MSCT was smaller than that by QCA with a difference of 0.61 mm in the CoCr-EES arm, vs. only 0.026 mm in the BVS arm. CONCLUSIONS The feasibility of MSCT assessment of BVS-treated lesions was greater than that for lesions with CoCr-EES.
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206
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Higuchi S, Ejima K, Shoda M, Yamamoto E, Iwanami Y, Yagishita D, Hagiwara N. Impact of a prolonged interatrial conduction time for predicting the recurrence of atrial fibrillation after circumferential pulmonary vein isolation of persistent atrial fibrillation. Heart Vessels 2018; 34:616-624. [PMID: 30291411 DOI: 10.1007/s00380-018-1272-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 09/28/2018] [Indexed: 11/26/2022]
Abstract
There are some cases that are difficult to cure with only circumferential pulmonary vein isolation (CPVI) of persistent atrial fibrillation (PerAF). Recently, prolonged interatrial conduction times (IACTs), which seem to be associated with progressive remodeled atria, have been reported as a predictor of new-onset AF. This study aimed to investigate the prognostic value of a prolonged IACT for predicting AF recurrences after CPVI of PerAF. One hundred thirteen patients who underwent CPVI without an empirical substrate modification of PerAF were retrospectively analyzed. The IACT was defined as the interval from the earliest P-wave onset on the ECG to the latest activation in the coronary sinus and was measured after achieving the CPVI and conversion to sinus rhythm. During a mean 22.7-month follow-up after the initial procedure, 56 patients (50%) had AF recurrences. Patients with AF recurrence had a longer IACT than those without AF recurrence (p < 0.001). The best discriminative cut-off value for the IACT was 123 ms (sensitivity 53%, specificity 85%). In a Cox multivariate analysis, a prolonged IACT of ≥ 123 ms was the only independent predictor (hazard ratio: 2.38; 95% confidence interval: 1.36-4.16, p = 0.002) of being associated with the incidence of an AF recurrence. Even after multiple CPVI procedures, patients with an IACT ≥ 123 ms had a higher AF recurrence rate than those with an IACT < 123 ms (p = 0.002). In conclusion, a prolonged IACT of ≥ 123 ms may be a useful marker for predicting AF recurrences after both initial and multiple CPVI procedures for PerAF.
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Affiliation(s)
- Satoshi Higuchi
- Department of Cardiology, Tokyo Women'S Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Koichiro Ejima
- Department of Cardiology, Tokyo Women'S Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Morio Shoda
- Department of Cardiology, Tokyo Women'S Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Eri Yamamoto
- Department of Cardiology, Tokyo Women'S Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yuji Iwanami
- Department of Cardiology, Tokyo Women'S Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Daigo Yagishita
- Department of Cardiology, Tokyo Women'S Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women'S Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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207
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Miyazaki M, Hattori H, Suzuki A, Serizawa N, Uto K, Fukushima K, Momose M, Shiga T, Hagiwara N. Successfully treated eosinophilic granulomatosis with polyangiitis relapse presenting as myocarditis and followed by multimodality imaging. J Cardiol Cases 2018; 18:145-148. [PMID: 30279934 DOI: 10.1016/j.jccase.2018.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022] Open
Abstract
A 60-year-old man with eosinophilic granulomatosis with polyangiitis (EGPA), which was diagnosed 12 years earlier and managed with prednisolone, was admitted to our hospital because of dyspnea and paresthesias in both hands. Laboratory test revealed peripheral eosinophilia along with elevated troponin T and brain natriuretic peptide (BNP). The patient's clinical picture was consistent with myocarditis and relapse of EGPA. Endomyocardial biopsy showed marked infiltration of eosinophils in myocardium, which confirmed relapse of EGPA with myocarditis. Thallium-201 and iodine-123-beta-methyl iodophenyl pentadecanoic acid dual single-photon emission computed tomography (TL-BMIPP SPECT), as well as cardiac magnetic resonance imaging (CMR), also confirmed cardiac involvement. The patient was treated with methylprednisolone and improved dramatically. CMR and TL-BMIPP SPECT performed after discharge showed improvement of abnormal lesions, while anomalies detected by these modalities remained. This is a case of EGPA relapse presenting as myocarditis despite treatment with prednisolone. <Learning objective: Cardiac involvement and relapse are frequent in eosinophilic granulomatosis with polyangiitis patients. Patients should be screened and monitored carefully for cardiac involvement during follow-up by multimodality imaging.>.
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Affiliation(s)
- Midori Miyazaki
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hidetoshi Hattori
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Atsushi Suzuki
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Naoki Serizawa
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenta Uto
- Department of Pathology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenji Fukushima
- Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Mitsuru Momose
- Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
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208
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Saito C, Minami Y, Arai K, Haruki S, Yagishita Y, Jujo K, Ashihara K, Hagiwara N. Prevalence, clinical characteristics, and outcome of atrial functional mitral regurgitation in hospitalized heart failure patients with atrial fibrillation. J Cardiol 2018; 72:292-299. [DOI: 10.1016/j.jjcc.2018.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/31/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022]
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209
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Hattori H, Suzuki A, Shiga T, Nishinaka T, Saito S, Yamazaki K, Nunoda S, Hagiwara N. Impact of Recurrent Ventricular Tachyarrhythmia on Outcome in Japanese Heart Transplant Candidates With a Left Ventricular Assist Device. Circ J 2018; 82:2305-2310. [PMID: 30012930 DOI: 10.1253/circj.cj-18-0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Recurrent ventricular tachyarrhythmias (VTA) are "A factor" modifiers in the Interagency Registry for Mechanically Assisted Circulatory Support profile. The effect of recurrent VTA on clinical outcome, however, is controversial. We evaluated the impact of recurrent VTA on outcome in Japanese heart transplant candidates with a left ventricular assist device (LVAD). Methods and Results: Sixty-six adult patients with advanced heart failure who were listed for heart transplantation between January 2005 and October 2017 were enrolled in the study. Recurrent VTA (modifier A status) was defined as a sustained ventricular tachycardia or fibrillation that required implantable cardioverter defibrillator shocks or an external defibrillator more than twice weekly. The primary outcome was death from any cause. The secondary outcomes were the first occurrence of VTA and recurrent VTA after LVAD implantation. Sixteen patients (24%) met the criteria for modifier A status, and 15 patients had an LVAD implanted. During a median follow-up of 1,124 days, 21 of 60 patients with an LVAD died. There was a significantly higher mortality rate in LVAD patients with modifier A status than in those who did not meet the modifier A criteria. On multivariate analysis, patients with modifier A status had an increased risk of mortality (HR, 3.43; 95% CI: 1.30-8.61, P=0.001). CONCLUSIONS Recurrent VTA might be a marker for worse outcome in Japanese heart transplant candidates with an LVAD.
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Affiliation(s)
| | - Atsushi Suzuki
- Department of Cardiology, Tokyo Women's Medical University
| | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University
| | | | - Satoshi Saito
- Department of Cardiovascular Surgery, Tokyo Women's Medical University
| | - Kenji Yamazaki
- Department of Cardiovascular Surgery, Tokyo Women's Medical University
| | - Shinichi Nunoda
- Department of Therapeutic Strategy for Severe Heart Failure, Tokyo Women's Medical University Graduate School of Medical Science
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210
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Abe T, Jujo K, Minami Y, Kametani M, Yoshikawa M, Mizobuchi K, Ishida I, Akashi M, Tanaka K, Haruki S, Sekiguchi H, Hagiwara N. 206Guideline-recommended medication including mineralocorticoid-receptor antagonists is associated with better long-term outcomes in octogenarian patients with acute heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Abe
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - Y Minami
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Kametani
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Yoshikawa
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Mizobuchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - I Ishida
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Akashi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Tanaka
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - S Haruki
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - H Sekiguchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
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211
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Otsuki H, Jujo K, Tanaka K, Okai I, Dohi T, Okazaki S, Kawashima H, Nakashima M, Nara Y, Kyono H, Yamaguchi J, Miyauchi K, Daida H, Kozuma K, Hagiwara N. P3587Gender difference in long-term clinical outcomes after rotational atherectomy in severely calcified coronary stenoses - From J2T multicenter registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Otsuki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Tanaka
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - I Okai
- Juntendo University, Cardiology, Tokyo, Japan
| | - T Dohi
- Juntendo University, Cardiology, Tokyo, Japan
| | - S Okazaki
- Juntendo University, Cardiology, Tokyo, Japan
| | | | | | - Y Nara
- Teikyo University, Cardiology, Tokyo, Japan
| | - H Kyono
- Teikyo University, Cardiology, Tokyo, Japan
| | - J Yamaguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Miyauchi
- Juntendo University, Cardiology, Tokyo, Japan
| | - H Daida
- Juntendo University, Cardiology, Tokyo, Japan
| | - K Kozuma
- Teikyo University, Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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212
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Sekiguchi H, Yoshimura A, Fukushima T, Suzuki K, Ogiso M, Kawada-Watanabe E, Arashi H, Yamaguchi J, Ogawa H, Hagiwara N. P6242Simple risk score for predicting secondary cardiovascular events in ACS patients undergoing contemporary aggressive lipid-lowering management for dyslipidaemia: a sub-analysis of the HIJ-PROPER study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Sekiguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - A Yoshimura
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - T Fukushima
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Suzuki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M Ogiso
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - E Kawada-Watanabe
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Arashi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - J Yamaguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Ogawa
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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213
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Kametani M, Jujo K, Minami Y, Abe T, Mizobuchi K, Ishida I, Yoshikawa M, Akashi M, Tanaka K, Haruki S, Hagiwara N. P6537J-shaped association between length of hospital stay and cardiovascular mortality after discharge in patients with acute heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Kametani
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - Y Minami
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - T Abe
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Mizobuchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - I Ishida
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Yoshikawa
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Akashi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Tanaka
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - S Haruki
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
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214
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Abe T, Sakai A, Watanabe E, Nagao M, Sakai S, Hagiwara N. P3701Analysis of myocardial fibrosis using cardiac magnetic resonance T1 imaging and late gadolinium enhancement: Association with ventricular tachycardia in hypertrophic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Abe
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - A Sakai
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - E Watanabe
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - M Nagao
- Tokyo Women's Medical University, Department of Diagnostic Imaging & Nuclear Medicine, Tokyo, Japan
| | - S Sakai
- Tokyo Women's Medical University, Department of Diagnostic Imaging & Nuclear Medicine, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
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215
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Kikuchi N, Yoshimura A, Suzuki A, Shiga T, Hattori H, Nishinaka T, Saito S, Yamazaki K, Niinami H, Hagiwara N, Nunoda S. 3277Impact of congestion in worsening renal failure after implantation of a centrifugal, continuous-flow left ventricular device. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Kikuchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - A Yoshimura
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - A Suzuki
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - T Shiga
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - H Hattori
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - T Nishinaka
- Tokyo Women's Medical University, Cardiovascular surgery, Tokyo, Japan
| | - S Saito
- Tokyo Women's Medical University, Cardiovascular surgery, Tokyo, Japan
| | - K Yamazaki
- Tokyo Women's Medical University, Cardiovascular surgery, Tokyo, Japan
| | - H Niinami
- Tokyo Women's Medical University, Cardiovascular surgery, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - S Nunoda
- Tokyo Women's Medical University, Therapeutic Strategy for Severe Heart Failure, Tokyo, Japan
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216
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Suzuki T, Shiga T, Omori H, Tatsumi F, Nishimura K, Hagiwara N. Self-Reported Non-adherence to Medication in Japanese Patients with Cardiovascular Diseases. Am J Cardiovasc Drugs 2018; 18:311-316. [PMID: 29748918 DOI: 10.1007/s40256-018-0278-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Non-adherence to medication is an important problem in cardiovascular treatment. The aim of this study was to assess self-reported non-adherence in Japanese patients with cardiovascular disease. METHODS A total of 1372 outpatients at three university hospitals who completed self-reported questionnaires were analyzed in this prospective study (mean age 67 ± 12 years; 31% female). Self-reported adherence to cardiovascular drugs was measured with a modified Siegal scale. Depressive symptoms were defined as a Patient Health Questionnaire-9 score of ≥ 10. RESULTS A total of 227 patients (17%) were defined as non-adherent. Multiple logistic regression analysis showed that ≥ 2 times daily dosing frequency, age < 65 years and active employment were significantly associated with non-adherence, with odds ratios of 4.42 [95% confidence interval (CI) 3.02-6.48], 1.70 (95% CI 1.23-2.35) and 1.43 (95% CI 1.03-1.99), respectively. However, depression was not a significant factor in non-adherence. CONCLUSIONS Our study showed that self-reported non-adherence to medications was 17% in Japanese patients with cardiovascular disease in the university hospital setting. Daily dosing frequency, younger age and employment were significantly associated with non-adherence. TRIAL REGISTRATION University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) no. UMIN 000023514.
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Affiliation(s)
- Tsuyoshi Suzuki
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Hisako Omori
- Department of Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Fujio Tatsumi
- Department of Cardiology, Institute of Geriatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsuji Nishimura
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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217
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Sekiguchi H, Yoshimura A, Fukushima T, Suzuki K, Ogiso M, Kawada-Watanabe E, Arashi H, Yamaguchi J, Ogawa H, Hagiwara N. P2531Comparison of risk factors for cardiovascular outcomes between patients with and without diabetes: results from the HIJ-PROPER Study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Sekiguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - A Yoshimura
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - T Fukushima
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Suzuki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M Ogiso
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - E Kawada-Watanabe
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Arashi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - J Yamaguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Ogawa
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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218
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Sekiguchi H, Abe T, Yamamoto E, Koike T, Sakai A, Sato K, Hagiwara N. P6267Underdiagnosis and non-treatment of heterozygous familial hypercholesterolemia in association with cardiovascular disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Sekiguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - T Abe
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - E Yamamoto
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - T Koike
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - A Sakai
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Sato
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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219
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Abe T, Jujo K, Minami Y, Kametani M, Yoshikawa M, Mizobuchi K, Ishida I, Akashi M, Tanaka K, Haruki S, Arashi H, Sekiguchi H, Hagiwara N. 5074The impact of additional mineralocorticoid receptor antagonist on guideline-recommended medical therapy in acute heart failure patients with ischemic heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Abe
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - Y Minami
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Kametani
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Yoshikawa
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Mizobuchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - I Ishida
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Akashi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Tanaka
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - S Haruki
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - H Arashi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - H Sekiguchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
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220
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Mizobuchi K, Jujo K, Minami Y, Kametani M, Abe T, Yoshikawa M, Ishida I, Akashi M, Haruki S, Arashi H, Sekiguchi H, Hagiwara N. P2779Therapeutic validity and effectiveness of guideline-recommended medical therapy in acute heart failure patients on regular hemodialysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Mizobuchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - Y Minami
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Kametani
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - T Abe
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Yoshikawa
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - I Ishida
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Akashi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - S Haruki
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - H Arashi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - H Sekiguchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
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221
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Kametani M, Jujo K, Minami Y, Abe T, Mizobuchi K, Ishida I, Yoshikawa M, Akashi M, Tanaka K, Haruki S, Hagiwara N. P273Full combination of guideline-recommended medical therapy is associated with better long-term mortality in acute heart failure patients with low blood pressure and renal dysfunction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Kametani
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - Y Minami
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - T Abe
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Mizobuchi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - I Ishida
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Yoshikawa
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Akashi
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Tanaka
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - S Haruki
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
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222
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Shiga T, Kohro T, Yamasaki H, Aonuma K, Suzuki A, Ogawa H, Hagiwara N, Yamazaki T, Nagai R, Kasanuki H. Body Mass Index and Sudden Cardiac Death in Japanese Patients After Acute Myocardial Infarction: Data From the JCAD Study and HIJAMI-II Registry. J Am Heart Assoc 2018; 7:JAHA.118.008633. [PMID: 29982233 PMCID: PMC6064840 DOI: 10.1161/jaha.118.008633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Although an “obesity paradox” exists in patients after myocardial infarction, the association between obesity and the risk of sudden cardiac death (SCD) is limited. The aim of this study was to determine whether obesity is associated with an increased risk of SCD in Japanese survivors of acute myocardial infarction. Methods and Results Pooled data from 2 cohort studies in Japan, JCAD (Japanese Coronary Artery Disease) study and the Heart Institute of Japan Acute Myocardial Infarction‐II (HIJAMI‐II) registry, comprising of 6216 patients (mean age 65±11 years, 75.2% male) with acute myocardial infarction who were discharged alive, were studied. The patients were categorized into the following body mass index (BMI) groups at baseline according to the World Health Organization classification for Asian populations: BMI <18.5 kg/m2 (n=335), 18.5 to 23 kg/m2 (n=2371), 23 to 27.5 kg/m2 (n=2823), and ≥27.5 kg/m2 (n=687). The main outcomes were all‐cause mortality and SCD. During an average follow‐up period of 3.6±1.4 years, all‐cause mortality was 10.1%, and SCD was 1.2%. Patients with BMI <18.5 kg/m2 had the highest rate of all‐cause mortality (adjusted hazard ratio, 1.61; 95% confidence interval, 1.20–2.16), but high BMI (≥27.5 kg/m2) was not associated with mortality compared with patients in the group with BMI ≥18.5 and <23 kg/m2. However, the long‐term risk of SCD was increased in the group with BMI ≥27.5 kg/m2 (adjusted hazard ratio, 2.97; 95% confidence interval, 1.24–7.15). Multivariate analysis revealed that BMI ≥27.5 kg/m2 was associated with an increased risk of SCD (hazard ratio, 2.78; 95% confidence interval, 1.35–5.74). Conclusions Obesity (BMI ≥27.5 kg/m2) was associated with the risk of SCD in Japanese patients after myocardial infarction, although an obesity paradox was found for all‐cause mortality.
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Affiliation(s)
- Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Takahide Kohro
- Department of Clinical Informatics, Jichi Medical University, Shimotsuke, Japan
| | - Hiro Yamasaki
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Japan
| | - Kazutaka Aonuma
- Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Japan
| | - Atsushi Suzuki
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroshi Ogawa
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tsutomu Yamazaki
- Clinical Research Support Center, University of Tokyo Hospital, Tokyo, Japan
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223
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Yamaguchi J, Kawada-Watanabe E, Koyanagi R, Arashi H, Sekiguchi H, Nakao K, Tobaru T, Tanaka H, Oka T, Endo Y, Saito K, Uchida T, Matsui K, Ogawa H, Hagiwara N. Baseline serum sitosterol level as predictor of adverse clinical events in acute coronary syndrome patients with dyslipidaemia: A sub-analysis of HIJ-PROPER. Atherosclerosis 2018; 274:139-145. [DOI: 10.1016/j.atherosclerosis.2018.04.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/07/2018] [Accepted: 04/27/2018] [Indexed: 10/17/2022]
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224
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Kitamura K, Sato K, Sawabe M, Yoshida M, Hagiwara N. P-Selectin Glycoprotein Ligand-1 (PSGL-1) Expressing CD4 T Cells Contribute Plaque Instability in Acute Coronary Syndrome. Circ J 2018; 82:2128-2135. [PMID: 29962384 DOI: 10.1253/circj.cj-17-1270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Adhesion molecules have essential roles in the development of atherosclerosis. We investigated whether P-selectin glycoprotein ligand-1 (PSGL-1)-expressing CD4 T cells contribute to plaque instability in acute coronary syndrome (ACS).Methods and Results:We studied the adhesion molecules on CD4 T cells from consecutive patients with ACS treated with thrombus-aspirating device and compared them with healthy controls (n=48 each). Blood, thrombi, and plaque samples from the culprit coronary arteries were collected by thrombus aspiration performed during emergency coronary artery angiography. According to flow cytometry results, peripheral CD4 T cells from ACS patients strongly expressed PSGL-1 and integrin β2 (P<0.05 for both) more than those from controls; culprit coronary arteries contained an abundance of PSGL-1+(P<0.001) but not integrin β2+CD4 T cells. In addition, immunohistochemical analysis of the thrombus-aspirating device samples revealed numerous PSGL-1+CD4 T cells in plaques from the culprit lesions. Results from the selectin-binding assay demonstrated that activated PSGL-1+CD4 T cells from ACS patients bound to P- or E-selectin after triggering the T-cell receptor, and adhered to endothelial cells under laminar flow conditions (P<0.05 and P<0.05, respectively), inducing their apoptosis (P<0.01) via activated caspase-3, which correlated with PSGL-1 expression (R=0.788, P=0.021) and was suppressed by application of a PSGL-1-specific antibody (P<0.05). CONCLUSIONS PSGL-1 contributed to cytotoxic CD4 T cell homing to the culprit coronary artery and promoted plaque instability in ACS.
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Affiliation(s)
| | - Kayoko Sato
- Department of Cardiology, Tokyo Women's Medical University
| | - Motoji Sawabe
- Section of Molecular Pathology, Graduate School of Health Care Sciences, Tokyo Medical and Dental University
| | - Masayuki Yoshida
- Life Sciences and Bioethics Research Center, Tokyo Medical and Dental University
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225
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Sekiguchi H, Koike T, Yamamoto E, Abe T, Sakai A, Sato K, Hagiwara N. Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK-9) Inhibitors Improve Lipid Profile and Vascular Atherosclerotic Plaque in Familial Hypercholesterolemia. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.04.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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226
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Sekiguchi H, Yamamoto E, Abe T, Koike T, Sato K, Sakai A, Hagiwara N. Insight into Polygenetic Abnormalities in Japanese Heterozygous Familial Hypercholesterolemia. ATHEROSCLEROSIS SUPP 2018. [DOI: 10.1016/j.atherosclerosissup.2018.04.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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227
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Hagiwara N, Watanabe M, Iizuka-Ohashi M, Yokota I, Toriyama S, Sukeno M, Tomosugi M, Sowa Y, Hongo F, Mikami K, Soh J, Fujito A, Miyashita H, Morioka Y, Miki T, Ukimura O, Sakai T. Mevalonate pathway blockage enhances the efficacy of mTOR inhibitors with the activation of retinoblastoma protein in renal cell carcinoma. Cancer Lett 2018; 431:182-189. [PMID: 29778569 DOI: 10.1016/j.canlet.2018.05.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/04/2018] [Accepted: 05/15/2018] [Indexed: 12/11/2022]
Abstract
Renal cell carcinoma (RCC) is the most common malignancy of kidney and remains largely intractable once it recurs after resection. mTOR inhibitors have been one of the mainstays used against recurrent RCC; however, there has been a major problem of the resistance to mTOR inhibitors, and thus new combination treatments with mTOR inhibitors are required. We here retrospectively showed that regular use of antilipidemic drug statins could provide a longer progression free survival (PFS) in RCC patients prescribed with an mTOR inhibitor everolimus than without statins (median PFS, 7.5 months vs. 3.2 months, respectively; hazard ratio, 0.52; 95% CI, 0.22-1.11). In order to give a rationale for this finding, we used RCC cell lines and showed the combinatorial effects of an mTOR inhibitor with statins induced a robust activation of retinoblastoma protein, whose mechanisms were involved in statins-mediated hindrance of KRAS or Rac1 protein prenylation. Finally, statins treatment also enhanced the efficacy of an mTOR inhibitor in RCC xenograft models. Thus, we provide molecular and (pre)clinical data showing that statins use could be a drug repositioning for RCC patients to enhance the efficacy of mTOR inhibitors.
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Affiliation(s)
- Nobuhisa Hagiwara
- Department of Molecular-targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan; Department of Urology, Kyoto Prefectural University of Medicine, Japan
| | - Motoki Watanabe
- Department of Molecular-targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Mahiro Iizuka-Ohashi
- Department of Molecular-targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan; Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Isao Yokota
- Department of Biostatistics, Kyoto Prefectural University of Medicine, Japan
| | - Seijiro Toriyama
- Department of Urology, Kyoto Prefectural University of Medicine, Japan
| | - Mamiko Sukeno
- Department of Molecular-targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Mitsuhiro Tomosugi
- Department of Molecular-targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshihiro Sowa
- Department of Molecular-targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Fumiya Hongo
- Department of Urology, Kyoto Prefectural University of Medicine, Japan
| | - Kazuya Mikami
- Department of Urology, Japanese Red Cross Kyoto Daiichi Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Jintetsu Soh
- Department of Urology, Japanese Red Cross Kyoto Daini Hospital, Kamannza-marutamachi, Kamigyo-ku, Kyoto, 602-8026, Japan
| | - Akira Fujito
- Department of Urology, Saiseikai Suita Hospital, Kawazonocho, Suita, Osaka, 564-0013, Japan
| | - Hiroaki Miyashita
- Department of Urology, Omihachiman City Hospital, Tsuchida-cho, Omihachiman, Shiga, 523-0082, Japan
| | - Yukako Morioka
- Department of Urology, Kyoto Prefectural University of Medicine, Japan
| | - Tsuneharu Miki
- Department of Urology, Saiseikai Shigaken Hospital, Ohashi, Ritto, Shiga, 520-3046, Japan
| | - Osamu Ukimura
- Department of Urology, Kyoto Prefectural University of Medicine, Japan
| | - Toshiyuki Sakai
- Department of Molecular-targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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228
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Higuchi S, Shoda M, Iwanami Y, Yagishita D, Ejima K, Hagiwara N. Targeting an epicardial-endocardial breakthrough in a case with an intractable common atrial flutter using ultra-high-resolution three-dimensional mapping. Pacing Clin Electrophysiol 2018; 41:1261-1263. [PMID: 29717782 DOI: 10.1111/pace.13361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/09/2018] [Accepted: 04/24/2018] [Indexed: 11/29/2022]
Abstract
The recent development of high-density high-spatial resolution three-dimensional mapping has provided detailed information for understanding complicated atrial activation patterns at a level not previously possible. Using this technology, we report a case with recurrent common atrial flutter, demonstrating the presence of a bridging epicardial fiber that traveled across the previous cavotricuspid isthmus ablation lesion with apparent epicardial-endocardial breakthrough (EEB) sites located on both sides of the ablation line. The entrainment study indicated that the EEB site, located adjacent to the coronary sinus ostium, was part of the recurrent circuit and a focal ablation targeting that site terminated the tachycardia.
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Affiliation(s)
- Satoshi Higuchi
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Morio Shoda
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuji Iwanami
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Daigo Yagishita
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Koichiro Ejima
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
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229
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Yasuda S, Kaikita K, Ogawa H, Akao M, Ako J, Matoba T, Nakamura M, Miyauchi K, Hagiwara N, Kimura K, Hirayama A, Matsui K. Atrial fibrillation and ischemic events with rivaroxaban in patients with stable coronary artery disease (AFIRE): Protocol for a multicenter, prospective, randomized, open-label, parallel group study. Int J Cardiol 2018; 265:108-112. [PMID: 29764706 DOI: 10.1016/j.ijcard.2018.04.131] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/12/2018] [Accepted: 04/30/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND In atrial fibrillation (AF) patients with coronary artery disease (CAD), anticoagulants are commonly used in combination with antiplatelet drugs. However, dual therapy can increase the risk of bleeding, and the potential therapeutic benefits must be weighed against this. Therefore, it is recommended that dual therapy is only used for a limited time, and that monotherapy with anticoagulants should start from 1 year after percutaneous coronary intervention (PCI). However, there is a lack of evidence on the use of monotherapy, in particular with direct oral anticoagulants, in this group of patients. METHODS The AFIRE Study is a multicenter, prospective, randomized, open-label, parallel group study conducted in patients aged ≥20 years with non-valvular AF (NVAF) and CAD. Patients who have undergone PCI or coronary artery bypass graft at least 1 year prior to enrollment, or those without significant coronary lesions requiring PCI (≥50% stenosis), will be included. Approximately 2200 participants will be randomized to receive either rivaroxaban monotherapy or rivaroxaban plus an antiplatelet drug (aspirin, clopidogrel, or prasugrel). The primary efficacy endpoints are the composite of cardiovascular events (stroke, non-central nervous system embolism, myocardial infarction, and unstable angina pectoris requiring revascularizations) and all-cause mortality. The primary safety endpoint is major bleeding as defined by the International Society on Thrombosis and Haemostasis criteria. CONCLUSIONS This study will be the first to assess the efficacy and safety of rivaroxaban monotherapy in NVAF patients with stable CAD.
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Affiliation(s)
- Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hisao Ogawa
- National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan
| | - Masaharu Akao
- Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Fukuoka 812-8582, Japan
| | - Masato Nakamura
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-17-6, Ohashi, Meguro-ku, Tokyo 153-8515, Japan
| | - Katsumi Miyauchi
- Department of Cardiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Kazuo Kimura
- Department of Cardiology, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
| | - Atsushi Hirayama
- Division of Cardiology, Nihon University School of Medicine, 30-1 Ohyaguchi Kamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Kunihiko Matsui
- Department of Community, Family, and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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Hagiwara N, Kawada-Watanabe E, Koyanagi R, Arashi H, Yamaguchi J, Nakao K, Tobaru T, Tanaka H, Oka T, Endoh Y, Saito K, Uchida T, Matsui K, Ogawa H. Low-density lipoprotein cholesterol targeting with pitavastatin + ezetimibe for patients with acute coronary syndrome and dyslipidaemia: the HIJ-PROPER study, a prospective, open-label, randomized trial. Eur Heart J 2018; 38:2264-2276. [PMID: 28430910 PMCID: PMC5837267 DOI: 10.1093/eurheartj/ehx162] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 03/16/2017] [Indexed: 01/02/2023] Open
Abstract
Aims To elucidate the effects of intensive LDL-C lowering treatment with a standard dose of statin and ezetimibe in patients with dyslipidaemia and high risk of coronary events, targeting LDL-C less than 70 mg/dL (1.8 mmol/L), compared with standard LDL-C lowering lipid monotherapy targeting less than 100 mg/dL (2.6 mmol/L). Methods and results The HIJ-PROPER study is a prospective, randomized, open-label trial to assess whether intensive LDL-C lowering with standard-dose pitavastatin plus ezetimibe reduces cardiovascular events more than standard LDL-C lowering with pitavastatin monotherapy in patients with acute coronary syndrome (ACS) and dyslipidaemia. Patients were randomized to intensive lowering (target LDL-C < 70 mg/dL [1.8 mmol/L]; pitavastatin plus ezetimibe) or standard lowering (target LDL-C 90 mg/dL to 100 mg/dL [2.3–2.6 mmol/L]; pitavastatin monotherapy). The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina, and ischaemia-driven revascularization. Between January 2010 and April 2013, 1734 patients were enroled at 19 hospitals in Japan. Patients were followed for at least 36 months. Median follow-up was 3.86 years. Mean follow-up LDL-C was 65.1 mg/dL (1.68 mmol/L) for pitavastatin plus ezetimibe and 84.6 mg/dL (2.19 mmol/L) for pitavastatin monotherapy. LDL-C lowering with statin plus ezetimibe did not reduce primary endpoint occurrence in comparison with standard statin monotherapy (283/864, 32.8% vs. 316/857, 36.9%; HR 0.89, 95% CI 0.76–1.04, P = 0.152). In, ACS patients with higher cholesterol absorption, represented by elevated pre-treatment sitosterol, was associated with significantly lower incidence of the primary endpoint in the statin plus ezetimibe group (HR 0.71, 95% CI 0.56–0.91). Conclusion Although intensive lowering with standard pitavastatin plus ezetimibe showed no more cardiovascular benefit than standard pitavastatin monotherapy in ACS patients with dyslipidaemia, statin plus ezetimibe may be more effective than statin monotherapy in patients with higher cholesterol absorption; further confirmation is needed. Trial No UMIN000002742, registered as an International Standard Randomized Controlled Trial.
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Affiliation(s)
- Nobuhisa Hagiwara
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
| | - Erisa Kawada-Watanabe
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
| | - Ryo Koyanagi
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
| | - Hiroyuki Arashi
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
| | - Junichi Yamaguchi
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
| | - Koichi Nakao
- Division of Cardiology, Cardiovascular Center, Saisei-Kai Kumamoto Hospital, 5-3-1 Chikami, Minami-ku, Kumamoto-shi, Kumamoto 861-4193, Japan
| | - Tetsuya Tobaru
- Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu-shi, Tokyo 183-0003, Japan
| | - Hiroyuki Tanaka
- Division of Cardiology, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo 183-8524, Japan
| | - Toshiaki Oka
- Department of Cardiology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-shi, Shizuoka 430-8558, Japan
| | - Yasuhiro Endoh
- Department of Cardiology, Saisei-Kai Kurihashi Hospital, 714-6 Kouemon, Kuki-shi, Saitama 349-1105, Japan
| | - Katsumi Saito
- Department of Cardiology, Nishiarai Heart Center, 1-12-8, Nishiarai-honcho, Adachi-Ku, Tokyo 123-0845, Japan
| | - Tatsuro Uchida
- Department of Cardiology, Cardiovascular Center of Sendai, 1-6-12 Izumichuo, Izumi-ku, Sendai-shi, Miyagi 981-3133, Japan
| | - Kunihiko Matsui
- Department of General and Community Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hiroshi Ogawa
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
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Minami Y, Haruki S, Kanbayashi K, Maeda R, Itani R, Hagiwara N. B-type natriuretic peptide and risk of sudden death in patients with hypertrophic cardiomyopathy. Heart Rhythm 2018; 15:1484-1490. [PMID: 29709578 DOI: 10.1016/j.hrthm.2018.04.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND The association between B-type natriuretic peptide (BNP) levels and sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM) remains unclear. OBJECTIVE This study evaluated the effect of elevated BNP levels on sudden death risk in a cohort of patients with HCM. METHODS This study included 346 patients with HCM. Plasma BNP levels were measured at the initial evaluation. RESULTS The median (interquartile range) BNP level in the study patients was 197.2 (84.4-353.3) pg/mL. During a median (interquartile range) follow-up period of 8.4 (4.2-12.5) years, 37 patients (10.7%) experienced the combined end point of sudden death or potentially lethal arrhythmic events, including 11 patients with sudden death (3.2%), 8 resuscitated after cardiac arrest, and 18 with appropriate implantable defibrillator shocks. Time-dependent receiver operating characteristic curve analysis of the prognostic value of BNP for the combined end point showed that the Harrell's concordance index was 0.748 and the optimal BNP cutoff point was 312 pg/mL. Patients with high BNP levels (>312 pg/mL) were at a significantly higher risk of sudden death (Gray test, P = .001) and the combined end point (Gray test, P < .001) than were patients with low BNP levels (≤312 pg/mL). Multivariable analysis that included BNP levels and established risk factors for sudden death showed that high BNP levels were an independent determinant of the combined end point (adjusted hazard ratio 5.71; 95% confidence interval 2.86-11.4; P < .001). CONCLUSION Elevated BNP levels may be associated with sudden death and the combination of sudden death or potentially lethal arrhythmic events in patients with HCM.
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Affiliation(s)
- Yuichiro Minami
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
| | - Shintaro Haruki
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Keigo Kanbayashi
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryozo Maeda
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Ryosuke Itani
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
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232
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Minami Y, Kajimoto K, Sato N, Hagiwara N. Effect of Elevated C-Reactive Protein Level at Discharge on Long-Term Outcome in Patients Hospitalized for Acute Heart Failure. Am J Cardiol 2018; 121:961-968. [PMID: 29454477 DOI: 10.1016/j.amjcard.2017.12.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 12/20/2017] [Accepted: 12/29/2017] [Indexed: 10/18/2022]
Abstract
In the acute heart failure (AHF) setting, the usefulness of C-reactive protein (CRP) at admission as a risk marker is challenged by the possible confounding effect of an acute-phase response. We thus evaluated the relation of CRP level at discharge (i.e., after stabilization of AHF) with subsequent postdischarge outcome in patients hospitalized for AHF. The acute decompensated heart failure syndromes study prospectively registered 4,269 hospitalized AHF patients with data on CRP levels at discharge. The median CRP level was 3.1 mg/L (interquartile range 1.1 to 9.5 mg/L). Within 120 days after discharge, only CRP levels in the fourth quartile (≥9.6 mg/L) were independently associated with higher all-cause mortality (adjusted hazard ratio [HR], 1.68) according to multivariable models with first-quartile (≤1.1 mg/L) as the reference. However, the HR for CRP levels in the fourth quartile decreased markedly with time, and CRP levels in the second (1.2 to 3.1 mg/L) and third (3.2 to 9.5 mg/L) quartiles were independently associated with poorer survival after the 120-day follow-up period (adjusted HR, 1.41 and 1.63, respectively). In addition, only CRP levels in the third quartile were independently associated with the composite end point of all-cause death and readmission for AHF after the 120 days of long-term follow-up (adjusted HR, 1.31). In conclusion, our results suggest that a modestly elevated CRP level (approximately 3 to 10 mg/L) at discharge had unique long-term prognostic implications in hospitalized patients with AHF.
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233
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Otsuki H, Yamaguchi J, Kamishima K, Arashi H, Hagiwara N. Real-world antithrombotic therapies and clinical outcomes after second-generation drug-eluting stent implantation in patients with atrial fibrillation: a multi-center cohort study. Heart Vessels 2018; 33:986-996. [PMID: 29549436 DOI: 10.1007/s00380-018-1148-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/09/2018] [Indexed: 11/26/2022]
Abstract
Previous reports have focused on cardiovascular and bleeding events in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). However, antithrombotic treatment strategies and clinical outcomes after second-generation drug-eluting stents (DES) implantation in AF patients remain to be determined. We enrolled 244 consecutive AF patients treated with second-generation DES. The study population was derived from multi-center AF registry (including 8 centers in Japan) from 2010 to 2012. Prescription of antithrombotic agents and clinical outcomes were retrospectively examined. Ninety-two patients (37.7%) were prescribed dual antiplatelet therapy (DAPT) at discharge and 152 patients (62.3%) were given DAPT plus oral anticoagulation (OAC) with warfarin. The median follow-up period was 730 days. Kaplan-Meier analysis showed that major adverse cardiac and cerebrovascular events (MACCE) were not significantly different (2-year event rate, 17.6 vs. 13.5%, p = 0.37), but bleeding events were significantly higher in the DAPT plus OAC group than in the DAPT group (2-year event rate, 6.1 vs. 17.9%, p = 0.033). In a sub-analysis of DAPT plus OAC patients, adequate time in the therapeutic range (TTR) group (TTR ≥ 65%) was not significantly different from the suboptimal OAC group (TTR < 65%) for bleeding events, but it had a lower incidence of MACCE, resulting in better net clinical outcomes (composite of MACCE and major bleeding, 2-year event rate, 9.2 vs. 27.8%, p = 0.008). DAPT plus OAC remains more common in AF patients undergoing PCI with second-generation DES. Under adequate TTR, DAPT plus OAC showed better net clinical outcomes by reducing MACCE without increasing bleeding.
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Affiliation(s)
- Hisao Otsuki
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
| | - Junichi Yamaguchi
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan.
| | - Kazuho Kamishima
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
| | - Hiroyuki Arashi
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan
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Ejima K, Higuchi S, Iwanami Y, Yagishita D, Arai K, Saito C, Tanino S, Ashihara K, Shoda M, Hagiwara N. 746Predictive value of the total atrial conduction time estimated with tissue Doppler imaging for predicting atrial tachyarrhythmia recurrences after catheter ablation. Europace 2018. [DOI: 10.1093/europace/euy015.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Ejima
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - S Higuchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - Y Iwanami
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - D Yagishita
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Arai
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - C Saito
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - S Tanino
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Ashihara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M Shoda
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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235
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Sekiguchi H, Koike T, Abe T, Sakai A, Sato K, Hagiwara N. POLYGENETIC ABNORMALITIES IN JAPANESE PATIENTS WITH HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32297-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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236
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Sekiguchi H, Yamamoto E, Abe T, Sakai A, Sato K, Hagiwara N. PROPROTEIN CONVERTASE SUBTILISIN/KEXIN TYPE 9 (PCSK-9) INHIBITORS IMPROVE LIPID PROFILE AND VASCULAR ATHEROSCLEROTIC PLAQUE FORMATION IN HIGH-RISK FAMILIAL HYPERCHOLESTEROLEMIA. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32634-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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237
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Sekiguchi H, Kawada-Watanabe E, Arashi H, Yamaguchi J, Ogawa H, Hagiwara N. ASSOCIATION BETWEEN THE LOW-DENSITY LIPOPROTEIN-CHOLESTEROL/HIGH-DENSITY LIPOPROTEIN-CHOLESTEROL RATIO AND CLINICAL OUTCOMES IN PATIENTS WITH ACUTE CORONARY SYNDROME AND DYSLIPIDEMIA: A SUBANALYSIS OF THE HIJ-PROPER STUDY. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32298-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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238
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Sekiguchi H, Kawamoto T, Suzuki A, Shiga T, Hagiwara N. THE IMPACT OF BRAIN ATROPHY IN THE YOUNG PATIENT WITH SEVERE HEART FAILURE. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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239
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Mizobuchi K, Jujo K, Minami Y, Ishida I, Haruki S, Kadowaki H, Tanaka K, Akashi M, Kametani M, Nakao M, Yamaguchi J, Hagiwara N. BASELINE NUTRITIONAL STATUS PREDICTS LONG-TERM AMPUTATION-FREE SURVIVAL IN PATIENTS UNDERGOING ENDOVASCULAR THERAPY. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31775-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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240
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Im J, Serizawa N, Fukushima K, Imamura Y, Nomura A, Sakai A, Momose M, Nagao M, Shiga T, Abe K, Hagiwara N. IS DISEASE ACTIVITY OF CARDIAC SARCOIDOSIS SUPPRESSED DURING MAINTENANCE DOSE PERIOD OF CORTICOSTEROID THERAPY? EVALUATION BY FDG-PET. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32232-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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241
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Tobita T, Nomura S, Fujita T, Morita H, Asano Y, Onoue K, Ito M, Imai Y, Suzuki A, Ko T, Satoh M, Fujita K, Naito AT, Furutani Y, Toko H, Harada M, Amiya E, Hatano M, Takimoto E, Shiga T, Nakanishi T, Sakata Y, Ono M, Saito Y, Takashima S, Hagiwara N, Aburatani H, Komuro I. Genetic basis of cardiomyopathy and the genotypes involved in prognosis and left ventricular reverse remodeling. Sci Rep 2018; 8:1998. [PMID: 29386531 PMCID: PMC5792481 DOI: 10.1038/s41598-018-20114-9] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 01/11/2018] [Indexed: 01/06/2023] Open
Abstract
Dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are genetically and phenotypically heterogeneous. Cardiac function is improved after treatment in some cardiomyopathy patients, but little is known about genetic predictors of long-term outcomes and myocardial recovery following medical treatment. To elucidate the genetic basis of cardiomyopathy in Japan and the genotypes involved in prognosis and left ventricular reverse remodeling (LVRR), we performed targeted sequencing on 120 DCM (70 sporadic and 50 familial) and 52 HCM (15 sporadic and 37 familial) patients and integrated their genotypes with clinical phenotypes. Among the 120 DCM patients, 20 (16.7%) had TTN truncating variants and 13 (10.8%) had LMNA variants. TTN truncating variants were the major cause of sporadic DCM (21.4% of sporadic cases) as with Caucasians, whereas LMNA variants, which include a novel recurrent LMNA E115M variant, were the most frequent in familial DCM (24.0% of familial cases) unlike Caucasians. Of the 52 HCM patients, MYH7 and MYBPC3 variants were the most common (12 (23.1%) had MYH7 variants and 11 (21.2%) had MYBPC3 variants) as with Caucasians. DCM patients harboring TTN truncating variants had better prognosis than those with LMNA variants. Most patients with TTN truncating variants achieved LVRR, unlike most patients with LMNA variants.
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Affiliation(s)
- Takashige Tobita
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Seitaro Nomura
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.,Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takanori Fujita
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Asano
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenji Onoue
- First Department of Internal Medicine, Nara Medical University, Kashihara, Japan
| | - Masamichi Ito
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasushi Imai
- Division of Cardiovascular Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Atsushi Suzuki
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Toshiyuki Ko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Satoh
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kanna Fujita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsuhiko T Naito
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiyuki Furutani
- Department of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Haruhiro Toko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mutsuo Harada
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eiki Takimoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Toshio Nakanishi
- Department of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Minoru Ono
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiko Saito
- First Department of Internal Medicine, Nara Medical University, Kashihara, Japan
| | - Seiji Takashima
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroyuki Aburatani
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Sekiguchi H, Ajiro Y, Uchida Y, Jujo K, Iwade K, Tanaka N, Shimamoto K, Tsurumi Y, Kawana M, Hagiwara N. Contrast-Induced Nephropathy and Oxygen Pretreatment in Patients With Impaired Renal Function. Kidney Int Rep 2018; 3:65-72. [PMID: 29340315 PMCID: PMC5762947 DOI: 10.1016/j.ekir.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 08/01/2017] [Accepted: 08/07/2017] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Contrast-induced nephropathy is a complication following coronary angiography and percutaneous coronary intervention. Because contrast-induced nephropathy is a predictor of long-term mortality in patients with ischemic heart disease undergoing percutaneous coronary intervention, preventive strategies are required. We assessed the effects of periprocedural oxygenation on contrast-induced nephropathy among patients with pre-existing renal dysfunction. METHODS A total of 200 consecutive patients with impaired renal function (estimated glomerular filtration < 60 ml/min per 1.73 m2) undergoing elective cardiovascular angiography were randomly assigned to an oxygenation treatment (n = 100) or control group (n = 100). In oxygenation treatment, pure oxygen (2 L/min) was administered for 10 minutes before exposure to contrast medium. The primary endpoint was the incidence of contrast-induced nephropathy, defined as a ≥ 25% increase in serum creatinine levels from baseline within 48 hours of exposure. RESULTS In the oxygenation treatment group, partial pressure of arterial oxygen was higher (135 ± 25 mm Hg vs. 84 ± 10 mm Hg, P < 0.001); contrast-induced nephropathy incidence was lower (1% vs. 8%, odds ratio [OR] = 0.12, 95% confidence interval [CI] = 0.01-0.95, P = 0.02); and partial pressure of arterial carbon dioxide and bicarbonate base lactate levels were similar compared with those in the control group. Upon univariate analysis, excess and absence of oxygenation treatment (OR = 9.18, CI = 1.13-74.86, P = 0.03) and anemia (OR = 4.30, CI = 1.04-17.78, P = 0.04) were shown to be associated with contrast-induced nephropathy incidence. CONCLUSION Oxygenation, a simple, nonpharmacological strategy, may be beneficial when using contrast media in patients with impaired renal function from noninvasive angiography to emergency catheterization.
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Affiliation(s)
- Haruki Sekiguchi
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Aoyama Hospital Tokyo Women’s Medical University, Tokyo, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Yoichi Ajiro
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Yoshie Uchida
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | | | - Kazunori Iwade
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Naohide Tanaka
- National Hospital Organization Yokohama Medical Center, Kanagawa, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Ken Shimamoto
- Aoyama Hospital Tokyo Women’s Medical University, Tokyo, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
| | - Yukio Tsurumi
- Aoyama Hospital Tokyo Women’s Medical University, Tokyo, Japan
- You Heart Clinic, Tokyo, Tokyo, Japan
| | - Masatoshi Kawana
- Aoyama Hospital Tokyo Women’s Medical University, Tokyo, Japan
- Tokyo Women’s Medical University, Tokyo, Japan
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Kogure T, Jujo K, Hamada K, Saito K, Hagiwara N. Correction to: Good response to tolvaptan shortens hospitalization in patients with congestive heart failure. Heart Vessels 2017; 33:384. [PMID: 29234859 DOI: 10.1007/s00380-017-1102-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the original publication of the article, the values of blood urea nitrogen (BUN) and plasma renin activity (PRA) have been published incorrectly and the corrected values are as follows.
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Affiliation(s)
- Tomohito Kogure
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Kentaro Jujo
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan.
| | - Kazuyuki Hamada
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Katsumi Saito
- Department of Cardiology, Nishiarai Heart Center Hospital, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan
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244
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Tobita T, Nomura S, Morita H, Ko T, Fujita T, Toko H, Uto K, Hagiwara N, Aburatani H, Komuro I. Identification of MYLK3 mutations in familial dilated cardiomyopathy. Sci Rep 2017; 7:17495. [PMID: 29235529 PMCID: PMC5727479 DOI: 10.1038/s41598-017-17769-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 11/30/2017] [Indexed: 12/31/2022] Open
Abstract
Dilated cardiomyopathy (DCM) is a primary cause of heart failure, life-threatening arrhythmias, and cardiac death. Pathogenic mutations have been identified at the loci of more than 50 genes in approximately 50% of DCM cases, while the etiologies of the remainder have yet to be determined. In this study, we applied whole exome sequencing in combination with segregation analysis to one pedigree with familial DCM, and identified a read-through mutation (c.2459 A > C; p.*820Sext*19) in the myosin light chain kinase 3 gene (MYLK3). We then conducted MYLK3 gene screening of 15 DCM patients (7 familial and 8 sporadic) who were negative for mutation screening of the previously-reported cardiomyopathy-causing genes, and identified another case with a MYLK3 frameshift mutation (c.1879_1885del; p.L627fs*41). In vitro experiments and immunohistochemistry suggested that the MYLK3 mutations identified in this study result in markedly reduced levels of protein expression and myosin light chain 2 phosphorylation. This is the first report that MYLK3 mutations can cause DCM in humans. The clinical phenotypes of DCM patients were consistent with MYLK3 loss-of-function mouse and zebrafish models in which cardiac enlargement and heart failure are observed. Our findings highlight an essential role for cardiac myosin light chain kinase in the human heart.
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Affiliation(s)
- Takashige Tobita
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Seitaro Nomura
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshiyuki Ko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takanori Fujita
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Haruhiro Toko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenta Uto
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroyuki Aburatani
- Genome Science Division, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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245
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Kelly CR, Teirstein PS, Meredith IT, Farah B, Dubois CL, Feldman RL, Dens J, Hagiwara N, Rabinowitz A, Carrié D, Pompili V, Bouchard A, Saito S, Allocco DJ, Dawkins KD, Stone GW. Long-Term Safety and Efficacy of Platinum Chromium Everolimus-Eluting Stents in Coronary Artery Disease: 5-Year Results From the PLATINUM Trial. JACC Cardiovasc Interv 2017; 10:2392-2400. [PMID: 29217001 PMCID: PMC5866729 DOI: 10.1016/j.jcin.2017.06.070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/01/2017] [Accepted: 06/29/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The authors sought to evaluate the final 5-year safety and effectiveness of the platinum-chromium everolimus-eluting stent (PtCr-EES) in the randomized trial, as well as in 2 single-arm substudies that evaluated PtCr-EES in small vessels (diameter <2.5 mm; n = 94) and long lesions (24 to 34 mm; n = 102). BACKGROUND In the multicenter, randomized PLATINUM (PLATINUM Clinical Trial to Assess the PROMUS Element Stent System for Treatment of De Novo Coronary Artery Lesions), the PtCr-EES was noninferior to the cobalt-chromium everolimus-eluting stent (CoCr-EES) at 1 year in 1,530 patients undergoing percutaneous coronary intervention. METHODS Patients with 1 or 2 de novo coronary artery lesions (reference vessel diameter 2.50 to 4.25 mm, length ≤24 mm) were randomized 1:1 to PtCr-EES versus CoCr-EES. All patients in the substudies received PtCr-EES. The primary endpoint was target lesion failure (TLF), a composite of target vessel-related cardiac death, target vessel-related myocardial infarction, or ischemia-driven target lesion revascularization. RESULTS In the randomized trial, the 5-year TLF rate was 9.1% for PtCr-EES and 9.3% for CoCr-EES (hazard ratio [HR]: 0.97; p = 0.87). Landmark analysis demonstrated similar TLF rates from discharge to 1 year (HR: 1.12; p = 0.70) and from 1 to 5 years (HR: 0.90; p = 0.63). There were no significant differences in the rates of cardiac death, myocardial infarction, target lesion or vessel revascularization, or stent thrombosis. PtCr-EES had 5-year TLF rates of 7.0% in small vessels and 13.6% in long lesions. CONCLUSIONS PtCr-EES demonstrated comparable safety and effectiveness to CoCr-EES through 5 years of follow-up, with low rates of stent thrombosis and other adverse events. The 5-year event rates were also acceptable in patients with small vessels and long lesions treated with PtCr-EES. (The PLATINUM Clinical Trial to Assess the PROMUS Element Stent System for Treatment of De Novo Coronary Artery Lesions [PLATINUM]; NCT00823212; The PLATINUM Clinical Trial to Assess the PROMUS Element Stent System for Treatment of De Novo Coronary Artery Lesions in Small Vessels [PLATINUM SV]; NCT01498692; The PLATINUM Clinical Trial to Assess the PROMUS Element Stent System for Treatment of Long De Novo Coronary Artery Lesions [PLATINUM LL]; NCT01500434).
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Affiliation(s)
- Christopher R Kelly
- Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York
| | | | - Ian T Meredith
- MonashHEART, Southern Health, Monash Medical Centre, Clayton, Victoria, Australia
| | | | | | - Robert L Feldman
- Mediquest Research at Munroe Regional Medical Center, Ocala, Florida
| | - Joseph Dens
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | | | | | - Didier Carrié
- Université Paul Sabatier, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | | | | | | | | | | | - Gregg W Stone
- Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York.
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246
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Suzuki A, Shiga T, Yagishita D, Yagishita-Tagawa Y, Arai K, Iwanami Y, Ejima K, Ashihara K, Shoda M, Hagiwara N. Narrowing filtered QRS duration on signal-averaged electrocardiogram predicts outcomes in cardiac resynchronization therapy patients with nonischemic heart failure. Ann Noninvasive Electrocardiol 2017; 23:e12523. [PMID: 29194868 DOI: 10.1111/anec.12523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 10/17/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND To evaluate the impact of changes in the filtered QRS duration (fQRS) on signal-averaged electrocardiograms (SAECGs) from pre- to postimplantation on the clinical outcomes in nonischemic heart failure (HF) patients under cardiac resynchronization therapy (CRT). METHODS We studied 103 patients with nonischemic HF and sinus rhythm who underwent CRT implantation. SAECGs were obtained within 1 week before and 1 week after implantation and narrowing fQRS was defined as a decrease in fQRS from pre- to postimplantation. Echocardiography was performed before and 6 months after CRT implantation. The primary outcome was death from any cause. The secondary outcomes were hospitalization due to worsened HF and occurrence of ventricular tachyarrhythmias. RESULTS Of the 103 CRT patients, 53 (51%) showed narrowing fQRS. Left ventricular end-diastolic volume and end-systolic volume were significantly reduced (both p < .001), and the left ventricular ejection fraction was significantly increased (p < .001) after CRT in patients with narrowing fQRS, but not in patients with nonnarrowing fQRS. During a median follow-up period of 33 months, patients with narrowing fQRS exhibited better survival than patients with nonnarrowing fQRS (p = .007). A lower incidence of hospitalization due to worsened HF (p < .001) and a lower occurrence of ventricular tachyarrhythmias (p = .071) were obtained in patients with narrowing fQRS. After adjusting for confounding variables, narrowing fQRS was associated with a low risk of mortality (HR 0.27, p = .006). CONCLUSION Our results suggested that narrowing fQRS on SAECG after CRT implantation predicts LV reverse remodeling and long-term outcomes in nonischemic HF patients.
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Affiliation(s)
- Atsushi Suzuki
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Daigo Yagishita
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Kotaro Arai
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuji Iwanami
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Koichiro Ejima
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kyomi Ashihara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Morio Shoda
- Clinical Research Division for Heart Rhythm Management, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
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247
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Ishizuka K, Hoshino T, Ashihara K, Mruyama K, Toi S, Mizuno S, Shirai Y, Hagiwara N, Kitagawa K. Associations of Mitral and Aortic Valve Calcifications with Complex Aortic Atheroma in Patients with Embolic Stroke of Undetermined Source. J Stroke Cerebrovasc Dis 2017; 27:697-702. [PMID: 29174290 DOI: 10.1016/j.jstrokecerebrovasdis.2017.09.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 09/22/2017] [Accepted: 09/29/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study investigated the associations of mitral and aortic valve calcification with complex aortic atheroma among patients with embolic stroke of undetermined source. METHODS We included 52 consecutive patients (mean age 58.1 years; 75.0% male) with embolic stroke of undetermined source. Mitral annular calcification, aortic annular calcification, and aortic valve sclerosis were assessed by transthoracic echocardiography. Complex aortic atheroma was assessed by transesophageal echocardiography and was defined as plaque protruding greater than or equal to 4 mm into the lumen or with ulcerated or mobile components. RESULTS Ten patients (19.2%) had complex aortic atheroma. Patients with and without complex aortic atheroma showed significant differences in terms of hypertension (80.0% versus 38.1%, P = .017), dyslipidemia (90.0% versus 31.0%, P <.01), chronic kidney disease (60.0% versus 14.3%, P <.01), previous coronary artery disease (30.0% versus 4.8%, P = .013), prior stroke (40.0% versus 7.1%, P <.01), left atrial dimension (4.0 cm versus 3.6 cm, P = .023), aortic valve sclerosis (80.0% versus 26.2%, P <.01), aortic valve calcification (aortic annular calcification or aortic valve sclerosis) (80.0% versus 26.0%, P <.01), and left-sided valve calcification (mitral annular calcification or aortic annular calcification or aortic valve sclerosis) (80.0% versus 28.6%, P <.01). In multivariate analysis, left-sided valve calcification was independently associated with complex aortic atheroma (odds ratio 4.1, 95% confidence interval 1.3-26.1, P = .049). CONCLUSIONS Mitral or aortic valve calcification detected by transthoracic echocardiography can be a useful marker for predicting complex aortic atheroma in patients with embolic stroke of undetermined source.
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Affiliation(s)
- Kentaro Ishizuka
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.
| | - Takao Hoshino
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan; Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France
| | - Kyomi Ashihara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenji Mruyama
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Sono Toi
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Satoko Mizuno
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuka Shirai
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan
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248
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Jujo K, Saito K, Ishida I, Furuki Y, Shibahashi E, Shimazaki K, Sekiguchi H, Minami Y, Yamaguchi J, Ogawa H, Hagiwara N. Pilot Cohort Study Assessing the Efficacy of Endovascular Revascularization in the Restoration of Peripheral Sensory Disturbance in Patients With Critical Limb Ischemia. Circ J 2017; 81:1919-1926. [PMID: 28674266 DOI: 10.1253/circj.cj-17-0405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Sensory disturbance (SD) is a common consequence of peripheral nerve damage associated with diabetes and severe ischemia. Progression of SD places patients at high risk for lower extremity ulcers and amputations. SD has been thought to be progressive and irreversible, and possibly caused by microvascular dysfunction. The aim of this study was to determine whether endovascular revascularization (EVR) induces quantifiable changes in SD in chronic critical limb ischemia (CLI) patients with neuropathy.Methods and Results:In all, 36 legs from 28 chronic CLI patients who underwent elective EVR were prospectively enrolled in this study (64% with diabetes and 54% on maintenance hemodialysis). The current perception threshold (CPT), an established diagnostic parameter for SD, was measured before and 3 months after EVR. Of the target lesions, 11%, 47%, and 81% were in the aortoiliac, femoropopliteal, and below-the-knee arteries, respectively, and 58% were totally occluded. Overall CPT in the target foot had improved significantly 3 months after EVR (from 53 to 30 µA; P=0.010); however, EVR did not change CPT in the non-target foot (from 44 to 33 µA; P=0.33). Patients with improved SD after EVR had a significantly higher 180-day survival rate (94% vs. 63%; P=0.040). CONCLUSIONS EVR improved CPT in target limbs of patients with CLI, and may be a promising option to improve SD associated with peripheral ischemic sensory neuropathy.
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Affiliation(s)
- Kentaro Jujo
- Department of Cardiology, Tokyo Women's Medical University.,Department of Cardiology, Nishiarai Heart Center Hospital
| | - Katsumi Saito
- Department of Cardiology, Nishiarai Heart Center Hospital
| | - Issei Ishida
- Department of Cardiology, Nishiarai Heart Center Hospital
| | - Yuho Furuki
- Department of Cardiology, Nishiarai Heart Center Hospital
| | | | | | | | | | | | - Hiroshi Ogawa
- Department of Cardiology, Tokyo Women's Medical University
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249
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Kogure T, Jujo K, Hamada K, Saito K, Hagiwara N. Good response to tolvaptan shortens hospitalization in patients with congestive heart failure. Heart Vessels 2017; 33:374-383. [PMID: 29128962 DOI: 10.1007/s00380-017-1072-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
Abstract
Tolvaptan has been gradually spread to use as a potent diuretic for congestive heart failure in the limited country. However, the response to this aquaretic drug still is unpredictable. A total of 92 patients urgently hospitalized due to congestive heart failure and treated with tolvaptan in addition to standard treatment was retrospectively analyzed. Responder of tolvaptan treatment was defined as a patient with peak negative fluid balance greater than 500 mL/day, and clinical profiles were compared between 76 responders and 16 non-responders. Responders started to increase daily urine volume (UV) from Day 1 through Day 3. In contrast, non-responders showed no significant increase in daily UV from the baseline up to Day 5. Time between admission and tolvaptan administration was shorter in responders, even without statistical significance (3.3 vs. 4.6 days, p = 0.053). Multivariate analysis revealed that blood urea nitrogen (BUN) [cutoff: 34 mg/dL, odds ratio (OR) 9.0, 95% confidence interval (CI) 1.42-57.3, p < 0.01] and plasma renin activity (PRA) (cutoff: 4.7 ng/mL/h, OR 6.1, 95% CI 1.01-36.4, p < 0.01) at baseline were independent predictors for tolvaptan responsiveness. It suggests that renal perfusion may affect tolvaptan-induced UV. Finally, durations of stay in intensive care unit and total hospitalization were significantly shorter in responders (median: 6.0 vs. 13.0 days, p = 0.022; 15.0 vs. 25.0 days, p = 0.016, respectively). Responders of tolvaptan have lower BUN and renin activity at baseline, and shorten hospitalization period. Trial Registration The study was registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) with the identifier UMIN000023594. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024988.
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Affiliation(s)
- Tomohito Kogure
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Kentaro Jujo
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan.
| | - Kazuyuki Hamada
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan
| | - Katsumi Saito
- Department of Cardiology, Nishiarai Heart Center Hospital, Tokyo, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-0054, Japan
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250
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Kubota Y, Tay WT, Asai K, Murai K, Nakajima I, Hagiwara N, Ikeda T, Kurita T, Teng THK, Anand I, Lam CSP, Shimizu W. Chronic obstructive pulmonary disease and β-blocker treatment in Asian patients with heart failure. ESC Heart Fail 2017; 5:297-305. [PMID: 29055972 PMCID: PMC5880660 DOI: 10.1002/ehf2.12228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/21/2017] [Accepted: 09/01/2017] [Indexed: 01/12/2023] Open
Abstract
Aims Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are increasingly frequent in Asia and commonly coexist in patients. However, the prevalence of COPD among Asian patients with HF and its impact on HF treatment are unclear. Methods and results We compared clinical characteristics and treatment approaches between patients with or without a history of COPD, before and after 1:2 propensity matching (for age, sex, geographical region, income level, and ethnic group) in 5232 prospectively recruited patients with HF and reduced ejection fraction (HFrEF, <40%) from 11 Asian regions (Northeast Asia: South Korea, Japan, Taiwan, Hong Kong, and China; South Asia: India; Southeast Asia: Thailand, Malaysia, Philippines, Indonesia, and Singapore). Among the 5232 patients with HFrEF, a history of COPD was present in 8.3% (n = 434), with significant variation in geography (11.0% in Northeast Asia vs. 4.7% in South Asia), regional income level (9.7% in high income vs. 5.8% in low income), and ethnicity (17.0% in Filipinos vs. 5.2% in Indians) (all P < 0.05). Use of mineralocorticoid receptor antagonists and diuretics was similar between groups, while usage of all β‐blockers was lower in the COPD group than in the non‐COPD group in the overall (66.3% vs. 79.9%) and propensity‐matched cohorts (66.3% vs. 81.7%) (all P < 0.05). A striking exception was the Japanese cohort in which β‐blocker use was high in COPD and non‐COPD patients (95.2% vs. 91.2%). Conclusions The prevalence of COPD in HFrEF varied across Asia and was related to underuse of β‐blockers, except in Japan.
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Affiliation(s)
- Yoshiaki Kubota
- Department of Cardiovascular Medicine, Nippon Medical School, Bunkyō, Tokyo, Japan
| | - Wan Ting Tay
- National Heart Centre Singapore, Singapore, Singapore
| | - Kuniya Asai
- Department of Cardiovascular Medicine, Nippon Medical School, Bunkyō, Tokyo, Japan
| | - Koji Murai
- Department of Cardiovascular Medicine, Nippon Medical School, Bunkyō, Tokyo, Japan
| | - Ikutaro Nakajima
- Division of Cardiology, Department of Internal Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, Japan
| | - Nobuhisa Hagiwara
- Department of Cardiology, School of Medicine, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Takanori Ikeda
- Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Omori Hospital, Ōta, Tokyo, Japan
| | - Takashi Kurita
- Division of Cardiology, Department of Internal Medicine, Kinki University School of Medicine, Higashiōsaka, Osaka, Japan
| | - Tiew-Hwa Katherine Teng
- National Heart Centre Singapore, Singapore, Singapore.,School of Population Health, University of Western Australia, Perth, WA, Australia
| | - Inder Anand
- VA Medical Center, University of Minnesota, Minneapolis, MN, USA
| | - Carolyn S P Lam
- National Heart Centre Singapore, Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre, Singapore, Singapore.,Duke-National University of Singapore, Singapore, Singapore
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Bunkyō, Tokyo, Japan
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