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Monteagudo B, Marqués FM, Gibelin J, Orr NA, Corsi A, Kubota Y, Casal J, Gómez-Camacho J, Authelet G, Baba H, Caesar C, Calvet D, Delbart A, Dozono M, Feng J, Flavigny F, Gheller JM, Giganon A, Gillibert A, Hasegawa K, Isobe T, Kanaya Y, Kawakami S, Kim D, Kiyokawa Y, Kobayashi M, Kobayashi N, Kobayashi T, Kondo Y, Korkulu Z, Koyama S, Lapoux V, Maeda Y, Motobayashi T, Miyazaki T, Nakamura T, Nakatsuka N, Nishio Y, Obertelli A, Ohkura A, Ota S, Otsu H, Ozaki T, Panin V, Paschalis S, Pollacco EC, Reichert S, Rousse JY, Saito AT, Sakaguchi S, Sako M, Santamaria C, Sasano M, Sato H, Shikata M, Shimizu Y, Shindo Y, Stuhl L, Sumikama T, Sun YL, Tabata M, Togano Y, Tsubota J, Uesaka T, Yang ZH, Yasuda J, Yoneda K, Zenihiro J. Mass, Spectroscopy, and Two-Neutron Decay of ^{16}Be. Phys Rev Lett 2024; 132:082501. [PMID: 38457706 DOI: 10.1103/physrevlett.132.082501] [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] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/18/2023] [Accepted: 01/29/2024] [Indexed: 03/10/2024]
Abstract
The structure and decay of the most neutron-rich beryllium isotope, ^{16}Be, has been investigated following proton knockout from a high-energy ^{17}B beam. Two relatively narrow resonances were observed for the first time, with energies of 0.84(3) and 2.15(5) MeV above the two-neutron decay threshold and widths of 0.32(8) and 0.95(15) MeV, respectively. These were assigned to be the ground (J^{π}=0^{+}) and first excited (2^{+}) state, with E_{x}=1.31(6) MeV. The mass excess of ^{16}Be was thus deduced to be 56.93(13) MeV, some 0.5 MeV more bound than the only previous measurement. Both states were observed to decay by direct two-neutron emission. Calculations incorporating the evolution of the wave function during the decay as a genuine three-body process reproduced the principal characteristics of the neutron-neutron energy spectra for both levels, indicating that the ground state exhibits a strong spatially compact dineutron component, while the 2^{+} level presents a far more diffuse neutron-neutron distribution.
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Affiliation(s)
- B Monteagudo
- LPC Caen, ENSICAEN, CNRS/IN2P3, Université de Caen, Normandie Université, 14050 Caen, France
- FRIB, Michigan State University, East Lansing, Michigan 48824, USA
| | - F M Marqués
- LPC Caen, ENSICAEN, CNRS/IN2P3, Université de Caen, Normandie Université, 14050 Caen, France
| | - J Gibelin
- LPC Caen, ENSICAEN, CNRS/IN2P3, Université de Caen, Normandie Université, 14050 Caen, France
| | - N A Orr
- LPC Caen, ENSICAEN, CNRS/IN2P3, Université de Caen, Normandie Université, 14050 Caen, France
| | - A Corsi
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - Y Kubota
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo 113-0033, Japan
- Department of Physics, Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - J Casal
- Dipartimento di Fisica e Astronomia "G. Galilei" and INFN-Sezione di Padova, Via Marzolo 8, 35131 Padova, Italy
- Departamento de Física Atómica, Molecular y Nuclear, Facultad de Física, Universidad de Sevilla, Apartado 1065, E-41080 Sevilla, Spain
| | - J Gómez-Camacho
- Departamento de Física Atómica, Molecular y Nuclear, Facultad de Física, Universidad de Sevilla, Apartado 1065, E-41080 Sevilla, Spain
| | - G Authelet
- Département des Accélérateurs, de Cryogénie et de Magnétisme, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - H Baba
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - C Caesar
- Department of Physics, Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - D Calvet
- Département d'électronique des Détecteurs et d'Informatique pour la Physique, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - A Delbart
- Département d'électronique des Détecteurs et d'Informatique pour la Physique, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - M Dozono
- Center for Nuclear Study, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo 113-0033, Japan
| | - J Feng
- School of Physics, Peking University, Beijing 100871, China
| | - F Flavigny
- Institut de Physique Nucléaire, IN2P3-CNRS, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
| | - J-M Gheller
- Département des Accélérateurs, de Cryogénie et de Magnétisme, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - A Giganon
- Département d'électronique des Détecteurs et d'Informatique pour la Physique, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - A Gillibert
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - K Hasegawa
- Department of Physics, Tohoku University, Miyagi 980-8578, Japan
| | - T Isobe
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - Y Kanaya
- Department of Applied Physics, University of Miyazaki, Gakuen-Kibanadai-Nishi 1-1, Miyazaki 889-2192, Japan
| | - S Kawakami
- Department of Applied Physics, University of Miyazaki, Gakuen-Kibanadai-Nishi 1-1, Miyazaki 889-2192, Japan
| | - D Kim
- Department of Physics, Ewha Womans University, Republic of Korea
| | - Y Kiyokawa
- Center for Nuclear Study, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo 113-0033, Japan
| | - M Kobayashi
- Center for Nuclear Study, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo 113-0033, Japan
| | - N Kobayashi
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - T Kobayashi
- Department of Physics, Tohoku University, Miyagi 980-8578, Japan
| | - Y Kondo
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - Z Korkulu
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - S Koyama
- Department of Physics, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo 113-0033, Japan
| | - V Lapoux
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - Y Maeda
- Department of Applied Physics, University of Miyazaki, Gakuen-Kibanadai-Nishi 1-1, Miyazaki 889-2192, Japan
| | - T Motobayashi
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - T Miyazaki
- Department of Physics, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo 113-0033, Japan
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - N Nakatsuka
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - Y Nishio
- Department of Physics, Kyushu University, Nishi, Fukuoka 819-0367, Japan
| | - A Obertelli
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Department of Physics, Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - A Ohkura
- Department of Physics, Kyushu University, Nishi, Fukuoka 819-0367, Japan
| | - S Ota
- Center for Nuclear Study, University of Tokyo, Hongo 7-3-1, Bunkyo, Tokyo 113-0033, Japan
| | - H Otsu
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - T Ozaki
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - V Panin
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - S Paschalis
- Department of Physics, Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - E C Pollacco
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - S Reichert
- Department of Physics, Technische Universität Munchen, 85748 Garching bei München, Germany
| | - J-Y Rousse
- Département d'Ingénierie des Systèmes, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - A T Saito
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - S Sakaguchi
- Department of Physics, Kyushu University, Nishi, Fukuoka 819-0367, Japan
| | - M Sako
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - C Santamaria
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - M Sasano
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - H Sato
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - M Shikata
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - Y Shimizu
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - Y Shindo
- Department of Physics, Kyushu University, Nishi, Fukuoka 819-0367, Japan
| | - L Stuhl
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - T Sumikama
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - Y L Sun
- Département de Physique Nucléaire, IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Department of Physics, Institut für Kernphysik, Technische Universität Darmstadt, D-64289 Darmstadt, Germany
| | - M Tabata
- Department of Physics, Kyushu University, Nishi, Fukuoka 819-0367, Japan
| | - Y Togano
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - J Tsubota
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - T Uesaka
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - Z H Yang
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - J Yasuda
- Department of Physics, Kyushu University, Nishi, Fukuoka 819-0367, Japan
| | - K Yoneda
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - J Zenihiro
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
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Hata A, Fifer S, Hasegawa K, Ando E, Kasahara‐Kiritani M, Takahashi M, Ordman R, Toh L, Inoue A. Treatment preferences among Japanese patients and physicians for epidermal growth factor receptor-mutant non-small cell lung cancer. Cancer Med 2024; 13:e6777. [PMID: 38196301 PMCID: PMC10807555 DOI: 10.1002/cam4.6777] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/30/2023] [Accepted: 11/21/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION Evidence is limited on preferences of Japanese patients and physicians in treatment for epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). Several oral or intravenous novel agents for EGFR exon 20 insertions are under development. The aim of our study was to investigate which attributes of novel treatments influenced selection of oral or intravenous agents among treated patients and treating physicians in Japan. METHODS The study was designed by board-certified oncologists, patient representatives, and analytics specialists. Eligible participants completed an online survey with a discrete choice experiment presenting two treatment profiles described by attributes: mode of administration (oral or intravenous); frequency of administration; overall response rate (ORR); average progression-free survival (PFS); chance of experiencing severe side effects (SEs); mild-moderate gastrointestinal SEs; mild-moderate skin-related SEs; and patient out-of-pocket costs. RESULTS Fifty-four patients (all self-reported EGFR-mutant) and 74 physicians participated from December 2021 to August 2022. All attributes being equal, there was greater preference for oral administration. However, there was greater preference for intravenous over oral, when ORR and PFS improved by 10% and 1 month, and severe SEs reduced by 10%. Physicians exhibited greater preference for PFS compared to patients (p < 0.01). Ranked order of attribute importance was as follows: (1) PFS; (2) ORR; (3) severe SEs, expressed by patients and physicians alike. CONCLUSIONS Our study revealed Japanese physician and patient preferences in treatment options for EGFR-mutant NSCLC. Compared to the strong preference for a more efficacious drug, the preference of oral versus intravenous revealed a smaller impact.
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Affiliation(s)
- Akito Hata
- Division of Thoracic OncologyKobe Minimally Invasive Cancer CenterKobeHyogoJapan
| | - Simon Fifer
- Community and Patient Preference Research (CaPPRe)SydneyAustralia
| | - Kazuo Hasegawa
- NPO Lung Cancer Patients Association One StepKanagawaJapan
| | - Emiko Ando
- NPO Lung Cancer Patients Association One StepKanagawaJapan
| | | | | | - Robyn Ordman
- Community and Patient Preference Research (CaPPRe)SydneyAustralia
| | - Lili Toh
- Community and Patient Preference Research (CaPPRe)SydneyAustralia
| | - Akira Inoue
- Department of Palliative MedicineTohoku University School of MedicineSendaiMiyagiJapan
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Takeda M, Shimokawa M, Nakamura A, Nosaki K, Watanabe Y, Kato T, Hayakawa D, Tanaka H, Takahashi T, Oki M, Tachihara M, Fujimoto D, Hayashi H, Yamaguchi K, Yamamoto S, Iwama E, Azuma K, Hasegawa K, Yamamoto N, Nakagawa K. A phase II study (WJOG12819L) to assess the efficacy of osimertinib in patients with EGFR mutation-positive NSCLC in whom systemic disease (T790M-negative) progressed after treatment with first- or second-generation EGFR TKIs and platinum-based chemotherapy. Lung Cancer 2023; 177:44-50. [PMID: 36731290 DOI: 10.1016/j.lungcan.2023.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/30/2022] [Revised: 01/12/2023] [Accepted: 01/21/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that is an established standard treatment option for chemotherapy-naive patients with EGFR mutation-positive non-small cell lung cancer (NSCLC). However, of such patients who have received prior treatment with a first- or second-generation EGFR TKI, only approximately half are eligible for osimertinib therapy because its indication as second-line treatment and beyond is limited to metastatic NSCLC that is positive for the T790M resistance mutation of the EGFR gene. This study was initiated at the request of a dedicated network for patients with lung cancer in Japan. METHODS We conducted a phase II study to assess the efficacy of osimertinib in patients with EGFR mutation-positive NSCLC in whom systemic disease (T790M-negative) progressed after treatment with first- or second-generation EGFR TKIs and platinum-based chemotherapy. The primary end point was response rate (assessed by a central imaging reviewer). RESULTS From August 2020 to February 2021, 55 patients from 15 institutions were enrolled in the study. The overall response for primary analysis was achieved in 16 patients (29.1 %; 95 % CI, 17.6-42.9), which exceeded the threshold response rate necessary for analysis. Stable disease was found in 16 patients (29.1 %), and progressive disease, in 18 (32.7 %). The median length of progression-free survival (PFS) was 4.07 months (95 % CI 2.10-4.30), and the rate of 12-month PFS was 17.3 %. CONCLUSIONS Osimertinib demonstrated modest antitumor activity against progressive EGFR T790M-negative disease.
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Affiliation(s)
- Masayuki Takeda
- Department of Medical Oncology, Kindai University, Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan; Department of Cancer Genomics and Medical Oncology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, Japan.
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube City, Yamaguchi 755-8505, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, 4-15 Hirose-machi, Sendai 980-0873, Japan
| | - Kaname Nosaki
- Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Yasutaka Watanabe
- Division of Thoracic Oncology, Saitama Cancer Center, 818 Komuro, Ina-machi, Kitaadachi-gun, Saitama 362-0806, Japan
| | - Terufumi Kato
- Department of Thoracic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama 241-8515, Japan
| | - Daisuke Hayakawa
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hiroshi Tanaka
- Department of Internal Medicine, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuo-ku, Niigata City, Niigata 951-8566, Japan
| | - Toshiaki Takahashi
- Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan
| | - Masahide Oki
- Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya 460-0001, Japan
| | - Motoko Tachihara
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Daichi Fujimoto
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8509, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University, Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan
| | - Kakuhiro Yamaguchi
- Department of Respiratory Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Shoichiro Yamamoto
- Departmentof Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime 791-0295, Japan
| | - Eiji Iwama
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | | | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8509, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University, Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan
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Nakaizumi Y, Hasegawa K, Inoue Y, Takai O. Fabrication of SiO:CH Particle-agglomerated Films by PECVD with Vinyl-group Organosilicon Reactants. J PHOTOPOLYM SCI TEC 2022. [DOI: 10.2494/photopolymer.35.283] [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: 03/14/2023]
Affiliation(s)
- Yuki Nakaizumi
- Department of Advanced Materials Science and Engineering, Graduate School of Engineering, Chiba Institute of Technology
| | - K. Hasegawa
- Department of Advanced Materials Science and Engineering, Graduate School of Engineering, Chiba Institute of Technology
| | - Yasushi Inoue
- Department of Advanced Materials Science and Engineering, Graduate School of Engineering, Chiba Institute of Technology
| | - Osamu Takai
- Materials and Surface Engineering Research Institute, Kanto-gakuin University
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Yonemori K, Fujiwara K, Hasegawa K, Yunokawa M, Ushijima K, Suzuki S, Shikama A, Minobe S, Usami T, Kim JW, Kim BG, Wang PH, Chang TC, Yamamoto K, Han S, McKenzie J, Barresi G, Miura T, Makker V, Kim Y. 177O Lenvatinib plus pembrolizumab versus treatment of physician’s choice in patients with previously treated advanced endometrial cancer: Study 309/KEYNOTE-775 Asian subgroup. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.213] [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: 12/05/2022] Open
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Matsuda M, Suzuki M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Iguchi M, Abe M, Akao M, Hasegawa K, Wada H. Involvement of growth differentiation factor 15 in paradoxical relationship between body mass index and mortality in patients with suspected or known coronary artery disease; The ANOX Study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2391] [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: 11/13/2022] Open
Abstract
Abstract
Background
Obesity is a well-established risk factor for type 2 diabetes mellitus, hypertension and dyslipidemia, leading to coronary artery disease (CAD). Nevertheless, body mass index (BMI) is inversely associated with cardiovascular (CV) mortality in patients with cardiac disorders, termed “obesity paradox”. However, the underlying mechanism remains unclear.
Purpose
To clarify important factors involved in the pathogenesis of obesity paradox.
Methods
Using data from a multicenter, prospective cohort of 2,418 patients with suspected or known CAD enrolled in the ANOX study, we assessed the relationship between BMI at baseline and the incidence of CV death over 3 years, and investigated the involvement of several endocrine factors which were previously reported to have some roles in obesity and heart diseases, such as adiponectin, N-terminal pro-brain natriuretic peptide (NT-proBNP) and growth differentiation factor 15 (GDF-15), in the relationship between BMI and CV death.
Results
In Kaplan-Meier analyses, the lower quartiles of BMI and the higher quartiles of adiponectin levels were paradoxically associated with the higher cumulative incidence of CV death. To clarify the important factors involved in the paradoxical association between BMI or adiponectin and mortality, we first investigated independent determinants for BMI and adiponectin levels respectively, using multiple stepwise regression analyses among many clinical factors, and then narrow down the prognostic factors commonly associated with BMI and adiponectin, which were age, hemoglobin and NT-proBNP. Interestingly, circulating levels of GDF15 were significantly correlated with NT-proBNP levels, and the presence of anemia raised the gradient of the correlation line in a scatter plot (without anemia, r=0.139, p<0.0001; with anemia, r=0.228, p<0.0001). Moreover, the highest GDF15 quartile showed significantly lower BMI and higher adiponectin levels compared to the lower quartiles (p<0.001 and p<0.001, respectively, by Student t-test). In Cox proportional hazard models, hazard ratios (HRs) of BMI (per 1-unit increase) were 0.90 (95% confidence interval [CI], 0.85–0.96) for CV death. Additional adjustment for hemoglobin, NT-proBNP, adiponectin or GDF15 diminished the statistical significance (HR, 0.92 [95% CI, 0.87–0.99], 0.95 [0.89–1.01], 0.92 [0.87–0.99], or 0.93 [0.87–0.99], respectively).
Conclusions
The lower BMI and the higher adiponectin levels were paradoxically associated with the higher incidence of CV death in patients with CAD. This paradox may be mediated by cardiac endocrine factors induced by cardiac stresses, including GDF-15 in addition to natriuretic peptides.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital , Hakodate , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital , Sagamihara , Japan
| | - M Iguchi
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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Iguchi M, Masunaga N, Ishii M, Fujino A, Ide Y, Hamatani Y, Yoshizawa T, Doi K, Ikeda S, Esato M, Wada H, Hasegawa K, Ogawa H, Abe M, Akao M. Association of beta blocker use with new-onset heart failure and mortality in atrial fibrillation without pre-existing heart failure: the Fushimi AF registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1041] [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: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is one of the major complications in atrial fibrillation (AF). We previously reported that not a few AF patients without pre-existing HF (defined as prior HF hospitalization, New York Heart Association functional class≥2, or left ventricular ejection fraction (LVEF)<40%) subsequently developed new-onset HF. Beta blockers are the established therapy for HF, but it remains unclear whether beta blockers prevent new-onset HF and improve outcomes in AF patients without preexisting HF.
Methods
In the Fushimi AF registry, 778 of 3,262 patients without pre-existing HF were receiving beta blockers at baseline. We investigated the incidence of new-onset HF defined as cardiac death or HF hospitalization, and all-cause death in a propensity-matched cohort (N=1,198; mean age, 71 years; 39% female; mean LVEF, 66%). Additionally, annual follow-up prescription data before the onset of events were collected in 294 of patients with beta blockers and 395 of those without beta blockers. We also investigated the association of starting or stopping beta blockers with the incidence of new-onset HF and all-cause death.
Results
During the median follow-up of 5.8 years, new-onset HF and all-cause death occurred in 77 (12.9%) and 118 (19.7%) of patients with beta blockers, and 70 (11.7%) and 131 (21.9%) of those without beta blockers, respectively. Incidence of new-onset HF was comparable between patients with and without beta blockers (Figure 1), and incidence of all-cause death was also comparable between the two groups (Figure 2). In exploratory subgroup analyses, there was no interaction in the association of beta blockers with the incidence of events, except for pulse rate for new-onset HF and left atrial size for all-cause death. Hazard ratio of beta blockers for new-onset HF tended to be lower in patients with higher pulse rates (>84 bpm) (Figure 1), and that for all-cause death was lower in those without left atrial enlargement (Figure 2). Of patients with follow-up prescription data, beta blockers were stopped in 55 (18.7%) and started in 97 (24.6%) patients, respectively. Patients with starting beta blockers had higher pulse rate (78.5±17.3 vs 74.9±13.9 bpm; p=0.03) and more symptomatic AF (58.8% vs 46.0%; p=0.03) compared to those without starting beta blockers, while there was no difference in baseline characteristics between those with and without stopping beta blockers. During the follow-up, the incidences of new-onset HF and all-cause death were also comparable between the patients with and without stopping beta blockers and those with and without starting beta blockers.
Conclusion
Beta blockers were not associated with the incidence of new-onset HF and all-cause death in AF patients without pre-existing HF. However, the exploratory subgroup analyses suggested the existence of subjects who may benefit from beta blockers.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi Sankyo, Novartis Pharma, MSD, Sanofi-Aventis, and Takeda Pharmaceutical.
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - N Masunaga
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Ishii
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - A Fujino
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - Y Ide
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - Y Hamatani
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - T Yoshizawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Doi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - S Ikeda
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Esato
- Ogaki Tokushukai Hospital , Gifu , Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - H Ogawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
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8
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Harano N, Liang LW, Hasegawa K, Maurer MS, Tower-Rader A, Fifer MA, Reilly MP, Shimada YJ. Prediction of new-onset atrial fibrillation in patients with hypertrophic cardiomyopathy using proteomics profiling. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1727] [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: 11/13/2022] Open
Abstract
Abstract
Background
Hypertrophic cardiomyopathy (HCM) is one of the most common genetic cardiac disorders and affects 1 in 200–500 individuals. HCM is known to be heterogeneous. Approximately 20–30% of patients with HCM develop atrial fibrillation (AF), which can lead to stroke and worsening of heart failure symptoms. As AF increases the risk of stroke by 8-fold, AF in HCM is a Class 1 indication for anticoagulation. Despite its high prevalence and clinical importance of early AF detection, there are no risk stratification tools available to predict new-onset AF in patients with HCM. Furthermore, it is still unknown which signaling pathways mediate AF in HCM. Proteomics profiling can determine concentrations of thousands of proteins and potentially reveal underlying molecular mechanisms of disease progression.
Purpose
To develop plasma proteomics-based model to predict new-onset AF in patients with HCM and to determine signaling pathways dysregulated in those who subsequently develop AF.
Methods
In this prospective, multi-center cohort study, we conducted plasma proteomics profiling of 5,032 proteins on 397 patients with HCM. We developed a proteomics-based random forest machine learning model to predict new-onset AF using samples from one institution (training set, n=278). We tested the predictive ability of the model using independent samples from the other institution (test set, n=119). We estimated the hazard ratio for new-onset AF using a Cox proportional hazards model comparing high- and low-risk groups as determined by the proteomics-based model. We also performed pathway analysis of proteins significantly (i.e., univariable P<0.05) associated with new-onset AF using a false discovery rate (FDR) threshold of 0.05.
Results
A total of 15 patients in the training set (5.4%) and 7 in the test set (5.9%) developed new-onset AF. Using the proteomics-based model developed in the training set, the area under the receiver-operating characteristic (ROC) curve to predict new-onset AF was 0.87 (95% confidence interval [CI] 0.77–0.98; Figure) in the test set. The sensitivity was 0.86 (95% CI 0.42–0.99) and the specificity was 0.77 (95% CI 0.68–0.84). In the test set, patients categorized as high-risk based on the proteomics model had a significantly higher rate of developing new-onset AF (hazard ratio 8.18; 95% CI 1.55–43.20; P=0.01). Pathway analysis revealed that the Ras-MAPK pathway was dysregulated in patients who subsequently developed AF (FDR=0.01; Table). Pathways involved in inflammation were also dysregulated.
Conclusions
This study serves as the first to demonstrate the ability of proteomics profiling to predict new-onset AF in patients with HCM, exhibiting dysregulation of both novel (e.g., Ras-MAPK) and known pathways in patients who subsequently experience AF. These results not only exhibit the utility of proteomics profiling for clinical risk stratification but also suggest mechanisms underlying the development of AF in HCM.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIH/NHLBI
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Affiliation(s)
- N Harano
- Columbia University , New York , United States of America
| | - L W Liang
- Columbia University Medical Center , New York , United States of America
| | - K Hasegawa
- Massachusetts General Hospital - Harvard Medical School , Boston , United States of America
| | - M S Maurer
- Columbia University Medical Center , New York , United States of America
| | - A Tower-Rader
- Massachusetts General Hospital - Harvard Medical School , Boston , United States of America
| | - M A Fifer
- Massachusetts General Hospital - Harvard Medical School , Boston , United States of America
| | - M P Reilly
- Columbia University Medical Center , New York , United States of America
| | - Y J Shimada
- Columbia University Medical Center , New York , United States of America
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9
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Iguchi M, Wada H, Shinozaki T, Suzuki M, Ajiro Y, Matsuda M, Koike A, Koizumi T, Shimizu M, Ono Y, Takenaka T, Kotani K, Abe M, Akao M, Hasegawa K. Vascular endothelial factor C and D in patients with heart failure with preserved, mildly reduced, and reduced ejection fraction: the PREHOSP-CHF study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.916] [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: 11/13/2022] Open
Abstract
Abstract
Background
The lymphatic system has been suggested to play an important role in cardiovascular diseases including heart failure (HF). Vascular endothelial growth factor C (VEGF-C) and D (VEGF-D) are key regulators of lymphangiogenesis, and we recently reported the association of low VEGF-C with the risk of all-cause death and high VEGF-D with the risk of HF hospitalization in patients with HF.
Purpose
To investigate the association of VEGF-C and VEGF-D with prognosis in patients with HF with preserved ejection fraction (EF) (HFpEF: EF≥50%), mildly reduced EF (HFmrEF: EF, 40–49%), and reduced EF (HFrEF: EF<40%).
Methods
The PREHOSP-CHF study is a multicenter prospective cohort study to determine the predictive value of angiogenesis-related biomarkers in HF. A total of 1,024 patients (mean age 75.5±12.6 years; 58.7% male) admitted to acute decompensated HF were included in the analyses. Serum levels of VEGF-C and VEGF-D, as well as N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin-I (hs-cTnI), high sensitivity C reactive protein, were measured at the time of discharge. Patients were followed-up over two years.
Results
The numbers of HFpEF, HFmrEF, and HFrEF were 429 (41.9%), 186 (18.2%), and 409 (39.9%), respectively. HFpEF patients were older, more likely to be female, and had more hypertension, atrial fibrillation, and anemia, but less coronary artery disease. NT-proBNP and hs-cTnI levels increased with decreasing EF. VEGF-C levels decreased with increasing EF (median [interquartile range]: HFpEF, 4508 [3318–5919] pg/ml; HFmrEF, 4719 [3663–6203] pg/ml; HFrEF, 5023 [3804–6382] pg/ml), whereas VEGF-D levels were comparable among the three EF groups (HFpEF, 404.6 [293.1–560.3] pg/ml; HFmrEF, 386.0 [298.5–556.3] pg/ml; HFrEF, 414.2 [296.1–557.3] pg/ml). In multivariate stepwise logistic regression analyses, anemia and high NT-proBNP were independently associated with low VEGF-C levels, and high NT-proBNP was independently associated with high VEGF-D levels, across all the EF groups. During the follow-up, incidences of all-cause death and HF hospitalizations were similar among the three EF groups (log-rank P=0.6 for all-cause death, and log-rank P=0.3 for HF hospitalization). On multivariate Cox proportional hazard analyses including established risk factors and cardiovascular biomarkers, VEGF-C levels tended to be inversely associated with the incidence of all-cause death in patients with HFpEF and HFrEF (Figure). On the contrary, VEGF-D levels were significantly and positively associated with the incidence of HF hospitalization in patients with HFpEF, and tended to be positively associated with it in patients with HFmrEF and HFrEF (Figure).
Conclusions
Low VEGF-C was associated with the risk of all-cause death in patients with HFpEF and HFrEF, while high VEGF-D was associated with the risk of HF hospitalization especially in HFpEF.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Grant-in-Aid for Clinical Research from the National Hospital Organization
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Saitama , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - A Koike
- National Hospital Organization Fukuokahigashi Medical Center , Fukuoka , Japan
| | - T Koizumi
- National Hospital Organization Mito Medical Center , Ibaraki , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - Y Ono
- National Hospital Organization Higashihiroshima Medical Center , Hiroshima , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - K Kotani
- Jichi Medical University , Tochigi , Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
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10
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Masunaga N, Ogawa H, Ikeda S, Doi K, Yoshizawa T, Hamatani Y, Ide Y, Fujino A, Ishii M, Iguchi M, Esato M, Wada H, Hasegawa K, Abe M, Akao M. Clinical characteristics and outcomes of atrial fibrillation patients with peripheral artery disease: the Fushimi AF Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.532] [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: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) represents the common arrhythmia and increases the risk of thromboembolism. Risk assessment for thromboembolism is important for the management of AF patients. Peripheral artery disease (PAD) is identified as a risk factor for thromboembolism in CHA2DS2-VASc score. However, there are little data on clinical characteristics and cardiovascular events of AF patients with PAD.
Purpose
In this study, we investigated the clinical characteristics and outcomes of AF patients with PAD.
Methods
The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients who visited the participating medical institutions in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011 and follow up data including prescription status were available in 4,464 patients from March 2011 to August 2021. Median follow-up period was 1,848 days.
Results
Of 4,464 patients, 183 patients had PAD (4.1%; PAD group). The mean age was higher in PAD group than no-PAD group (PAD group vs. no-PAD group: 76.7 vs. 73.5; p<0.01). Patients with PAD had more co-morbidities such as stroke, systemic embolism, congestive heart failure, hypertension, diabetes mellitus, dyslipidemia coronary artery disease and chronic kidney disease than those without PAD. Thus, CHADS2 score, CHA2DS2-VASc score and HAS-BLED score were higher in PAD group than no-PAD group (2.81 vs. 2.00; p<0.01, 5.17 vs. 3.30; p<0.01, 2.42 vs. 1.71; p<0.01, respectively). The proportion of patients with oral anticoagulant was similar between the two groups and the proportion of patients with antiplatelet drug was higher in PAD group than no-PAD group (59.0% vs. 55.6%; p=0.36, 62.9% vs. 24.7%; p<0.01, respectively). The incidences of all-cause death, cardiac death and myocardial infarction were higher in PAD group than no-PAD group (11.4 vs. 4.6 per 100 person-years; log-rank p<0.01, 1.7 vs. 0.8 per 100 person-years; log-rank p<0.01, 1.2 vs. 0.2 per 100 person-years; log-rank p<0.01). However, the incidence of stroke or systemic embolism was similar between the two groups (2.9 vs. 2.2 per 100 person-years, log-rank p=0.19). Finally, the incidence of composite of cardiac death, stroke, systemic embolism or myocardial infarction was higher in PAD group than no-PAD group (6.0 vs. 3.0 per 100 person-years; log-rank p<0.01).
Conclusion
AF patients with PAD had significantly higher risk for death and cardiac events, whereas the incidence of thromboembolism was similar between AF patients with and without PAD.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical Research and Development
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Affiliation(s)
- N Masunaga
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - H Ogawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - S Ikeda
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Doi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - T Yoshizawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - Y Hamatani
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - Y Ide
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - A Fujino
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Ishii
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Iguchi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Esato
- Ogaki Tokushukai Hospital , Ogaki , Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
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11
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Wada H, Shinozaki T, Suzuki M, Sakagami S, Ajiro Y, Funada J, Matsuda M, Shimizu M, Takenaka T, Morita Y, Wada K, Kotani K, Abe M, Akao M, Hasegawa K. Associations of soluble fms-like tyrosine kinase-1 with cardiovascular events and stroke in patients with atrial fibrillation and suspected or known coronary artery disease: the EXCEED-J study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.544] [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: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) increases the risk of stroke. Soluble fms-like tyrosine kinase-1 (sFlt-1), a vascular endothelial growth factor (VEGF) antagonist, has been suggested as a marker of endothelial dysfunction, which are associated with both AF and coronary artery disease (CAD). Recently, we demonstrated that sFlt-1 is independently associated with major adverse cardiovascular (CV) events (MACE) in patients with suspected or known CAD. However, the prognostic utility of sFlt-1 in patients with AF remains unknown.
Methods
Using data from a multicenter, prospective cohort of 3255 patients with suspected or known CAD, we investigated whether AF modifies the prognostic utility of sFlt-1. Heparin-free serum levels of sFlt-1, N-terminal pro-brain natriuretic peptide, high-sensitivity cardiac troponin-I, high-sensitivity C-reactive protein, cystatin C, neutrophil gelatinase-associated lipocalin, VEGF, and placental growth factor were measured in 324 patients with AF and 2931 patients without AF. The primary outcome was MACE defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all-cause death, CV death, stroke, heart failure (HF) hospitalization, and coronary/peripheral artery revascularization. The biomarkers were natural log-transformed for use as continuous variables.
Results
After adjustment for potential clinical confounders including anticoagulant drug use, sFlt-1 was significantly associated with MACE (hazard ratio for 1 standard deviation increase [HR], 1.55; 95% confidence interval [CI], 1.14–2.08), CV death (HR, 1.68; 95% CI, 1.10–2.48), and stroke (HR, 1.89; 95% CI, 1.16–3.10), but not with all-cause death (HR, 1.32; 95% CI, 0.99–1.73), HF hospitalization (HR, 0.97; 95% CI, 0.73–1.25), or revascularization (HR, 0.99; 95% CI, 0.74–1.28) in patients with AF, whereas sFlt-1 was significantly associated with MACE (HR, 1.19; 95% CI, 1.02–1.37), all-cause death (HR, 1.19; 95% CI, 1.05–1.34), CV death (HR, 1.26; 95% CI, 1.03–1.48), and HF hospitalization (HR, 1.26; 95% CI, 1.11–1.42), but not with stroke (HR, 1.06; 95% CI, 0.81–1.33) or revascularization (HR, 1.01; 95% CI, 0.95–1.07) in patients without AF. Among other biomarkers, only VEGF was significantly associated with MACE (HR, 1.55; 95% CI, 1.02–2.44), and no biomarkers were significantly associated with CV death or stroke in patients with AF. sFlt-1 added incremental prognostic information for MACE (P=0.005 for net reclassification improvement [NRI], P=0.026 for integrated discrimination improvement [IDI]) and stroke (P=0.034 for NRI, P=0.018 for IDI), but not for CV death (P=0.021 for NRI, P=0.134 for IDI), to the model with potential clinical confounders in patients with AF.
Conclusions
sFlt-1 independently predicted MACE and stroke in patients with AF and suspected or known CAD. sFlt-1 may serve as a novel prognostic biomarker to stratify the risk of MACE and stroke in patients with AF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Labour Sciences Research Grant (2013-2014), AMED (2015-2017, Grant Number JP17ek0210008)
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital , Sagamihara , Japan
| | - K Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Kotani
- Jichi Medical University , Shimotsuke , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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12
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Lumish H, Liang LW, Hasegawa K, Maurer M, Tower-Rader A, Fifer MA, Reilly MP, Shimada YJ. Prediction of worsening heart failure in patients with hypertrophic cardiomyopathy using plasma proteomics profiling. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1723] [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: 11/14/2022] Open
Abstract
Abstract
Background
While hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease affecting 1 in 200–500 people, it is a heterogeneous disease. Only a subset of patients with HCM develop heart failure (HF; prevalence 35–50%). Prediction of worsening HF using clinical measures alone (e.g., cardiac imaging, genetic testing) remains limited. Furthermore, the underlying mechanism by which patients with HCM develop worsening HF has not been fully investigated. Proteomics profiling measures concentrations of thousands of proteins simultaneously and has been used to predict worsening of HF and to highlight which signaling pathways mediate worsening HF in non-HCM populations.
Purpose
In patients with HCM, we aimed to develop a plasma proteomics-based model to predict which patients with HCM would develop worsening HF and to identify signaling pathways that are differentially regulated in those who subsequently develop worsening HF.
Methods
We conducted a prospective cohort study in our multi-center biorepository of patients with HCM. We performed plasma proteomics profiling of 5032 proteins. We then developed a random forest model to predict worsening HF using proteomics profiling data from patients enrolled through one institution (training set). The outcome of worsening HF was defined as an increase in New York Heart Association functional class by at least 1 class. We externally validated this model in independent samples from patients enrolled through a different institution (test set). Further, we executed pathway analysis of proteins significantly dysregulated (i.e., univariable p<0.05) in patients who developed worsening HF compared to those who did not. Pathways with false discovery rate [FDR]<0.05 were considered to be dysregulated.
Results
There were 398 patients included in the study, with 278 in the training set and 120 in the test set. During a median follow-up of 1.8 years [interquartile range, 1.2–2.6], 60 (15%) patients developed worsening HF symptoms (45 patients in the training set and 15 patients in the test set). Using the proteomics-based model derived from the training set, the area under the receiver-operating-characteristic curve to predict worsening HF was 0.85 (95% confidence interval: 0.75–0.95) in the test set (Figure 1). Pathway analysis revealed that the Ras-MAPK pathway (FDR<0.00001) and its upstream PI3K-Akt pathway (FDR<0.00001) were dysregulated in patients who subsequently developed worsening HF (Figure 2).
Conclusions
Our study is the first to apply proteomics profiling to the prediction of worsening HF symptoms in patients with HCM, identifying patients who are at high risk of worsening HF and elucidating that the Ras-MAPK and related signaling pathways as potential underlying mechanisms. These findings support the potential application of proteomics profiling to clinical risk stratification and the investigation of signaling pathways underlying disease progression in HCM.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIH/NHLBI R01 grant
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Affiliation(s)
- H Lumish
- Columbia University Medical Center , New York , United States of America
| | - L W Liang
- Columbia University Medical Center , New York , United States of America
| | - K Hasegawa
- Massachusetts General Hospital - Harvard Medical School , Boston , United States of America
| | - M Maurer
- Columbia University Medical Center , New York , United States of America
| | - A Tower-Rader
- Massachusetts General Hospital - Harvard Medical School , Boston , United States of America
| | - M A Fifer
- Massachusetts General Hospital - Harvard Medical School , Boston , United States of America
| | - M P Reilly
- Columbia University Medical Center , New York , United States of America
| | - Y J Shimada
- Columbia University Medical Center , New York , United States of America
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13
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Suzuki M, Kotani K, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada M, Abe M, Akao M, Hasegawa K, Wada H. Serum amyloid A-low-density-lipoprotein complex and mortality in patients with suspected or known coronary artery disease: the ANOX study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1161] [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: 11/13/2022] Open
Abstract
Abstract
Background
Serum amyloid A-low-density-lipoprotein (SAA-LDL) is a complex formed from the oxidative interaction between SAA and LDLs. A relatively small-scale study has shown that circulating SAA-LDL levels may serve as a prognostic marker in patients with stable coronary artery disease (CAD). However, the prognostic value of SAA-LDL should be confirmed in a larger-scale cohort study.
Methods
Using data from a multicenter, prospective cohort of 2416 patients with suspected or known CAD enrolled in the ANOX (Development of Novel Biomarkers Related to Angiogenesis or Oxidative Stress to Predict Cardiovascular Events) study, we assessed the prognostic value of serum levels of SAA-LDL. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. Patients were followed up over 3 years.
Results
Stepwise regression analysis including baseline data on potential clinical confounders (i.e., age, sex, body mass index, hypertension, dyslipidemia, diabetes, current smoking, estimated glomerular filtration rate, the Gensini score, previous myocardial infarction, previous stroke, previous heart failure hospitalization, atrial fibrillation, malignancies, anemia, antihypertensive drug use, statin use, and aspirin use) and established cardiovascular biomarkers (i.e., N-terminal pro-brain natriuretic peptide, high-sensitivity cardiac troponin I [hs-cTnI], and high-sensitivity C-reactive protein [hs-CRP]) revealed that independent determinants of SAA-LDL levels were female sex, dyslipidemia, the Gensini score, absence of statin use, hs-cTnI, and hs-CRP. After adjusting for potential clinical confounders and established cardiovascular biomarkers, the highest quartile of SAA-LDL levels (vs. the lowest quartile) was significantly associated with the incidence of all-cause death (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.02–2.26), but not with that of cardiovascular death (HR, 1.11; 95% CI, 0.59–2.10) or MACE (HR, 1.57; 95% CI, 0.97–2.57). Stratified analyses revealed that this association was pronounced in patients with low hs-cTnI (<75th percentile) (HR, 1.85; 95% CI, 1.06–3.30) and in patients with low hs-CRP levels (≤1.0 mg/L) (HR, 2.30; 95% CI, 1.17–4.79).
Conclusions
Elevated SAA-LDL levels were independently associated with the risk of all-cause death in patients with suspected or known CAD. The SAA-LDL level appears to serve as a prognostic biomarker for risk stratification in relatively low-risk patients with low hs-cTnI (<75th percentile) or low hs-CRP (≤1.0 mg/L).
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - K Kotani
- Jichi Medical University , Shimotsuke , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital , Hakodate , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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14
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Hamatani Y, Iguchi M, Minami K, Ishigami K, Ikeda S, Doi K, Yoshizawa T, Masunaga N, Esato M, Tsuji H, Wada H, Hasegawa K, Ogawa H, Abe M, Akao M. The association of left ventricular ejection fraction with incident heart failure in patients with atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.553] [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: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) increases the risk of incident heart failure (HF). Left ventricular ejection fraction (LVEF) is an important prognostic parameter in patients with HF. However, little is known regarding the association of LVEF with incident HF in patients with AF.
Purpose
The aim of this study is to investigate the relationship between LVEF at enrollment and incidence of HF hospitalization during follow-up period in patients with AF.
Methods
The Fushimi AF Registry is a community-based prospective survey of patients with AF in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,489 patients by the end of August 2021. In the present study, we investigated 3,544 patients with the data of LVEF at enrollment. We divided the patients into 4 groups stratified by LVEF (reduced LVEF [LVEF <40%], mildly reduced LVEF [LVEF: 40–49%], slightly reduced LVEF [LVEF: 50–59%], and normal LVEF [LVEF ≥60%]), and compared the backgrounds and outcomes between these 4 groups.
Results
Of 3,544 patients, the mean age was 73.6±10.7 years, 1,420 (40%) were female, 1,781 (50%) were paroxysmal AF, and 1,085 (30%) had pre-existing HF. The mean CHADS2 and CHA2DS2-VASc scores were 2.1±1.3 and 3.4±1.7, respectively. The mean LVEF at enrollment was 63±12% (reduced LVEF: 197 [6%], mildly reduced LVEF: 250 [7%], slightly reduced LVEF: 532 [15%] and normal LVEF: 2,565 [72%], respectively). Patients with lower LVEF demonstrated lower prevalence of female and paroxysmal AF, and had a higher CHADS2 and CHA2DS2-VASc scores (all P<0.01). A total of 605 patients were hospitalized for HF during the median follow-up period of 5.5 years, corresponding to an annual incidence of 3.4% per person-year. Kaplan-Meier curves demonstrated that LVEF at enrollment could stratify the incidence of HF hospitalization during follow-up in patients with AF (Picture 1). Multivariable Cox regression analysis revealed that lower LVEF strata were significantly associated with the increased risk of HF hospitalization even after adjustment by age, sex, type of AF and CHA2DS2-VASc score (Picture 1). An increased risk of HF hospitalization was observed even in patients with mildly reduced LVEF (adjusted hazard ratio: 2.56, 95% CI: 1.99–3.29) as well as in those with slightly reduced LVEF (adjusted hazard ratio: 1.79, 95% CI: 1.45–2.22) compared with those with normal LVEF. These results were also the case in AF patients without pre-existing HF (Picture 2).
Conclusion
LVEF at enrollment could stratify the incidence of HF hospitalization in patients with AF, suggesting the importance of measuring LVEF in all patients with AF. Even mildly (LVEF: 40–49%) or slightly (LVEF: 50–59%) reduced LVEF was independently associated with the risk of incident HF in patients with AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Hamatani
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Iguchi
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Minami
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Ishigami
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - S Ikeda
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Doi
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - T Yoshizawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - N Masunaga
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Esato
- Ogaki Tokushukai Hospital, Arrhythmia , Ogaki , Japan
| | - H Tsuji
- Tsuji Clinic , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Ogawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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15
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Lee C, Liang LW, Hasegawa K, Maurer MS, Tower-Rader A, Fifer MA, Reilly MP, Shimada YJ. Proteomics profiling reveals signaling pathways associated with major adverse cardiovascular events in patients with hypertrophic cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1724] [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: 11/14/2022] Open
Abstract
Abstract
Background
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy affecting 1 in 200–500 people in the US. It is characterized by a diverse clinical course, and only a subset of patients with HCM experience major adverse cardiovascular events (MACE) such as arrhythmias (e.g., ventricular tachycardia/fibrillation [VT/VF], atrial fibrillation [AF]), stroke, and heart failure. However, the molecular mechanisms underlying the presence of MACE in HCM are still not well understood.
Purpose
Our aim was to reveal signaling pathways associated with prior MACE in patients with HCM by applying plasma proteomics profiling.
Methods
We conducted a multicenter case-control study of patients with HCM comparing those with and without a prior history of MACE. We performed plasma proteomics profiling of 5032 proteins. We defined prior MACE as a composite outcome of sustained VT/VF, AF, stroke/transient ischemic attack, left ventricular ejection fraction ≤50%, New York Heart Association functional class ≥2 symptoms, resuscitated cardiac arrest, or appropriate implantable cardioverter defibrillator therapy. We applied the random forest method to derive a proteomics-based discrimination model developed in patients enrolled at one institution (training set) and externally validated the model on patients enrolled at another institution (test set). We then performed pathway analysis of proteins differentially regulated in patients with prior MACE. Pathways with a false discovery rate (FDR) <0.05 with at least 5 associated proteins were declared positive.
Results
A total of 396 patients were included, with 278 in the training set and 118 in the test set. In this cohort, 251 (63%) patients had prior MACE (171 in the training set and 80 in the test set). Using the proteomics-based model derived from the training set, the area under the receiver operating characteristic curve was 0.81 (95% CI 0.73–0.88) in the test set (Figure 1). There were 632 differentially expressed proteins (univariable p<0.05). Pathway analysis identified significantly dysregulated pathways in patients with prior MACE (Figure 2). This included both pathways known to be associated with MACE (e.g., TGF-β [FDR=0.03]) and novel pathways (e.g., Ras-MAPK [FDR=0.01] and its upstream PI3K-Akt [FDR=7.7x10–7] pathways). Pathways involved in cellular metabolism/proliferation (e.g., HIF 1 [FDR=0.01] and Wnt [FDR=0.04] pathways) and inflammation (e.g., complement and coagulation cascades [FDR=2.7x10–21], cytokine-cytokine receptor interaction [FDR=8.1x10–16]) were also significantly dysregulated.
Conclusions
Our study in patients with HCM reveals that those with a prior history of MACE have a distinctive plasma proteomics profile. We further identified both previously known and novel pathways dysregulated in this subset with a more severe form of HCM. Our findings may aid in development of targeted therapies for the prevention of MACE in HCM.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): R01 HL157216
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Affiliation(s)
- C Lee
- Columbia University Medical Center , New York , United States of America
| | - L W Liang
- Columbia University Medical Center , New York , United States of America
| | - K Hasegawa
- Massachusetts General Hospital , Boston , United States of America
| | - M S Maurer
- Columbia University Medical Center , New York , United States of America
| | - A Tower-Rader
- Massachusetts General Hospital , Boston , United States of America
| | - M A Fifer
- Massachusetts General Hospital , Boston , United States of America
| | - M P Reilly
- Columbia University Medical Center , New York , United States of America
| | - Y J Shimada
- Columbia University Medical Center , New York , United States of America
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16
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Zhang Y, Li S, Uenaka T, Furuuchi K, Yonemori K, Shimizu T, Nishio S, Yunokawa M, Matsumoto K, Takehara K, Hasegawa K, Hirashima Y, Kato H, Otake Y, Miura T, Matsui J. Phase I Biomarker Analysis Results of MORAb-202 (Farletuzumab Ecteribulin) Effects on Vascular Remodeling and Immune Modulation in Patients With Ovarian Cancer. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01032-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Inoue A, Hata A, Fifer S, Hasegawa K, Ando E, Takahashi M, Ordman R, Kasahara-Kiritani M. EP10.01-003 Non-Small Cell Lung Cancer Treatment Preferences Among EGFR Mutation Patients and Physicians in Japan. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.880] [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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18
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Freyer G, Gonzalez Martin A, Raspagliesi F, Peron J, Van Nieuwenhuysen E, Hasegawa K, Lim MC, Ray-Coquard I. 615TiP NIRVANA-1: A multicentre randomized study comparing carboplatin-paclitaxel (CP) followed by niraparib (nira) to CP–bevacizumab (bev) followed by nira-bev in patients with FIGO stage III ovarian high-grade epithelial cancer and no residual disease after upfront surgery. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1871] [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: 11/01/2022] Open
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19
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Wijaya S, Tan T, Ngoi N, Yabuno A, Takehara K, Nakazawa H, Hirasawa T, Fujiwara H, Yasuda M, Jan YH, Chen SJ, Huang RJ, Fujiwara K, Hasegawa K, Tan D. 577P Impact of homologous recombination deficiency (HRD) on outcomes with intraperitoneal (IP) and intravenous (IV) chemotherapy in ovarian cancer: Analyses from the translational iPocc study (TriPocc). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.705] [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: 11/16/2022] Open
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Arita J, Kiritani S, Ichida A, Kawaguchi Y, Akamatsu N, Kaneko J, Hasegawa K. 497P Prognostic impact of venous and lymphatic invasion of pancreatic neuroendocrine neoplasm in patients undergoing resection. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.625] [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: 11/01/2022] Open
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21
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Kawaguchi Y, Kita R, Kimura T, Goto R, Takayama T, Izumi N, Kudo M, Kaneko S, Yamanaka N, Inomata M, Shimada M, Baba H, Koike K, Omata M, Makuuchi M, Matsuyama Y, Yamada Y, Kokudo N, Hasegawa K. 723P Medical expenditures and treatment efficacy of patients who had initial hepatocellular carcinoma and underwent surgery or radiofrequency ablation: Accompanying research of the SURF trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.847] [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] Open
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22
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Fujiwara K, Nishio S, Yamamoto K, Fujiwara H, Itagaki H, Nagai T, Takano H, Yamaguchi S, Kudoh A, Suzuki Y, Nakamoto T, Kamio M, Kato K, Nakamura K, Takehara K, Yahata H, Kobayashi H, Saito M, Ushijima K, Hasegawa K. LBA31 Randomized phase III trial of maintenance chemotherapy with tegafur-uracil versus observation following concurrent chemoradiotherapy for locally advanced cervical cancer, GOTIC-002 LUFT trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.027] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abbott R, Abe H, Acernese F, Ackley K, Adhikari N, Adhikari R, Adkins V, Adya V, Affeldt C, Agarwal D, Agathos M, Agatsuma K, Aggarwal N, Aguiar O, Aiello L, Ain A, Ajith P, Akutsu T, Albanesi S, Alfaidi R, Allocca A, Altin P, Amato A, Anand C, Anand S, Ananyeva A, Anderson S, Anderson W, Ando M, Andrade T, Andres N, Andrés-Carcasona M, Andrić T, Angelova S, Ansoldi S, Antelis J, Antier S, Apostolatos T, Appavuravther E, Appert S, Apple S, Arai K, Araya A, Araya M, Areeda J, Arène M, Aritomi N, Arnaud N, Arogeti M, Aronson S, Arun K, Asada H, Asali Y, Ashton G, Aso Y, Assiduo M, Melo SADS, Aston S, Astone P, Aubin F, AultONeal K, Austin C, Babak S, Badaracco F, Bader M, Badger C, Bae S, Bae Y, Baer A, Bagnasco S, Bai Y, Baird J, Bajpai R, Baka T, Ball M, Ballardin G, Ballmer S, Balsamo A, Baltus G, Banagiri S, Banerjee B, Bankar D, Barayoga J, Barbieri C, Barish B, Barker D, Barneo P, Barone F, Barr B, Barsotti L, Barsuglia M, Barta D, Bartlett J, Barton M, Bartos I, Basak S, Bassiri R, Basti A, Bawaj M, Bayley J, Mills J, Milotti E, Minenkov Y, Mio N, Mir L, Miravet-Tenés M, Mishkin A, Mishra C, Mishra T, Mistry T, Bazzan M, Mitra S, Mitrofanov V, Mitselmakher G, Mittleman R, Miyakawa O, Miyo K, Miyoki S, Mo G, Modafferi L, Moguel E, Becher B, Mogushi K, Mohapatra S, Mohite S, Molina I, Molina-Ruiz M, Mondin M, Montani M, Moore C, Moragues J, Moraru D, Bécsy B, Morawski F, More A, Moreno C, Moreno G, Mori Y, Morisaki S, Morisue N, Moriwaki Y, Mours B, Mow-Lowry C, Bedakihale V, Mozzon S, Muciaccia F, Mukherjee A, Mukherjee D, Mukherjee S, Mukherjee S, Mukherjee S, Mukund N, Mullavey A, Munch J, Beirnaert F, Muñiz E, Murray P, Musenich R, Muusse S, Nadji S, Nagano K, Nagar A, Nakamura K, Nakano H, Nakano M, Bejger M, Nakayama Y, Napolano V, Nardecchia I, Narikawa T, Narola H, Naticchioni L, Nayak B, Nayak R, Neil B, Neilson J, Belahcene I, Nelson A, Nelson T, Nery M, Neubauer P, Neunzert A, Ng K, Ng S, Nguyen C, Nguyen P, Nguyen T, Benedetto V, Quynh LN, Ni J, Ni WT, Nichols S, Nishimoto T, Nishizawa A, Nissanke S, Nitoglia E, Nocera F, Norman M, Beniwal D, North C, Nozaki S, Nurbek G, Nuttall L, Obayashi Y, Oberling J, O’Brien B, O’Dell J, Oelker E, Ogaki W, Benjamin M, Oganesyan G, Oh J, Oh K, Oh S, Ohashi M, Ohashi T, Ohkawa M, Ohme F, Ohta H, Okada M, Bennett T, Okutani Y, Olivetto C, Oohara K, Oram R, O’Reilly B, Ormiston R, Ormsby N, O’Shaughnessy R, O’Shea E, Oshino S, Bentley J, Ossokine S, Osthelder C, Otabe S, Ottaway D, Overmier H, Pace A, Pagano G, Pagano R, Page M, Pagliaroli G, BenYaala M, Pai A, Pai S, Pal S, Palamos J, Palashov O, Palomba C, Pan H, Pan KC, Panda P, Pang P, Bera S, Pankow C, Pannarale F, Pant B, Panther F, Paoletti F, Paoli A, Paolone A, Pappas G, Parisi A, Park H, Berbel M, Park J, Parker W, Pascucci D, Pasqualetti A, Passaquieti R, Passuello D, Patel M, Pathak M, Patricelli B, Patron A, Bergamin F, Paul S, Payne E, Pedraza M, Pedurand R, Pegoraro M, Pele A, Arellano FP, Penano S, Penn S, Perego A, Berger B, Pereira A, Pereira T, Perez C, Périgois C, Perkins C, Perreca A, Perriès S, Pesios D, Petermann J, Petterson D, Bernuzzi S, Pfeiffer H, Pham H, Pham K, Phukon K, Phurailatpam H, Piccinni O, Pichot M, Piendibene M, Piergiovanni F, Pierini L, Bersanetti D, Pierro V, Pillant G, Pillas M, Pilo F, Pinard L, Pineda-Bosque C, Pinto I, Pinto M, Piotrzkowski B, Piotrzkowski K, Bertolini A, Pirello M, Pitkin M, Placidi A, Placidi E, Planas M, Plastino W, Pluchar C, Poggiani R, Polini E, Pong D, Betzwieser J, Ponrathnam S, Porter E, Poulton R, Poverman A, Powell J, Pracchia M, Pradier T, Prajapati A, Prasai K, Prasanna R, Beveridge D, Pratten G, Principe M, Prodi G, Prokhorov L, Prosposito P, Prudenzi L, Puecher A, Punturo M, Puosi F, Puppo P, Bhandare R, Pürrer M, Qi H, Quartey N, Quetschke V, Quinonez P, Quitzow-James R, Raab F, Raaijmakers G, Radkins H, Radulesco N, Bhandari A, Raffai P, Rail S, Raja S, Rajan C, Ramirez K, Ramirez T, Ramos-Buades A, Rana J, Rapagnani P, Ray A, Bhardwaj U, Raymond V, Raza N, Razzano M, Read J, Rees L, Regimbau T, Rei L, Reid S, Reid S, Reitze D, Bhatt R, Relton P, Renzini A, Rettegno P, Revenu B, Reza A, Rezac M, Ricci F, Richards D, Richardson J, Richardson L, Bhattacharjee D, Riemenschneider G, Riles K, Rinaldi S, Rink K, Robertson N, Robie R, Robinet F, Rocchi A, Rodriguez S, Rolland L, Bhaumik S, Rollins J, Romanelli M, Romano R, Romel C, Romero A, Romero-Shaw I, Romie J, Ronchini S, Rosa L, Rose C, Bianchi A, Rosińska D, Ross M, Rowan S, Rowlinson S, Roy S, Roy S, Rozza D, Ruggi P, Ruiz-Rocha K, Ryan K, Bilenko I, Sachdev S, Sadecki T, Sadiq J, Saha S, Saito Y, Sakai K, Sakellariadou M, Sakon S, Salafia O, Salces-Carcoba F, Billingsley G, Salconi L, Saleem M, Salemi F, Samajdar A, Sanchez E, Sanchez J, Sanchez L, Sanchis-Gual N, Sanders J, Sanuy A, Bini S, Saravanan T, Sarin N, Sassolas B, Satari H, Sauter O, Savage R, Savant V, Sawada T, Sawant H, Sayah S, Birney R, Schaetzl D, Scheel M, Scheuer J, Schiworski M, Schmidt P, Schmidt S, Schnabel R, Schneewind M, Schofield R, Schönbeck A, Birnholtz O, Schulte B, Schutz B, Schwartz E, Scott J, Scott S, Seglar-Arroyo M, Sekiguchi Y, Sellers D, Sengupta A, Sentenac D, Biscans S, Seo E, Sequino V, Sergeev A, Setyawati Y, Shaffer T, Shahriar M, Shaikh M, Shams B, Shao L, Sharma A, Bischi M, Sharma P, Shawhan P, Shcheblanov N, Sheela A, Shikano Y, Shikauchi M, Shimizu H, Shimode K, Shinkai H, Shishido T, Biscoveanu S, Shoda A, Shoemaker D, Shoemaker D, ShyamSundar S, Sieniawska M, Sigg D, Silenzi L, Singer L, Singh D, Singh M, Bisht A, Singh N, Singha A, Sintes A, Sipala V, Skliris V, Slagmolen B, Slaven-Blair T, Smetana J, Smith J, Smith L, Biswas B, Smith R, Soldateschi J, Somala S, Somiya K, Song I, Soni K, Soni S, Sordini V, Sorrentino F, Sorrentino N, Bitossi M, Soulard R, Souradeep T, Sowell E, Spagnuolo V, Spencer A, Spera M, Spinicelli P, Srivastava A, Srivastava V, Staats K, Bizouard MA, Stachie C, Stachurski F, Steer D, Steinlechner J, Steinlechner S, Stergioulas N, Stops D, Stover M, Strain K, Strang L, Blackburn J, Stratta G, Strong M, Strunk A, Sturani R, Stuver A, Suchenek M, Sudhagar S, Sudhir V, Sugimoto R, Suh H, Blair C, Sullivan A, Summerscales T, Sun L, Sunil S, Sur A, Suresh J, Sutton P, Suzuki T, Suzuki T, Suzuki T, Blair D, Swinkels B, Szczepańczyk M, Szewczyk P, Tacca M, Tagoshi H, Tait S, Takahashi H, Takahashi R, Takano S, Takeda H, Blair R, Takeda M, Talbot C, Talbot C, Tanaka K, Tanaka T, Tanaka T, Tanasijczuk A, Tanioka S, Tanner D, Tao D, Bobba F, Tao L, Tapia R, Martín ETS, Taranto C, Taruya A, Tasson J, Tenorio R, Terhune J, Terkowski L, Thirugnanasambandam M, Bode N, Thomas M, Thomas P, Thompson E, Thompson J, Thondapu S, Thorne K, Thrane E, Tiwari S, Tiwari S, Tiwari V, Boër M, Toivonen A, Tolley A, Tomaru T, Tomura T, Tonelli M, Tornasi Z, Torres-Forné A, Torrie C, e Melo IT, Töyrä D, Bogaert G, Trapananti A, Travasso F, Traylor G, Trevor M, Tringali M, Tripathee A, Troiano L, Trovato A, Trozzo L, Trudeau R, 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D, Davis M, Daw E, Dean R, DeBra D, Deenadayalan M, Degallaix J, De Laurentis M, Deléglise S, Del Favero V, De Lillo F, De Lillo N, Dell’Aquila D, Del Pozzo W, DeMarchi L, De Matteis F, D’Emilio V, Demos N, Dent T, Depasse A, De Pietri R, De Rosa R, De Rossi C, DeSalvo R, De Simone R, Dhurandhar S, Díaz M, Didio N, Dietrich T, Di Fiore L, Di Fronzo C, Di Giorgio C, Di Giovanni F, Di Giovanni M, Di Girolamo T, Di Lieto A, Di Michele A, Ding B, Di Pace S, Di Palma I, Di Renzo F, Divakarla A, Dmitriev A, Doctor Z, Donahue L, D’Onofrio L, Donovan F, Dooley K, Doravari S, Drago M, Driggers J, Drori Y, Ducoin JG, Dupej P, Dupletsa U, Durante O, D’Urso D, Duverne PA, Dwyer S, Eassa C, Easter P, Ebersold M, Eckhardt T, Eddolls G, Edelman B, Edo T, Edy O, Effler A, Eguchi S, Eichholz J, Eikenberry S, Eisenmann M, Eisenstein R, Ejlli A, Engelby E, Enomoto Y, Errico L, Essick R, Estellés H, Estevez D, Etienne Z, Etzel T, Evans M, Evans T, Evstafyeva T, Ewing B, Fabrizi F, Faedi F, Fafone V, Fair H, Fairhurst S, Fan P, Farah A, Farinon S, Farr B, Farr W, Fauchon-Jones E, Favaro G, Favata M, Fays M, Fazio M, Feicht J, Fejer M, Fenyvesi E, Ferguson D, Fernandez-Galiana A, Ferrante I, Ferreira T, Fidecaro F, Figura P, Fiori A, Fiori I, Fishbach M, Fisher R, Fittipaldi R, Fiumara V, Flaminio R, Floden E, Fong H, Font J, Fornal B, Forsyth P, Franke A, Frasca S, Frasconi F, Freed J, Frei Z, Freise A, Freitas O, Frey R, Fritschel P, Frolov V, Fronzé G, Fujii Y, Fujikawa Y, Fujimoto Y, Fulda P, Fyffe M, Gabbard H, Gabella W, Gadre B, Gair J, Gais J, Galaudage S, Gamba R, Ganapathy D, Ganguly A, Gao D, Gaonkar S, Garaventa B, Núñez CG, García-Quirós C, Garufi F, Gateley B, Gayathri V, Ge GG, Gemme G, Gennai A, George J, Gerberding O, Gergely L, Gewecke P, Ghonge S, Ghosh A, Ghosh A, Ghosh S, Ghosh S, Ghosh T, Giacomazzo B, Giacoppo L, Giaime J, Giardina K, Gibson D, Gier C, Giesler M, Giri P, Gissi F, Gkaitatzis S, Glanzer J, Gleckl A, Godwin P, Goetz E, Goetz R, Gohlke N, Golomb J, 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A, Vivanco FH, Heurs M, Hewitt A, Higginbotham S, Hild S, Hill P, Himemoto Y, Hines A, Hirata N, Hirose C, Ho TC, Hochheim S, Hofman D, Hohmann J, Holcomb D, Holland N, Hollows I, Holmes Z, Holt K, Holz D, Hong Q, Hough J, Hourihane S, Howell E, Hoy C, Hoyland D, Hreibi A, Hsieh BH, Hsieh HF, Hsiung C, Hsu Y, Huang HY, Huang P, Huang YC, Huang YJ, Huang Y, Huang Y, Hübner M, Huddart A, Hughey B, Hui D, Hui V, Husa S, Huttner S, Huxford R, Huynh-Dinh T, Ide S, Idzkowski B, Iess A, Inayoshi K, Inoue Y, Iosif P, Isi M, Isleif K, Ito K, Itoh Y, Iyer B, JaberianHamedan V, Jacqmin T, Jacquet PE, Jadhav S, Jadhav S, Jain T, James A, Jan A, Jani K, Janquart J, Janssens K, Janthalur N, Jaranowski P, Jariwala D, Jaume R, Jenkins A, Jenner K, Jeon C, Jia W, Jiang J, Jin HB, Johns G, Johnston R, Jones A, Jones D, Jones P, Jones R, Joshi P, Ju L, Jue A, Jung P, Jung K, Junker J, Juste V, Kaihotsu K, Kajita T, Kakizaki M, Kalaghatgi C, Kalogera V, Kamai B, Kamiizumi M, Kanda N, Kandhasamy S, Kang G, Kanner J, Kao Y, Kapadia S, Kapasi D, Karathanasis C, Karki S, Kashyap R, Kasprzack M, Kastaun W, Kato T, Katsanevas S, Katsavounidis E, Katzman W, Kaur T, Kawabe K, Kawaguchi K, Kéfélian F, Keitel D, Key J, Khadka S, Khalili F, Khan S, Khanam T, Khazanov E, Khetan N, Khursheed M, Kijbunchoo N, Kim A, Kim C, Kim J, Kim J, Kim K, Kim W, Kim YM, Kimball C, Kimura N, Kinley-Hanlon M, Kirchhoff R, Kissel J, Klimenko S, Klinger T, Knee A, Knowles T, Knust N, Knyazev E, Kobayashi Y, Koch P, Koekoek G, Kohri K, Kokeyama K, Koley S, Kolitsidou P, Kolstein M, Komori K, Kondrashov V, Kong A, Kontos A, Koper N, Korobko M, Kovalam M, Koyama N, Kozak D, Kozakai C, Kringel V, Krishnendu N, Królak A, Kuehn G, Kuei F, Kuijer P, Kulkarni S, Kumar A, Kumar P, Kumar R, Kumar R, Kume J, Kuns K, Kuromiya Y, Kuroyanagi S, Kwak K, Lacaille G, Lagabbe P, Laghi D, Lalande E, Lalleman M, Lam T, Lamberts A, Landry M, Lane B, Lang R, Lange J, Lantz B, La Rosa I, Lartaux-Vollard A, Lasky P, Laxen M, Lazzarini A, Lazzaro C, Leaci P, Leavey S, LeBohec S, Lecoeuche Y, Lee E, Lee H, Lee H, Lee K, Lee R, Legred I, Lehmann J, Lemaître A, Lenti M, Leonardi M, Leonova E, Leroy N, Letendre N, Levesque C, Levin Y, Leviton J, Leyde K, Li A, Li B, Li J, Li K, Li P, Li T, Li X, Lin CY, Lin E, Lin FK, Lin FL, Lin H, Lin LC, Linde F, Linker S, Linley J, Littenberg T, Liu G, Liu J, Liu K, Liu X, Llamas F, Lo R, Lo T, London L, Longo A, Lopez D, Portilla ML, Lorenzini M, Loriette V, Lormand M, Losurdo G, Lott T, Lough J, Lousto C, Lovelace G, Lucaccioni J, Lück H, Lumaca D, Lundgren A, Luo LW, Lynam J, Ma’arif M, Macas R, Machtinger J, MacInnis M, Macleod D, MacMillan I, Macquet A, Hernandez IM, Magazzù C, Magee R, Maggiore R, Magnozzi M, Mahesh S, Majorana E, Maksimovic I, Maliakal S, Malik A, Man N, Mandic V, Mangano V, Mansell G, Manske M, Mantovani M, Mapelli M, Marchesoni F, Pina DM, Marion F, Mark Z, Márka S, Márka Z, Markakis C, Markosyan A, Markowitz A, Maros E, Marquina A, Marsat S, Martelli F, Martin I, Martin R, Martinez M, Martinez V, Martinez V, Martinovic K, Martynov D, Marx E, Masalehdan H, Mason K, Massera E, Masserot A, Masso-Reid M, Mastrogiovanni S, Matas A, Mateu-Lucena M, Matichard F, Matiushechkina M, Mavalvala N, McCann J, McCarthy R, McClelland D, McClincy P, McCormick S, McCuller L, McGhee G, McGuire S, McIsaac C, McIver J, McRae T, McWilliams S, Meacher D, Mehmet M, Mehta A, Meijer Q, Melatos A, Melchor D, Mendell G, Menendez-Vazquez A, Menoni C, Mercer R, Mereni L, Merfeld K, Merilh E, Merritt J, Merzougui M, Meshkov S, Messenger C, Messick C, Meyers P, Meylahn F, Mhaske A, Miani A, Miao H, Michaloliakos I, Michel C, Michimura Y, Middleton H, Mihaylov D, Milano L, Miller A, Miller A, Miller B, Millhouse M. Search for continuous gravitational wave emission from the Milky Way center in O3 LIGO-Virgo data. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.042003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kanno I, Hasegawa K, Nakamura T, Kogure M, Itabashi F, Narita A, Tsuchiya N, Hirata T, Nakaya N, Sugawara J, Kuriyama S, Tsuji I, Kure S, Hozawa A. Relationship between the housing coldness/warmth evaluation by CASBEE Housing Health Checklist and psychological distress based on TMM Community-Based Cohort Study: a cross-sectional analysis. Public Health 2022; 208:98-104. [PMID: 35738131 DOI: 10.1016/j.puhe.2022.05.003] [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] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 03/11/2022] [Accepted: 05/08/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Previous studies have reported the relationship between housing environment and health, although due to cost and effort, it was difficult to conduct housing condition surveys on a large scale. The CASBEE Housing Health Checklist (the Checklist) made it possible to easily evaluate the housing condition from the resident's perspective. This study examined the relationship between housing coldness/warmth evaluation using the Checklist and psychological distress in a large-scale general Japanese population. STUDY DESIGN A cross-sectional study. METHODS We analysed data from 29,380 people aged ≥20 years who lived in Miyagi Prefecture, Japan. As an assessment of housing coldness/warmth, we used the Checklist. We classified participants' total scores on the Checklist related to coldness/warmth into quartiles. The Kessler 6 scale was used as an indicator of psychological distress. Multivariable logistic regression models were used to estimate the adjusted odds ratio (OR) and 95% confidence intervals (CIs). Adjusted OR and P-values for linear trends were calculated using the quartiles of the Checklists' score. RESULTS Among participants in Q1 (i.e., poorer subjective house condition), the percentage of people with psychological distress was high. Compared to the highest quartile, Q1 showed poorer evaluation of housing coldness/warmth, and higher OR for psychological distress. The OR (95% CI) of psychological distress for Q3, Q2, and Q1 compared with Q4 were 1.93 (1.74-2.14), 2.82 (2.55-3.12), and 5.78 (5.25-6.35), respectively. CONCLUSIONS Housing coldness/warmth evaluation was significantly related to psychological distress. This finding suggests that maintaining a comfortable thermal environment at home could be important for residents' mental health.
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Affiliation(s)
- I Kanno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - K Hasegawa
- Akita Prefectural University, Akita, Japan
| | - T Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - M Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - F Itabashi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - A Narita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - N Tsuchiya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Yamato Home Medical Care Clinic Kurihara, Kurihara, Japan
| | - T Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Nara, Japan
| | - N Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - J Sugawara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan; Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - S Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan; International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - I Tsuji
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - S Kure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan; Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - A Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Graduate School of Medicine, Tohoku University, Sendai, Japan.
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Mio N, Mir L, Miravet-Tenés M, Mishra C, Mishra T, Mistry T, Mitra S, Mitrofanov V, Mitselmakher G, Mittleman R, Miyakawa O, Miyamoto A, Miyazaki Y, Miyo K, Miyoki S, Mo G, Moguel E, Mogushi K, Mohapatra S, Mohite S, Molina I, Molina-Ruiz M, Mondin M, Montani M, Moore C, Moraru D, Morawski F, More A, Moreno C. All-sky, all-frequency directional search for persistent gravitational waves from Advanced LIGO’s and Advanced Virgo’s first three observing runs. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.122001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Joliat GR, de Man R, Rijckborst V, Cimino M, Torzilli G, Choi GH, Lee HS, Goh B, Kokudo T, Shirata C, Hasegawa K, Nishioka Y, Vauthey JN, Baimas-George M, Vrochides D, Demartines N, Halkic N, Labgaa I. Long-term outcomes of ruptured hepatocellular carcinoma: An international multicentric propensity score-matched study. Br J Surg 2022. [DOI: 10.1093/bjs/znac178.002] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Long-term outcomes of patients with ruptured hepatocellular carcinoma (rHCC) remain scant. This study aimed to assess disease-free survival (DFS) and overall survival (OS) after surgical resection of rHCC compared to non-ruptured HCC (nrHCC).
Methods
Patients with rHCC and nrHCC were collected from 8 centers in Europe, Asia, and North America. Resected rHCC patients were matched 1:1 to patients undergoing surgery for nrHCC using propensity score and nearest-neighbor method (matching criteria: age, tumor size, cirrhosis, Child-Pugh score, Barcelona Clinic Liver Cancer stage, resection status, grade, and microvascular invasion). Survival rates were calculated using Kaplan-Meier method.
Results
A total of 2033 patients were included: 226 rHCC patients (172 operated: 68 with upfront surgery and 104 after embolization) and 1807 nrHCC patients. Median DFS and OS of rHCC patients (all treatments confounded) were 10 months (95% CI 7–13) and 22 months (95% CI 13–31). Prognostic factors for worse OS among rHCC patients were absence of preoperative arterial embolization (HR 2.3, 95% CI 1.2–4.6, p=0.016), cirrhosis Child B/C (HR 2.4, 95% CI 1.1–5.4, p=0.040), and R1/R2 margins (HR 2, 95% CI 1–5, p=0.049). Survivals were similar between Western and Eastern rHCC patients.
After propensity score matching, 106 rHCC patients and 106 nrHCC patients displayed similar characteristics. Patients with rHCC had shorter median DFS (12 months, 95% CI 7–17 vs. 22 months, 95% CI 12–32, p=0.011), but similar median OS compared to nrHCC patients (43 months, 95% CI 21–65 vs. 63 months, 95% CI 21–105, p=0.060).
Conclusion
In this large dataset including Eastern and Western patients, rHCC was associated with shorter DFS compared to nrHCC, while OS was similar.
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Affiliation(s)
- G-R Joliat
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - R de Man
- Department of Gastroenterology and Hepatology, Erasmus Medical Center , Rotterdam, The Netherlands
| | - V Rijckborst
- Department of Gastroenterology and Hepatology, Erasmus Medical Center , Rotterdam, The Netherlands
| | - M Cimino
- Department of General and Minimally Invasive Surgery, Humanitas Clinical and Research Hospital , Milan, Italy
| | - G Torzilli
- Department of General and Minimally Invasive Surgery, Humanitas Clinical and Research Hospital , Milan, Italy
| | - G H Choi
- Department of Surgery, Yonsei University College of Medicine , Seoul, South Korea
| | - H S Lee
- Department of Surgery, Yonsei University College of Medicine , Seoul, South Korea
| | - B Goh
- Department of Surgery, Singapore General Hospital , Singapore, Singapore
| | - T Kokudo
- Department of Surgery, The University of Tokyo Hospital , Tokyo, Japan
| | - C Shirata
- Department of Surgery, The University of Tokyo Hospital , Tokyo, Japan
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - K Hasegawa
- Department of Surgery, The University of Tokyo Hospital , Tokyo, Japan
| | - Y Nishioka
- Department of Surgical Oncology, MD Anderson Cancer Center , Houston, USA
| | - J-N Vauthey
- Department of Surgical Oncology, MD Anderson Cancer Center , Houston, USA
| | - M Baimas-George
- Department of Surgery, Atrium Health, Carolinas Medical Center , Charlotte, USA
| | - D Vrochides
- Department of Surgery, Atrium Health, Carolinas Medical Center , Charlotte, USA
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - N Halkic
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - I Labgaa
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
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Yamamoto K, Kinsho M, Hayashi N, Saha PK, Tamura F, Yamamoto M, Tani N, Takayanagi T, Kamiya J, Shobuda Y, Yoshimoto M, Harada H, Takahashi H, Watanabe Y, Okabe K, Nomura M, Shimada T, Nakanoya T, Ono A, Moriya K, Yamazaki Y, Suganuma K, Fujirai K, Kikuzawa N, Meigo SI, Ooi M, Hatakeyama S, Togashi T, Wada K, Hotchi H, Yoshii M, Ohmori C, Toyama T, Satou K, Irie Y, Ueno T, Horino K, Yanagibashi T, Saeki R, Sato A, Takeda O, Kawase M, Suzuki T, Watanabe K, Ishiyama T, Fukuta S, Sawabe Y, Ito Y, Kato Y, Hasegawa K, Suzuki H, Noda F. Design and actual performance of J-PARC 3 GeV rapid cycling synchrotron for high-intensity operation. J NUCL SCI TECHNOL 2022. [DOI: 10.1080/00223131.2022.2038301] [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: 10/19/2022]
Affiliation(s)
- Kazami Yamamoto
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | - Naoki Hayashi
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | - Fumihiko Tamura
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | - Norio Tani
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | | | | | | | - Hiroyuki Harada
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | | | - Kota Okabe
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | - Masahiro Nomura
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | - Taihei Shimada
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | - Ayato Ono
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | - Yoshio Yamazaki
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | - Kosuke Fujirai
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | | | - Motoki Ooi
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | | | | | - Kaoru Wada
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
| | - Hideaki Hotchi
- J-PARC Center, High Energy Accelerator Research Organization, Tokai-mura, Japan
| | - Masahito Yoshii
- J-PARC Center, High Energy Accelerator Research Organization, Tokai-mura, Japan
| | - Chihiro Ohmori
- J-PARC Center, High Energy Accelerator Research Organization, Tokai-mura, Japan
| | - Takeshi Toyama
- J-PARC Center, High Energy Accelerator Research Organization, Tokai-mura, Japan
| | - Kenichirou Satou
- J-PARC Center, High Energy Accelerator Research Organization, Tokai-mura, Japan
| | - Yoshiro Irie
- J-PARC Center, High Energy Accelerator Research Organization, Tokai-mura, Japan
| | - Tomoaki Ueno
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- NAT Corporation, Tokai-mura, Japan
| | - Koki Horino
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- NAT Corporation, Tokai-mura, Japan
| | - Toru Yanagibashi
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- NAT Corporation, Tokai-mura, Japan
| | - Riuji Saeki
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- NAT Corporation, Tokai-mura, Japan
| | - Atsushi Sato
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- NAT Corporation, Tokai-mura, Japan
| | - Osamu Takeda
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- NAT Corporation, Tokai-mura, Japan
| | - Masato Kawase
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- Mitsubishi Electric System & Service Co.,Ltd, Tokai-mura, Japan
| | - Takahiro Suzuki
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- Mitsubishi Electric System & Service Co.,Ltd, Tokai-mura, Japan
| | - Kazuhiko Watanabe
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- Mitsubishi Electric System & Service Co.,Ltd, Tokai-mura, Japan
| | - Tatsuya Ishiyama
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- Mitsubishi Electric System & Service Co.,Ltd, Tokai-mura, Japan
| | - Shinpei Fukuta
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- Mitsubishi Electric System & Service Co.,Ltd, Tokai-mura, Japan
| | - Yuki Sawabe
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- Mitsubishi Electric System & Service Co.,Ltd, Tokai-mura, Japan
| | - Yuichi Ito
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- Total Support Systems Co, Tokai-mura, Japan
| | - Yuko Kato
- J-PARC Center, Japan Atomic Energy Agency, Tokai-mura, Japan
- Total Support Systems Co, Tokai-mura, Japan
| | - Kazuo Hasegawa
- National Institutes for Quantum Science and Technology, Aomori-ken and Chiba-ken, Japan
| | - Hiromitsu Suzuki
- National Institutes for Quantum Science and Technology, Aomori-ken and Chiba-ken, Japan
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Furukawa Y, Saito H, Hasegawa K, Ichikawa M. Assessing the quality of cancer screening leaflets using the International Patient Decision Aids Standards instrument: A cross-sectional content analysis. Patient Educ Couns 2021; 104:3100-3103. [PMID: 33846033 DOI: 10.1016/j.pec.2021.03.034] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the quality of national cancer screening program leaflets in Japan from the informed-decision perspective. METHODS Cross-sectional content analysis of invitation leaflets issued by centralized organizations and used nationwide in Japan was conducted. Three members independently evaluated the materials using International Patient Decision Aids Standards six-item minimum criteria for qualifying patient decision aids. PATIENT PUBLIC INVOLVEMENT Co-author KH is a cancer patient himself. We also sought feedbacks from three other cancer survivors and two bereaved family members. RESULTS Inter-rater agreement was substantial (Fleiss' kappa=0.62). The median score was 2 out of 6 (range: 2-3). All leaflets described the cancer (Q1: 7/7) and screening modality (Q2: 7/7). None stated not undergoing screening as an option. One stated another screening modality (Q3: 1/7). None stated both the positive and negative features of multiple options (Q4: 0/7. Q5: 0/7). One described the psychological and social experience of screening but only its positive side (Q6: 1/7). CONCLUSIONS There is room for improvement in the content of the public cancer screening invitation leaflets in Japan from informed-decision perspective. PRACTICE IMPLICATIONS Cancer screening leaflets should provide evidence-based, well-balanced, easy-to-understand information to educate people on cancer screening while maintaining people's autonomy.
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Affiliation(s)
- Yuki Furukawa
- Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Hiroko Saito
- Teikyo University Graduate School of Public Health, 2-11-1, Kaga, Itabashi-ku, Tokyo 173-8605, Japan
| | - Kazuo Hasegawa
- Non-Profit Organization Lung Cancer Patient Group ONE STEP, 1-38-9, Sakuragaoka, Hodogaya-ku, Yokohama-shi, Kanagawa 240-0011, Japan
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29
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Otani M, Hasegawa K, Kita K, Horikawa D, Mizukami S, Takeda T, Ohara M, Tani C, Shonaka T, Matsuno N, Sumi Y. Assessment of post-operative changes in body composition after pylorus-preserving gastrectomy for early gastric cancer. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.480] [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: 10/19/2022]
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30
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Ishii Y, Aiba N, Ando M, Asakura N, Bierwage A, Cara P, Dzitko H, Edao Y, Gex D, Hasegawa K, Hayashi T, Hiwatari R, Hoshino T, Ikeda Y, Ishida S, Isobe K, Iwai Y, Jokinen A, Kasugai A, Kawamura Y, Kim JH, Kondo K, Kwon S, Lorenzo SC, Masuda K, Matsuyama A, Miyato N, Morishita K, Nakajima M, Nakajima N, Nakamichi M, Nozawa T, Ochiai K, Ohta M, Oyaidzu M, Ozeki T, Sakamoto K, Sakamoto Y, Sato S, Seto H, Shiroto T, Someya Y, Sugimoto M, Tanigawa H, Tokunaga S, Utoh H, Wang W, Watanabe Y, Yagi M. R&D Activities for Fusion DEMO in the QST Rokkasho Fusion Institute. Fusion Science and Technology 2021. [DOI: 10.1080/15361055.2021.1925030] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Y. Ishii
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Aiba
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - M. Ando
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Asakura
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - A. Bierwage
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - P. Cara
- IFMIF/EVEDA Project Team, Rokkasho-Vill., Japan
| | - H. Dzitko
- Fusion for Energy, Broader Approach, Garching, Germany
| | | | - D. Gex
- Fusion for Energy, Broader Approach, Garching, Germany
| | - K. Hasegawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Hayashi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - R. Hiwatari
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Hoshino
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Ikeda
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Ishida
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Isobe
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Iwai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - A. Jokinen
- IFMIF/EVEDA Project Team, Rokkasho-Vill., Japan
| | - A. Kasugai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Kawamura
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - J. H. Kim
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Kondo
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Kwon
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. C. Lorenzo
- Fusion for Energy, Broader Approach, Barcelona, Spain
| | - K. Masuda
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - A. Matsuyama
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Miyato
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Morishita
- Kyoto University, Institute of Advanced Energy, Uji, Japan
| | - M. Nakajima
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Nakajima
- National Institute for Fusion Science, Department of Helical Plasma Research Rokkasho Research Center, Rokkasho-Vill., Japan
| | - M. Nakamichi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Nozawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Ochiai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Ohta
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Oyaidzu
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Ozeki
- NAT Corporation, Tohoku Branch Office, Rokkasho-Vill., Japan
| | - K. Sakamoto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Sakamoto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Sato
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - H. Seto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Shiroto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Someya
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Sugimoto
- NAT Corporation, Tohoku Branch Office, Rokkasho-Vill., Japan
| | - H. Tanigawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Tokunaga
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - H. Utoh
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - W. Wang
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Watanabe
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Yagi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
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Iguchi M, Wada H, Shinozaki T, Suzuki M, Ajiro Y, Matsuda M, Koike A, Koizumi T, Shimizu M, Ono Y, Takenaka T, Kotani K, Abe M, Akao M, Hasegawa K. Distinct association of VEGF-C and VEGF-D with prognosis in patients with chronic heart failure: the PREHOSP-CHF study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/14/2022] Open
Abstract
Abstract
Background
The lymphatic system has been suggested to play an important role in cardiovascular (CV) diseases including heart failure (HF). Vascular endothelial growth factor C (VEGF-C) and VEGF-D are key regulators of lymphoangiogenesis.
Purpose
To investigate the association of VEGF-C and VEGF-D with prognosis in patients with chronic HF (CHF).
Methods
The PREHOSP-CHF study is a multicenter prospective cohort study to determine the predictive value of angiogenesis-related biomarkers in CHF. A total of 1,024 patients (mean age, 75.5±12.6 years; male, 58.7%) admitted to acute decompensated HF were included in the analyses. The primary outcome was MACE defined as a composite of CV death or HF hospitalization. The secondary outcomes were all-cause death, CV death, and HF hospitalizations. Serum levels of VEGF-C and VEGF-D, as well as N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin-I (hs-cTnI), high sensitive C reactive protein (hs-CRP), VEGF, and soluble VEGF receptor-2 (sVEGFR-2) were measured at the time of discharge. Patients were followed-up over two years.
Results
Median [interquartile range] of VEGF-C and VEGF-D levels were 4821 [3633–6131] pg/ml and 404 [296–559] pg/ml, respectively. In multivariate stepwise regression analysis, independent determinants of VEGF-C levels were younger age, female gender, absence of prior HF hospitalization, chronic kidney disease, and anemia, lower ejection fraction, lower NT-proBNP levels, higher VEGF levels, and higher sVEGFR-2 levels, while those of VEGF-D levels were lower body mass index, presence of diabetes and atrial fibrillation, and higher NT-proBNP levels. During the follow-up, a total of 209 (20.4%) all-cause deaths, 112 (10.9%) CV deaths, and 309 (30.2%) HF hospitalizations occurred. After adjusting for established risk factors and CV biomarkers, VEGF-C levels were significantly and inversely associated with the incidence of MACE and non-CV death (Fig.1, model 4). On the other hand, VEGF-D levels were significantly and positively associated with the incidence of HF hospitalization (Fig. 1, model 4). When we divided the patients into 4 groups based on the median of VEGF-C and VEGF-D levels, patients with low VEGF-C and high VEGF-D showed significantly higher incidence of MACE, all-cause death, CV death, and HF hospitalization compared to those with high VEGF-C and low VEGF-D (Fig. 2).
Conclusions
Among patients with CHF, VEGF-C and VEGF-D had different characteristic and association with the incidence of adverse events. VEGF-C levels were inversely associated with the incidence of MACE and non-CV death, and VEGF-D levels were positively associated with the incidence of HF hospitalization. These results suggests different effects of VEGF-C and VEGF-D in CHF. Combination of VEGF-C and VEGF-D enables us to make good risk stratification in patients with CHF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Clinical Research from the National Hospital Organization Figure 1Figure 2
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - A Koike
- National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - T Koizumi
- National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - Y Ono
- National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - K Kotani
- Jichi Medical University, Tochigi, Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
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Kuroki N, Abe D, Hasegawa K, Nagatomo R, Okochi M, Kato T, Aoyama T, Hirano H, Ohashi K, Takayama A, Hattori A, Kimata A, Hamabe Y, Suzuki K, Ueda T. Habitual exercise provides better prognosis for cardiac arrest with coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2705] [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: 11/14/2022] Open
Abstract
Abstract
Background
Although regular physical activity has beneficial cardiovascular effects, exercise can trigger sudden cardiac arrest (SCA). Coronary artery disease (CAD) was identified as the most common cause of an exercise-related out-of-hospital cardiac arrest (OHCA). Regular exercise has been reported to reduce the risk of plaque rupture in animal studies and basic research. Therefore, we compared the coronary artery findings in CAD-OHCA patients with and without habitual exercise.
There have been few reports on whether regular exercise changes the prognosis in OHCA due to CAD (CAD-OHCA). We investigated the association between the better clinical outcome and the regular exercise in patients with CAD-OHCA.
Methods
This is a single-center retrospective analysis from 2006 to 2019. The consecutive 397 patients with OHCA due to myocardial ischemia underwent coronary angiography (CAG). After excluding 73 patients with vasospastic angina, the remaining 324 patients with CAD were enrolled in this study. We divided these patients into two groups according to whether they were habitually exercising (Exercise group: N=37) or not/unknown (Non-Exercise group: N=287).
Clinical outcome was a 30-day survival with minimal neurologic impairment represented by a Glasgow-Pittsburgh Cerebral Performance Categories Scale value 1 or 2.
Results
The patients in the Exercise Group were significantly younger (exercise vs. non-exercise, 57±12 vs. 64±12 years; P<0.01) than those in the non-exercise group. The Exercise group had a lower incidence of diabetes mellitus (22% vs. 42%; P=0.02) and a higher incidence of dyslipidemia (81% vs. 62%; P=0.02) than the non-exercise group. The time from collapse to cardiopulmonary resuscitation (1.4±4.0 vs. 3.0±4.8min) and from collapse to return of spontaneous circulation (11.9±10.0 vs. 28.0±25.3min) were shorter in Exercise group (all p<0.05). The ST-segment elevation was recorded on electrocardiography in fewer of the Exercise group (22% vs. 63%; P<0.01). The finding of culprit lesion in the coronary arteries on arrival resulted significant differences between the 2groups (good collateral and/or TIMI3 flow: 62% vs. 25%, the plaque rupture and/or thrombus: 22% vs. 73%) (all p<0.01) (Figure 1). Kaplan-Meier curve showed Exercise group has better neurological outcome at 30days compared than Non-Exercise (95% vs 51%; P<0.001, log-rank test) (Figure 2). Multivariable Cox proportional hazards models revealed that a habitual exercise was one of the predictors of a good neurological outcome (HR 0.21, 95% CI 0.05–0.92; P=0.039).
Conclusions
The patients with habitual exercise had less plaque rupture, less coronary thrombosis than non-exercise. The patients with regular exercise had better clinical outcomes than non-exercise after CAD-OHCA.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Tokyo Metropolitan Goverment Figure 1. Findings of the culprit lesion in coronar arteriesFigure 2. Kaplan-Meier analysis
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Affiliation(s)
- N Kuroki
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - D Abe
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - K Hasegawa
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - R Nagatomo
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - M Okochi
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - T Kato
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - T Aoyama
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - H Hirano
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - K Ohashi
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - A Takayama
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - A Hattori
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - A Kimata
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - Y Hamabe
- Tokyo Metropolitan Bokutoh Hospital, Emergency and Intensive Care Center, Tokyo, Japan
| | - K Suzuki
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - T Ueda
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
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Iguchi M, Masunaga N, Ishii M, An Y, Fujino A, Hamatani Y, Doi K, Esato M, Wada H, Hasegawa K, Ogawa H, Abe M, Akao M. Association of low total cholesterol level with clinical outcomes in patients with atrial fibrillation: the Fushimi AF registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0435] [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: 11/13/2022] Open
Abstract
Abstract
Background
Hyperlipidemia is a well-established risk factor for cardiovascular disease. However, low cholesterol is also reported to be associated with poor outcome in patients with chronic disease, which is called “cholesterol paradox”, and the association of cholesterol level with the incidence of clinical outcomes in patients with atrial fibrillation (AF) remains unclear.
Methods
In the Fushimi AF Registry, a community-based prospective survey of the AF patients in Fushimi-ku, Kyoto, Japan, follow-up data and baseline total cholesterol levels were available in 3,054 patients. We excluded 767 patients who were taking statins, and 2,267 patients were included in the analyses. We defined low cholesterol as total cholesterol <150 mg/dl, and examined the incidence of all-cause death, stroke/systemic embolism (SE), heart failure (HF) hospitalization, and major bleeding.
Results
Patients with low cholesterol (N=464 (20.4%)) were older, more often male, and had higher prevalence of low body weight (<50 kg), permanent/persistent AF, prior stroke/SE, HF, chronic kidney disease, and anemia (hemoglobin <11 g/dl). CHA2DS2-VASc score was higher in patients with low cholesterol (low cholesterol vs others; 3.6±1.6 vs 3.2±1.7: P<0.001). Prescription of oral anti-coagulants was comparable between the groups (50.0% vs 54.5%: P=0.09). During the median follow-up of 1,805 days, the incidence of all-cause death, stroke/SE, HF hospitalization, and major bleeding was significantly higher in patients with low cholesterol (all-cause death, 10.9 vs 3.8 /100 person-years; stroke/SE, 3.4 vs 1.9 /100 person-years; HF hospitalization, 4.7 vs 2.5 /100 person-years; major bleeding, 2.7 vs 1.4 /100 person-years) (Figure 1). After adjustment for the components of CHA2DS2-VASc score, low body weight, permanent/persistent AF, chronic kidney disease, anemia, and prescription of oral anti-coagulants, low cholesterol was significantly associated with the incidence of all-cause death and stroke/SE, but not with that of HF hospitalization or major bleeding (Figure 2, model 3). Total cholesterol levels were still significantly and inversely associated with the incidence of all-cause death (hazard ratio, 0.94; 95% confidence interval, 0.92–0.96 for 10 mg/dl increase) and stroke/SE (hazard ratio, 0.96; 95% confidence interval, 0.92–0.999 for 10 mg/dl increase), when analyzed as continuous variables. Subgroup analysis revealed that the risk of low cholesterol for all-cause death was more pronounced in female (interaction P, 0.049), patient without prior stroke/SE (interaction P, 0.01), those without HF (interaction P, 0.01), and those without vascular disease (interaction P, 0.001). The risk for stroke/SE was more pronounced in patients without vascular disease (interaction P, 0.01).
Conclusion
Low total cholesterol level was significantly associated with the incidence of all-cause and stroke/SE in AF patients not taking statins, suggesting the existence of cholesterol paradox in AF.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi-Sankyo, Novartis Pharma, MSD, Sanofi-Avent
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - N Masunaga
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Ishii
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - Y An
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - A Fujino
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - Y Hamatani
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Doi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Esato
- Ogaki Tokushukai Hospital, Gifu, Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - H Ogawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
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Ikeda S, Iguchi M, Ogawa H, Ishigami K, Doi K, Hamatani Y, Ide Y, Fujino A, Ishii M, Masunaga N, Esato M, Wada H, Hasegawa K, Abe M, Akao M. The relationship between diastolic blood pressure and the risk of cardiovascular events in patients with atrial fibrillation whose systolic blood pressure was treated to less than 130 mmHg. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2387] [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: 11/12/2022] Open
Abstract
Abstract
Background
Hypertension is one of the major risk factors of cardiovascular events in patients with atrial fibrillation (AF). Low diastolic blood pressure (DBP) has been reported to be associated with the incidence of cardiovascular events, but current guidelines recommend an intensive blood pressure target of less than 130/80 mmHg for AF patients taking oral anticoagulants without mentioning the lower limits of DBP.
Methods
The Fushimi AF Registry is a community-based prospective survey of AF patients in a city of Japan. Follow-up data were available in 4,472 patients, and hypertensive patients who received prescription of any antihypertensive agents and whose systolic blood pressure was treated to less than 130 mmHg were available were examined (n=1,319). We divided the patients into four groups according to their DBP at baseline; G1 (DBP<60 mmHg, n=349), G2 (60≤DBP<70, n=434), G3 (70≤DBP<80, n=386) and G4 (80≤DBP, n=150), and compared the clinical background and outcomes among groups.
Results
The proportion of female was grater in G1 group, and the patients in G1 group were older. During the median follow-up of 2,458 days, in Kaplan-Meier analysis, the incidence rates of cardiovascular events (composite of cardiac death, ischemic stroke, systemic embolism, non-fatal myocardial infarction and heart failure hospitalization during follow up) were the highest in G1 group and the lowest in G3 group (G1: 7.2% per person-year vs. G2: 4.9% vs. G3: 2.2% vs. G4: 4.4%; p<0.01). Multivariate Cox proportional hazards regression analysis revealed that DBP was an independent determinant of cardiovascular events (G1 vs. G3; hazard ratio (HR): 1.96, 95% confidence intervals (CI): 1.39–2.76, G2 vs. G3; HR: 1.79, 95% CI: 1.28–2.50, G4 vs. G3; HR: 1.56, 95% CI: 0.99–2.45) (Figure 1). When we examined the association of DBP according to 10 mmHg increment, patients with excessively low DBP (<50 mmHg) had significantly higher incidence of cardiovascular events than patients with DBP of 70–79 mmHg (HR: 2.80, 95% CI: 1.81–4.33), and DBP exhibited J curve association with higher incidence of cardiovascular events (Figure 2).
Conclusion
In Japanese AF patients whose systolic blood pressure was treated to less than 130 mmHg, patients with excessively low DBP had significantly higher incidence of cardiovascular events, and DBP exhibited J curve association with higher incidence of cardiovascular events.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Ikeda
- Kyoto Medical Centre, Kyoto, Japan
| | - M Iguchi
- Kyoto Medical Centre, Kyoto, Japan
| | - H Ogawa
- Kyoto Medical Centre, Kyoto, Japan
| | | | - K Doi
- Kyoto Medical Centre, Kyoto, Japan
| | | | - Y Ide
- Kyoto Medical Centre, Kyoto, Japan
| | - A Fujino
- Kyoto Medical Centre, Kyoto, Japan
| | - M Ishii
- Kyoto Medical Centre, Kyoto, Japan
| | | | - M Esato
- Ogaki Tokushukai Hospital, Arrhythmia, Ogaki, Japan
| | - H Wada
- Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - M Abe
- Kyoto Medical Centre, Kyoto, Japan
| | - M Akao
- Kyoto Medical Centre, Kyoto, Japan
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Ogawa H, Esato M, Minami K, Ikeda S, Doi K, Hamatani Y, Ide Y, Fujino A, Ishii M, Iguchi M, Masunaga N, Wada H, Hasegawa K, Abe M, Akao M. Previous pacemaker therapy was not associated with the risk of clinical events in patients with atrial fibrillation: the Fushimi AF Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0542] [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: 11/13/2022] Open
Abstract
Abstract
Background
Patients with atrial fibrillation (AF) occasionally require pacemaker implantation. Meanwhile, patients with implanted pacemaker are occasionally found to have subclinical AF and develop clinical AF. However, little is known about the clinical outcomes of AF patients with implanted pacemaker.
Purpose
We aimed to investigate the clinical outcomes in AF patients undergoing previous pacemaker therapy.
Methods
The Fushimi AF Registry is a community-based prospective survey of the AF patients in a city of Japan. Follow-up data including prescription status were available for 4,447 patients. After exclusion of patients with implantable cardioverter defibrillator and cardiac resynchronization therapy, we investigated 293 AF patients with pacemaker implantation at baseline. We performed propensity score-matching analysis to assess the impact of pacemaker therapy in AF patients.
Results
Of a total cohort, patients with pacemaker were more often female (51.2% vs. 39.7%; p<0.01) and older (78.0 vs. 73.3 years of age; p<0.01). Patients with pacemaker were more likely to have pre-existing heart failure (33.1% vs. 26.6%; p<0.01), valvular heart disease (22.9% vs. 16.8%; p<0.01), chronic kidney disease (48.8% vs. 34.7%; p<0.01), and history of performing direct current cardioversion (7.2% vs. 3.1%; p<0.01), compared with patients without pacemaker. Mean CHA2DS2-VASc score was higher in patients with pacemaker (3.80 vs. 3.34; p<0.01). Patients with pacemaker were more often prescribed oral anticoagulants (62.1% vs. 55.2%; p=0.02), verapamil (13.3% vs. 9.4%; p=0.03), and loop diuretics (30.7% vs. 21.8%; p<0.01). Using propensity score-matching, 291 patients with pacemaker and 291 without pacemaker were matched and baseline characteristics were comparable. The median follow-up period was 1,819 days. All-cause death occurred in 91 patients with pacemaker (6.0 /100 person-years) and 79 patients without pacemaker (5.9 /100 person-years), with a hazard ratio (HR) for patients with pacemaker of 1.01 (95% confidence interval [CI], 0.75 to 1.37; p=0.93). Furthermore, HR of cardiac death for patients with pacemaker was 1.00 (95% CI, 0.23 to 4.32; p=0.99), that of stroke or systemic embolism was 0.69 (95% CI, 0.44 to 1.07; p=0.10) and that of hospitalization for heart failure was 0.94 (95% CI, 0.65 to 1.37; p=0.76).
Conclusion
We identified that patients undergoing previous pacemaker therapy were not associated with the incidence of various adverse clinical events in Japanese AF patients.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi Sankyo, Novartis Pharma, MSD, Sanofi-Aventis, Takeda Pharmaceutical, and the Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus from Japan Agency for Medical Research and Development.
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Affiliation(s)
- H Ogawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Esato
- Ogaki Tokushukai Hospital, Ogaki, Japan
| | - K Minami
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - S Ikeda
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Doi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - Y Hamatani
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - Y Ide
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - A Fujino
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Ishii
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Iguchi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - N Masunaga
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
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Ishigami K, Ikeda S, Doi K, Hamatani Y, Ide Y, Fujino A, An Y, Ishii M, Iguchi M, Ogawa H, Masunaga N, Wada H, Hasegawa K, Abe M, Akao M. Association of the degree of thrombocytopenia with cause of death in patients with atrial fibrillation: the Fushimi AF Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0462] [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: 11/14/2022] Open
Abstract
Abstract
Background
Thrombocytopenia is sometimes found in routine blood tests and is associated with an increased risk of mortality in general population. We have previously reported that atrial fibrillation (AF) patients with thrombocytopenia have a higher mortality than those without thrombocytopenia. However, association of the degree of thrombocytopenia with cause of death in AF patients is unknown.
Purpose
We aimed to investigate the association of baseline platelet count with cause of death including cardiac death, intracranial death, malignancy, infection, extracranial bleeding death, renal failure death, respiratory failure death and undetermined death.
Methods
The Fushimi AF Registry was designed to enroll all of the AF patients in Fushimi-ku, Kyoto. Fushimi-ku is densely populated with a total population of 283,000 and is assumed to represent a typical urban community in Japan. We started to enroll patients from March 2011, and follow-up data with baseline platelet counts less than 150,000/μL were available in 853 patients by the end of September 2020. We divided them into 3 groups according to baseline platelet level: Mild thrombocytopenia (100,000–149,999/μL, n=703), Moderate thrombocytopenia (50,000–99,999/μL, n=120), and Severe thrombocytopenia (<50,000/μL, n=30).
Results
In the entire cohort, the mean age was 76 years, 34% were women, the mean body weight and body mass index was 59.3 kg and 22.9 kg/m2, and the median platelet count were 121,000/μL (interquartile range 109,000 to 141,000/μL). Compared to Mild thrombocytopenia, patients with Moderate or Severe thrombocytopenia were more likely to have chronic kidney disease (42.2% vs 54.2% vs 73.3%, p=0.0003), have higher HAS-BLED score (1.90 vs 2.14 vs 2.00, p=0.047) and lower hemoglobin (12.8g/dL vs 11.7g/dL vs 11.2g/dL, p<0.0001) and were less often prescribed anti platelet drugs. Age, sex, body weight, systolic blood pressure, previous stroke, previous major bleeding, hypertension, diabetes mellitus, CHADS2 score and CHA2DS2-VASc score were comparable between three groups. During the median follow-up period, the incidence rate (per 100 person-years) of all-cause death was 6.82 vs 15.27 vs 9.64. (p<0.001) On univariate analysis, the incidence of all-cause death was higher in Moderate group than Mild group. (HR: 2.15; 95% CI 1.61–2.87, p<0.0001), but there was no significant difference between Mild and Severe groups. (HR: 1.44; 95% CI 0.78–2.64, p=0.243). The incidence of cardiac death was comparable between three groups. (Mild vs Moderate: HR 0.65; 95% CI 0.15–2.75, p=0.56, Mild vs Severe: HR 1.11; 95% CI 0.15–8.23, p=0.92) Regarding other causes of death such as intracranial bleeding, extracranial bleeding, malignancy, infection, renal failure, respiratory failure and undetermined cause, there was no significant difference.
Conclusion
Mortality was higher according to the degree of thrombocytopenia in AF patients, but the cause of death was not different among three groups.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Ishigami
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - S Ikeda
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - K Doi
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - Y Hamatani
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - Y Ide
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - A Fujino
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - Y An
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Ishii
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Iguchi
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - H Ogawa
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - N Masunaga
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - H Wada
- Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - M Abe
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Akao
- Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
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Shimada YJ, Raita Y, Maurer MS, Hasegawa K, Fifer MA, Reilly MP. Prediction of major adverse cardiovascular events in patients with hypertrophic cardiomyopathy using proteomics profiling. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1776] [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: 11/12/2022] Open
Abstract
Abstract
Background
Hypertrophic cardiomyopathy (HCM) is one of the most common genetic cardiac diseases, affecting 1 in 200–500 people in the US. HCM often causes major adverse cardiovascular events (MACE) – e.g., arrhythmias (atrial fibrillation, ventricular tachycardia/fibrillation), cerebrovascular accident, heart failure (HF), and sudden cardiac death (SCD). Although these HCM-related morbidities and mortality substantially affect the patients' quality and quantity of life, no systems are available to predict MACE. Furthermore, it remains unclear which signaling pathways mediate MACE.
Purpose
To prospectively determine protein biomarkers that predict MACE in patients with HCM and to identify signaling pathways differentially regulated in patients with HCM who subsequently develop MACE.
Methods
In this multi-center prospective cohort study of patients with HCM, we carried out plasma proteomics profiling of 4,979 proteins upon enrollment. We defined MACE as a composite of new-onset arrhythmias, cerebrovascular accident, increase in New York Heart Association class, HF death, SCD, and emergency department visit or non-elective hospitalization for HCM-related morbidities. We performed a sparse partial least squares discriminant analysis to develop a proteomics-based model to predict MACE using data from one institution (i.e., the training set). We tested the predictive ability in independent samples from the other institution (i.e., the test set) and performed time-to-event analysis. Additionally, we executed pathway analysis of the predictive proteins. A pathway was declared positive (i.e., dysregulated) if the false discovery rate (FDR) of the pathway was <0.01 and there were ≥5 proteins that map to the pathway.
Results
The study included 257 patients with HCM (n=186 in the training set; n=71 in the test set). The median follow-up duration was 2.5 years (interquartile range, 1.4–3.1 years). Each year, 11.7% of patients had MACE. Using the proteomics-based prediction model derived from the training set, the area under the receiver-operating-characteristic curve was 0.84 (95% confidence interval [CI] 0.72–0.96) in the test set (Figure 1). The sensitivity was 0.82 (95% CI, 0.72–0.91) and the specificity was 0.84 (95% CI, 0.79–0.89) in the test set. In the test set, high-risk group determined by the proteomics-based predictive model had significantly higher rate of developing MACE (hazard ratio 20.2; 95% CI 2.4–168; p=0.005; Figure 2). The Ras-MAPK and related pathways were upregulated in patients who subsequently developed MACE (FDR<0.001). Pathways involved in inflammation and fibrosis – e.g., the TGF-β pathway – were also upregulated.
Conclusions
This multi-center prospective cohort study with validation serves as the first to demonstrate the ability of proteomics profiling to predict MACE in HCM, exhibiting both novel (e.g., Ras-MAPK) and known (e.g., TGF-β) pathways that are differentially regulated in patients who subsequently experience MACE.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Health, American Heart Association Figure 1Figure 2
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Affiliation(s)
- Y J Shimada
- Columbia University Medical Center, New York, United States of America
| | - Y Raita
- Massachusetts General Hospital, Boston, United States of America
| | - M S Maurer
- Columbia University Medical Center, New York, United States of America
| | - K Hasegawa
- Massachusetts General Hospital, Boston, United States of America
| | - M A Fifer
- Massachusetts General Hospital, Boston, United States of America
| | - M P Reilly
- Columbia University Medical Center, New York, United States of America
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Hamatani Y, Iguchi M, Minami K, Ishigami K, Ikeda S, Doi K, Masunaga N, Esato M, Tsuji H, Wada H, Hasegawa K, Ogawa H, Abe M, Akao M. Predictors and risk model for heart failure hospitalization in atrial fibrillation patients without pre-existing heart failure: the Fushimi AF Registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0476] [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: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) increases the risk of hospitalization for heart failure (HF), as well as that of thromboembolism. The strategy for prediction of thromboembolism has been well-established; however, little focus has been placed on the risk stratification for and prevention of HF hospitalization in AF patients.
Purpose
The aim of this study is to investigate the predictors and risk model of HF hospitalization in non-valvular AF patients without pre-existing HF.
Methods
The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. The inclusion criterion of the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time, and there are no exclusion criteria. We started to enroll patients from March 2011, and follow-up data were available for 4,472 patients by the end of October 2020. From the registry, we excluded patients without a pre-existing HF (defined as having one of the following; prior hospitalization for HF, New York Heart Association class ≥2, or left ventricular ejection fraction [LVEF] <40%), and those with valvular AF (mitral stenosis or prosthetic heart valve). Among 3,188 non-valvular AF patients without pre-existing HF, we explored the risk factors for the HF hospitalization during follow-up period. The risk model for predicting HF hospitalization was determined by the cumulative numbers of risk factors which were significant on multivariate analysis.
Results
The mean age was 72.4±10.8 years, 1197 were female and 1787 were paroxysmal AF. The mean CHADS2 and CHA2DS2-VASc scores were 1.7±1.2 and 2.9±1.6, respectively. During the median follow-up period of 5.1 years, HF hospitalization occurred in 285 (8.9%), corresponding to an annual incidence of 1.8 events per 100 person-years. In multivariable Cox regression analysis, advanced age (≥75 years), valvular heart disease, coronary artery disease, reduced LVEF (<60%), chronic obstructive pulmonary disease (COPD) and anemia were independently associated with the higher incidence of HF hospitalization (all P<0.001) (Picture 1). A risk model based on these 6 variables could stratify the incidence of HF hospitalization during follow-up period (log-rank; P<0.001) (Picture 2). Patients with ≥3 risk factors had an 11-fold higher incidence of HF hospitalization compared with those not having any of these risk factors (hazard ratio: 11.3, 95% confidence interval: 7.0–18.4; P<0.001).
Conclusions
Advanced age, coronary artery disease, valvular heart disease, reduced LVEF, COPD and anemia were independently associated with the risk of HF hospitalization in AF patients without pre-existing HF. There was good prediction for endpoint of HF hospitalization using these 6 variables, providing the opportunities for the implementation of strategies to reduce the incidence of HF among AF patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Hamatani
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Iguchi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Minami
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Ishigami
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - S Ikeda
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Doi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - N Masunaga
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Esato
- Ogaki Tokushukai Hospital, Arrhythmia, Ogaki, Japan
| | | | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Ogawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Liang LW, Raita Y, Hasegawa K, Fifer MA, Maurer MS, Reilly MP, Shimada YJ. Proteomics profiling reveals distinct molecular subtypes of hypertrophic cardiomyopathy with differential risks of major adverse cardiovascular events. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1765] [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: 11/13/2022] Open
Abstract
Abstract
Background
Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease, and a subset (10–15%) of patients per year experience major adverse cardiovascular events (MACE). Current risk prediction models based solely on clinical data have yielded limited power in predicting MACE. Although the diagnosis of HCM is made based on clinical features, the heterogeneity of HCM suggests that “HCM” may actually encompass several subtypes of disease with distinct biological mechanisms that can only be elucidated via molecular-level investigation. Proteomics profiling measures concentrations of thousands of proteins simultaneously and has the potential to reveal underlying molecular mechanisms of disease and distinct subtypes of HCM.
Purpose
Our aim was to derive distinct subtypes of HCM in our multi-center biorepository of patients with HCM using proteomics profiling, and to examine their associations with MACE.
Methods
We applied unsupervised machine learning methods to derive HCM molecular subtypes using plasma proteomics profiling data from 258 patients in our multi-center HCM prospective cohort study. The primary outcome was MACE, defined as a composite of arrhythmias, progressive heart failure, stroke, and sudden cardiac death. We performed time-to-event analysis with a Cox proportional hazards model, using the subtype with the lowest risk as the reference group. We also performed pathway analysis of proteins differentially regulated in patients in the highest-risk subtype.
Results
We identified 4 distinct HCM subtypes. Patients in subtype D (n=74) were older on average compared to the other groups and more likely to be female. 50% of patients in subtype D had NYHA class II or greater heart failure symptoms compared to 37% in the rest of the groups combined. There were no significant differences in echocardiographic parameters or rates of genotype positivity between the four subtypes. Compared to the reference group (i.e., subtype A), patients in subtype D had a higher rate of MACE with a hazard ratio of 2.59 (95% CI 1.21–5.57, p=0.01 compared to subtype A; Figure). Pathway analysis identified significantly upregulated signaling pathways in the high-risk subtype D compared to the other subtypes (Table), with a number of upstream and downstream pathways associated with the Ras-MAPK pathway (FDR 0.0005).
Conclusions
Our study exhibits not only the presence of HCM molecular subtypes but also their distinct pathobiological mechanisms associated with different MACE risks. The four subtypes identified bore similar clinical characteristics and would not have been distinguishable based on the conventional analysis of clinical and echocardiographic parameters alone, but rather required deeper investigation at the molecular level. Furthermore, pathway analysis revealed an upregulation of Ras-MAPK pathways in the subtype with the highest risk of MACE, implicating this pathway as a potential underlying mechanism of more severe disease.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIH
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Affiliation(s)
- L W Liang
- Columbia University Medical Center, Cardiology, New York, United States of America
| | - Y Raita
- Massachusetts General Hospital - Harvard Medical School, Emergency Medicine, Boston, United States of America
| | - K Hasegawa
- Massachusetts General Hospital - Harvard Medical School, Emergency Medicine, Boston, United States of America
| | - M A Fifer
- Massachusetts General Hospital - Harvard Medical School, Cardiology, Boston, United States of America
| | - M S Maurer
- Columbia University Medical Center, Cardiology, New York, United States of America
| | - M P Reilly
- Columbia University Medical Center, Cardiology, New York, United States of America
| | - Y J Shimada
- Columbia University Medical Center, Cardiology, New York, United States of America
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Miyashita S, Zhao Y, Hasegawa K, Maurer M, Fifer M, Reilly M, Takayama H, Shimada YJ. Bariatric surgery is associated with lower risk of acute cardiovascular events in patients with obesity and hypertrophic cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1762] [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: 11/14/2022] Open
Abstract
Abstract
Background
Prior studies have suggested causal relationships between obesity and acute cardiovascular events (e.g., acute coronary syndrome, hypertensive crisis, and heart failure exacerbation). It has been known that the risk of cardiovascular events is reduced by bariatric surgery, the most effective method for substantial and sustained weight loss. However, little is known about whether bariatric surgery lowers the risk of acute cardiovascular events in the hypertrophic cardiomyopathy (HCM) population.
Purpose
To test the hypothesis that patients with obesity and HCM who underwent bariatric surgery have lower risk of developing acute cardiovascular events than those who did not.
Methods
In this population-based study of adults with obesity and HCM, the bariatric surgery group consisted of patients who underwent bariatric surgery from January 2004 to December 2014, whereas the control group included those who received non-bariatric elective intra-abdominal surgery during the same period. The outcome was an acute cardiovascular event – defined as emergency department (ED) visit or unplanned hospitalization for cardiovascular disease – during a 1-year post-surgery period. We used the SPARCS database, a population-based ED and inpatient database that captures all the ED visits and hospitalizations in New York State. We constructed logistic regression models with generalized estimating equations to compare the risk of the outcome events during sequential 6-month periods. We conducted multivariable analysis, adjusting for age, sex, number of ED visits and hospitalizations for cardiovascular disease within 2 years before the index surgery, and the Elixhauser comorbidity measures. We also performed additional analyses with propensity score (PS)-matching at 2:1 ratio and inverse probability treatment weighting (IPTW) using these variables.
Results
The analytic cohort consisted of 207 adults with obesity and HCM, including 147 patients who underwent bariatric surgery and 60 who had non-bariatric elective intra-abdominal surgery. In the 7–12 months post-surgery period, the risk of acute cardiovascular event was significantly lower in the bariatric surgery group (adjusted OR 0.23; 95% CI, 0.068–0.71; P=0.01; Figure) compared to the control group. In the PS-matched cohort (n=82 vs. 47), there were no significant differences in the baseline characteristics (P>0.50 for all comparisons). Similar to the main analysis, the PS-matched analysis demonstrated lower risk of the outcome event in the bariatric surgery group in the 7–12 months post-surgery period (OR 0.26; 95% CI, 0.083–0.73; P=0.01). The IPTW analysis also replicated the findings (OR 0.33; 95% CI, 0.16–0.71; P=0.004 during the 7–12 months post-surgery period).
Conclusion
In this population-based study of 207 adults with obesity and HCM, bariatric surgery was associated with a lower risk of acute cardiovascular events in the 7–12 months post-surgery period in real-world settings.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Health (USA) and American Heart Association
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Affiliation(s)
- S Miyashita
- Tufts Medical Center, Boston, United States of America
| | - Y Zhao
- Columbia University Medical Center, New York, United States of America
| | - K Hasegawa
- Massachusetts General Hospital - Harvard Medical School, Boston, United States of America
| | - M Maurer
- Columbia University Medical Center, New York, United States of America
| | - M Fifer
- Massachusetts General Hospital - Harvard Medical School, Boston, United States of America
| | - M Reilly
- Columbia University Medical Center, New York, United States of America
| | - H Takayama
- Columbia University Medical Center, New York, United States of America
| | - Y J Shimada
- Columbia University Medical Center, New York, United States of America
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Wada H, Shinozaki T, Suzuki M, Sakagami S, Ajiro Y, Funada J, Matsuda M, Shimizu M, Takenaka T, Morita Y, Yonezawa K, Kotani K, Abe M, Akao M, Hasegawa K. Impact of atrial fibrillation on soluble fms-like tyrosine kinase-1 and cardiovascular events in patients with suspected or known coronary artery disease: the EXCEED-J study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1390] [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: 11/14/2022] Open
Abstract
Abstract
Background
Soluble fms-like tyrosine kinase-1 (sFlt-1), a vascular endothelial growth factor (VEGF) antagonist, has been suggested as a marker of endothelial dysfunction. Circulating sFlt-1 levels are associated with adverse outcomes in patients with preeclampsia, chronic kidney disease, and heart failure. Atrial fibrillation (AF) and coronary artery disease (CAD) are both associated with endothelial dysfunction. However, whether sFlt-1 can predict cardiovascular (CV) events and whether AF modifies the relationship between sFlt-1 and CV events in patients with suspected or known CAD are unknown.
Methods
We performed a nationwide, multicenter, prospective cohort study to determine the prognostic value of sFlt-1 and other biomarkers in patients with suspected or known CAD undergoing elective angiography. Heparin-free fasting serum was collected from the peripheral vein to determine levels of sFlt-1, VEGF, placental growth factor, cystatin C, neutrophil gelatinase-associated lipocalin, N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin-I (hs-cTnI), and high-sensitivity C-reactive protein (hs-CRP). The primary outcome was 3-point major adverse CV events (3P-MACE) defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all-cause death, CV death, and 5P-MACE defined as a composite of 3P-MACE, heart failure hospitalization, and coronary/peripheral artery revascularization.
Results
3311 patients were consecutively enrolled between Nov 2013 and May 2017. After excluding 56 ineligible patients, 3255 patients (324 AF and 2931 non-AF) were followed up over 3 years (follow-up rate, 99%). During the follow-up, 156 patients developed 3P-MACE, 215 died from any cause, 82 died from cardiovascular disease, and 1361 developed 5P-MACE. The sFlt-1 level was significantly higher in AF compared to non-AF patients (p<0.001). Stepwise regression analysis revealed that the sFlt-1 level was independently associated with AF. After adjusting for potential clinical confounders, serum levels of sFlt-1, NT-proBNP, hs-cTnI and cystatin C, but not other biomarkers, were significantly associated with 3P-MACE in the entire cohort. These associations were still significant in non-AF patients, whereas only the sFlt-1 level was significantly associated with 3P-MACE in AF patients. Serum levels of sFlt-1, but not other biomarkers, were also significantly associated with CV death in AF patients. Among the biomarkers, only the hs-CRP level was significantly associated with all-cause death, and no biomarker was significantly associated with 5P-MACE in AF patients. Furthermore, sFlt-1 provided an incremental prognostic information for 3P-MACE to the model with potential clinical confounders in AF, but not in non-AF patients.
Conclusions
Serum levels of sFlt-1 were significantly associated with 3P-MACE in patients with suspected or known CAD. This association was pronounced in AF patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The EXCEED-J study is supported by Health Labour Sciences Research Grant (2013-2014), AMED (2015-2017, Grant Number JP17ek0210008) and Grant-in-Aid for Clinical Research from the National Hospital Organization (2018-2020).
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Wako, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - K Kotani
- Jichi Medical University,, Shimotsuke, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Shimada YJ, Raita Y, Liang LW, Maurer MS, Hasegawa K, Fifer MA, Reilly MP. Comprehensive proteomics profiling reveals molecular pathways that are differentially regulated in hypertrophic cardiomyopathy and correlate with clinical markers of disease severity. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1777] [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: 11/14/2022] Open
Abstract
Abstract
Background
Hypertrophic cardiomyopathy (HCM) is caused by mutations in the genes coding for proteins essential in normal myocardial contraction. However, it remains unclear through which molecular pathways gene mutations mediate the development and progression of HCM.
Purpose
To determine protein biomarkers and molecular pathways that are differentially regulated in HCM and correlated with disease severity.
Methods
We conducted a multicenter case-control study of cases with HCM and controls with hypertensive left ventricular hypertrophy. We carried out plasma proteomics profiling of 1681 proteins using the SOMAscan assay. We performed a sparse partial least squares discriminant analysis to develop a proteomics-based discrimination model with data from 1 institution (i.e., the training set). We tested the discriminative ability in independent samples from the other institutions (i.e., the test set). We executed pathway analysis using significantly dysregulated proteins with Bonferroni-corrected p<0.05. Pathways with false discovery rate (FDR) <0.05 and dysregulation of ≥5 member proteins were declared positive. In HCM, we also identified proteins with significant correlation with clinical markers of disease severity (e.g., New York Heart Association [NYHA] class, left atrial diameter) and performed pathway analysis.
Results
The study included 266 cases and 167 controls (n=308 in the training set; n=125 in the test set). Using the proteomics-based model derived from the training set, the area under the receiver-operating-characteristic curve was 0.89 (95% confidence interval [CI] 0.83–0.94, p<0.001) in the test set (Figure). The sensitivity was 0.84 (95% CI 0.76–0.92) and the specificity was 0.78 (95% CI 0.66–0.90). A total of 508 proteins were significantly associated with the disease status. As shown in the Table, pathway analysis revealed that the Ras-MAPK pathway, along with its upstream and downstream (e.g., Rap1, PI3K-Akt) pathways, was upregulated in HCM (FDR <0.001). Pathways involved in inflammation and fibrosis – e.g., the TGF-β pathway – were also found to be upregulated in HCM. In patients with HCM, 207 out of the 1681 proteins were significantly correlated with NYHA functional class. This number is more than twice as large as what would be expected by chance (i.e., 84 proteins at α=0.05 level). Pathway analysis of these 207 proteins showed upregulation of the Ras-MAPK and related pathways – e.g., PI3K-Akt, Rap1, and TNF. Similarly, 264 of the 1681 proteins were correlated with left atrial diameter in HCM. Pathway analysis of the 264 proteins revealed upregulation of the MAPK and the PI3K-Akt pathways.
Conclusions
This multicenter case-control study with independent validation serves as the largest-scale investigation with the most comprehensive proteomics profiling in HCM, exhibiting both novel (e.g., Ras-MAPK) and known (e.g., TGF-β) pathways that are differentially regulated in HCM and correlated with disease severity.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Health and American Heart Association Figure 1. ROC curveTable 1. Differentially regulated pathways
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Affiliation(s)
- Y J Shimada
- Columbia University Medical Center, New York, United States of America
| | - Y Raita
- Massachusetts General Hospital, Boston, United States of America
| | - L W Liang
- Columbia University Medical Center, New York, United States of America
| | - M S Maurer
- Columbia University Medical Center, New York, United States of America
| | - K Hasegawa
- Massachusetts General Hospital, Boston, United States of America
| | - M A Fifer
- Massachusetts General Hospital, Boston, United States of America
| | - M P Reilly
- Columbia University Medical Center, New York, United States of America
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Lander BS, Zhao Y, Hasegawa K, Maurer MS, Fifer MA, Reilly MP, Shimada YJ. Comprehensive proteomics profiling identifies patients with late gadolinium enhancement on cardiac magnetic resonance imaging in the hypertrophic cardiomyopathy population. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1764] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) represents myocardial fibrosis. In patients with hypertrophic cardiomyopathy (HCM), LGE on CMR has been associated with an increased risk of sudden cardiac death (SCD), which can be prevented with implantable cardioverter-defibrillators. Yet, CMR is expensive, resource-intensive, and, in certain patients, contraindicated. Therefore, it is important to determine which patients with HCM have a high pre-test probability of LGE on CMR. Proteomics profiling is a recently developed technology that simultaneously measures thousands of protein concentrations in plasma with a single blood draw. To date, no studies have examined the ability of proteomics profiling to identify which patients with HCM are more likely to have LGE on CMR.
Purpose
To test the hypothesis that plasma proteomics profiling can distinguish patients with and without LGE on CMR in the HCM population.
Methods
We performed a multicenter case-control (i.e., LGE vs. no LGE) study of 147 patients with HCM who underwent CMR between July 2006 and October 2020. We carried out plasma proteomics profiling of 4979 proteins using the SOMAscan assay. Using the 17 most discriminant proteins, we performed logistic regression analysis with elastic net regularization to develop a discrimination model with data from 1 institution (the training set; n=111) and tested the discriminative ability in independent samples from the other institution (the test set; n=36). We calculated the area under the receiver-operating-characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Furthermore, we performed pathway analysis of proteins that were differentially regulated between patients with and without LGE with p<0.05.
Results
The mean age was 57 years and 67% were male. Overall, 82 of the 147 patients (56%) had LGE on CMR. The AUC of the 17-protein model was 0.83 (95% CI, 0.75–0.90) in the training set and 0.71 in the independent test set for validation (95% CI, 0.54–0.88; Figure). The sensitivity, specificity, PPV, and NPV are shown in the Figure. The pathway analysis revealed that multiple signaling pathways were dysregulated in patients with LGE (Table). The list included signaling pathways that have been previously associated with myocardial fibrosis (e.g., pathways related to inflammation) and previously unrecognized pathways (e.g., glycolysis, amino acid metabolism).
Conclusions
In this multicenter study of 147 patients with HCM, comprehensive proteomics profiling identified a panel of 17 plasma protein biomarkers to specify patients with LGE on CMR and revealed associated signaling pathways. This 17-protein plasma protein biomarker panel would help physicians specify patients with LGE, in whom CMR is more likely to change the clinical management of HCM.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Health, USA
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Affiliation(s)
- B S Lander
- Columbia University Medical Center, Division of Cardiology, Department of Medicine, New York, United States of America
| | - Y Zhao
- Columbia University Medical Center, Department of Surgery, New York, United States of America
| | - K Hasegawa
- Massachusetts General Hospital - Harvard Medical School, Department of Emergency Medicine, Boston, United States of America
| | - M S Maurer
- Columbia University Medical Center, Division of Cardiology, Department of Medicine, New York, United States of America
| | - M A Fifer
- Massachusetts General Hospital - Harvard Medical School, Cardiology Division, Department of Medicine, Boston, United States of America
| | - M P Reilly
- Columbia University Medical Center, Division of Cardiology, Department of Medicine, New York, United States of America
| | - Y J Shimada
- Columbia University Medical Center, Division of Cardiology, Department of Medicine, New York, United States of America
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Colombo N, Dubot C, Lorusso D, Cáceres V, Hasegawa K, Shapira-Frommer R, Tewari K, Salman P, Hoyos E, Yañez E, Gumus M, Olivera Hurtado de Mendoza M, Samouëlian V, Castonguay V, Arkhipov A, Toker S, Li K, Keefe S, Monk B. LBA2 Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for persistent, recurrent, or metastatic cervical cancer: Randomized, double-blind, phase III KEYNOTE-826 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2108] [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: 10/20/2022] Open
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Hasegawa K, Nishikawa T, Hirakawa A, Kawasaki M, Tomatsuri S, Nagasaka Y, Nakamura K, Matsumoto K, Mori M, Hirashima Y, Takehara K, Ariyoshi K, Kato T, Yagishita S, Hamada A, Yoshida H, Yonemori K. 813P Efficacy and safety of trastuzumab deruxtecan in HER2-expressing uterine carcinosarcoma (STATICE trial, NCCH1615): A multicenter, phase II clinical trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Yagishita S, Nishikawa T, Yoshida H, Shintani D, Sato S, Miwa M, Suzuki M, Yasuda M, Yonemori K, Hasegawa K, Hamada A. 1767P Co-clinical PDX study of trastuzumab deruxtecan in HER2-positive uterine carcinosarcoma (STATICE trial, NCCH1615). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1711] [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: 11/25/2022] Open
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47
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Takayama T, Yamazaki S, Matsuyama Y, Midorikawa Y, Shiina S, Izumi N, Hasegawa K, Kokudo N, Sakamoto M, Kubo S, Kudo M, Murakami T, Nakashima O. Prognostic grade for resecting hepatocellular carcinoma: multicentre retrospective study. Br J Surg 2021; 108:412-418. [PMID: 33793713 DOI: 10.1093/bjs/znaa109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/31/2020] [Accepted: 11/03/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Surgical treatment for hepatocellular carcinoma (HCC) is advancing, but a robust prediction model for survival after resection is not available. The aim of this study was to propose a prognostic grading system for resection of HCC. METHODS This was a retrospective, multicentre study of patients who underwent first resection of HCC with curative intent between 2000 and 2007. Patients were divided randomly by a cross-validation method into training and validation sets. Prognostic factors were identified using a Cox proportional hazards model. The predictive model was built by decision-tree analysis to define the resection grades, and subsequently validated. RESULTS A total of 16 931 patients from 795 hospitals were included. In the training set (8465 patients), four surgical grades were classified based on prognosis: grade A1 (1236 patients, 14.6 per cent; single tumour 3 cm or smaller and anatomical R0 resection); grade A2 (3614, 42.7 per cent; single tumour larger than 3 cm, or non-anatomical R0 resection); grade B (2277, 26.9 per cent; multiple tumours, or vascular invasion, and R0 resection); and grade C (1338, 15.8 per cent; multiple tumours with vascular invasion and R0 resection, or R1 resection). Five-year survival rates were 73.9 per cent (hazard ratio (HR) 1.00), 64.7 per cent (HR 1.51, 95 per cent c.i. 1.29 to 1.78), 50.6 per cent (HR 2.53, 2.15 to 2.98), and 34.8 per cent (HR 4.60, 3.90 to 5.42) for grades A1, A2, B, and C respectively. In the validation set (8466 patients), the grades had equivalent reproducibility for both overall and recurrence-free survival (all P < 0.001). CONCLUSION This grade is used to predict prognosis of patients undergoing resection of HCC.
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Affiliation(s)
- T Takayama
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - S Yamazaki
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Y Matsuyama
- Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Y Midorikawa
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - S Shiina
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - N Izumi
- Department of Gastroenterology, Musashino Red Cross Hospital, Tokyo, Japan
| | - K Hasegawa
- Department of Hepato-biliary-pancreatic Surgery, School of Medicine, University of Tokyo, Tokyo, Japan
| | - N Kokudo
- Department of Hepato-biliary-pancreatic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Sakamoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - S Kubo
- Department of Hepato-biliary-pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan
| | - T Murakami
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - O Nakashima
- Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan
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Takeda M, Shimokawa M, Nakamura A, Nosaki K, Watanabe Y, Kato T, Hayakawa D, Tanaka H, Takahashi T, Kogure Y, Tachihara M, Fujimoto D, Yamaguchi K, Hamaguchi N, Okamoto I, Azuma K, Hasegawa K, Yamamoto N, Nakagawa K. A Phase II Study to Assess the Efficacy of Osimertinib in Patients With EGFR Mutation-positive NSCLC Who Developed Isolated CNS Progression (T790M-negative or Unknown) During First- or Second-generation EGFR-TKI or Systemic Disease Progression (T790M-negative) After Treatment With First- or Second-generation EGFR-TKI and Platinum-based Chemotherapy (WJOG12819L). Clin Lung Cancer 2021; 22:376-380. [PMID: 33612406 DOI: 10.1016/j.cllc.2020.12.009] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/04/2020] [Accepted: 12/12/2020] [Indexed: 01/30/2023]
Abstract
Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that has recently been established as a standard treatment option for chemotherapy-naive patients with EGFR mutation-positive non-small-cell lung cancer (NSCLC). However, only about one-half of patients who have received prior treatment with a first- or second-generation EGFR-TKI are eligible for osimertinib therapy because its indication in the second-line setting is limited to metastatic NSCLC positive for the T790M resistance mutation of EGFR. The dose-escalation part of a study in which patients received osimertinib at doses of 20 to 240 mg once daily after the development of resistance to first- or second-generation EGFR-TKIs revealed a response rate of 21% and a median progression-free survival of 2.8 months for individuals whose tumors were negative for EGFR T790M. We have now designed a phase II study of osimertinib for patients with EGFR mutation-positive NSCLC who develop isolated central nervous system progression (T790M-negative or unknown) after first- or second-generation EGFR-TKI therapy (cohort 1) or who develop systemic disease progression (T790M-negative) after first- or second-generation EGFR-TKI therapy and platinum-based chemotherapy (cohort 2). A total of 70 patients (cohort 1, n = 17; cohort 2, n = 53) will be enrolled in this study, which originated from a suggestion of a dedicated network for patients with lung cancer in Japan.
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Affiliation(s)
- Masayuki Takeda
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan.
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube City, Yamaguchi, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Kaname Nosaki
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Yasutaka Watanabe
- Division of Thoracic Oncology, Saitama Cancer Center, Ina-machi, Kitaadachi-gun, Saitama, Japan
| | - Terufumi Kato
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Daisuke Hayakawa
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Hiroshi Tanaka
- Department of Internal Medicine, Niigata Cancer Center Hospital, Chuo-ku, Niigata City, Niigata, Japan
| | - Toshiaki Takahashi
- Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Shizuoka, Japan
| | - Yoshihito Kogure
- Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Naka-ku, Nagoya, Japan
| | - Motoko Tachihara
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Daichi Fujimoto
- Internal Medicine III, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Kakuhiro Yamaguchi
- Department of Respiratory Medicine, Hiroshima University Hospital, Minami-ku, Hiroshima, Japan
| | - Naohiko Hamaguchi
- Departmentof Cardiology, Pulmonology, Hypertension, and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kazuo Hasegawa
- Onestep Lung Cancer Patient Network, ONE STEP, Tokyo, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
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Dzitko H, Cara P, Carin Y, Chel S, Facco A, Gex D, Hasegawa K, Kasugai A, Kondo K, Massaut V, Molla J, Phillips G, Pisent A, Sakamoto K, Sugimoto M. Status and future developments of the Linear IFMIF Prototype Accelerator (LIPAc). Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shimizu H, Takahama T, Kaneda H, Horinouchi H, Yoshida T, Watanabe K, Hasegawa K, Onishi K, Yoshimura K, Sawa T, Gemma A. MO16-3 Results of the first survey using EORTC QLQ INFO25 on information acquisition and satisfaction of lung cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.603] [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: 10/20/2022] Open
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