Updated on 2024/03/13

写真a

 
TANAKA Akihito
 
Organization
Nagoya University Hospital Cardiology Assistant Professor
Graduate School
Graduate School of Medicine
Title
Assistant Professor
External link

Degree 1

  1. 医学博士 ( 2018.3   名古屋大学 ) 

Education 1

  1. Nagoya University   Faculty of Medicine

    - 2004.3

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    Country: Japan

 

Papers 203

  1. Refractory atrial tachycardia after transcatheter closure of an atrial septal defect, successfully treated by catheter ablation with transseptal approach via the side of the device Reviewed International journal

    Hiramatsu K., Tanaka A., Furusawa K., Inden Y., Murohara T.

    Journal of Cardiology Cases     2024

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Journal of Cardiology Cases  

    Atrial tachyarrhythmias occurring after transcatheter atrial septal defect closure are not uncommon; however, those related to device stimulation are rare. Herein, a case involving a 24-year-old female, who developed drug-refractory atrial tachycardia during the early postoperative period, is reported. The results of electroanatomical mapping could eventually be obtained from both atria. They revealed a focal pattern, and the earliest site was located on the left atrial side of the superior atrial septum, between the left and right atrial discs of the device. An ablation catheter was inserted through the side of the device into the left atrial septum, and cauterization successfully achieved recovery of the sinus rhythm without device dislodgement. Learning objective: Atrial tachyarrhythmia related to mechanical stimulation with an atrial septal defect closure device in the early perioperative period is a rare complication. Catheter ablation with transseptal approach through the side of the device might be an option, although careful attention should be paid to the risk for device dislodgement.

    DOI: 10.1016/j.jccase.2024.02.007

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  2. Clinical features, future cardiac events, and prognostic factors following percutaneous coronary intervention in young female patients Reviewed International journal

    Tatami Y., Tanaka A., Ohashi T., Kubota R., Kaneko S., Shinoda M., Uemura Y., Takagi K., Tanaka M., Umemoto N., Tashiro H., Shibata N., Yoshioka N., Watarai M., Morishima I., Takada Y., Shimizu K., Ishii H., Murohara T.

    Heart and Vessels     2024

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Heart and Vessels  

    Background: The proportion of young females among the patients who undergo percutaneous coronary intervention (PCI) is relatively small, and information on their clinical characteristics is limited. This study investigated the clinical characteristics and prognostic factors for future cardiac events in young females who underwent PCI. Methods: This multicenter observational study included 187 consecutive female patients aged < 60 years who underwent PCI in seven hospitals. The primary composite endpoint was the incidence of cardiac death, nonfatal myocardial infarction, and target vessel revascularization. Results: The mean patient age was 52.1 ± 6.1 years and 89 (47.6%) had diabetes, and renal dysfunction (an estimated glomerular filtration rate < 60 mL/min/1.73 m2) was observed in 38 (20.3%). During a median follow-up of 3.3 years, the primary endpoint occurred in 28 patients. The Cox proportional hazards models showed that renal dysfunction was an independent predictor for the primary endpoint (hazard ratio 3.04, 95% confidence interval 1.25–7.40, p = 0.01), as well as multivessel disease (hazard ratio 2.79, 95% confidence interval 1.12–6.93, p = 0.03). Patients with renal dysfunction had a significantly higher risk for the primary endpoint than those without renal dysfunction. Conclusions: Renal dysfunction was strongly associated with future cardiac events in young females who underwent PCI.

    DOI: 10.1007/s00380-024-02369-7

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  3. Can a new biomarker complement the current diagnostic gap in the management of patients with suspected acute coronary syndrome? Invited Reviewed International journal

    Tanaka A., Ishii H.

    International Journal of Cardiology   Vol. 393   page: 131390   2023.12

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    Authorship:Lead author, Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:International Journal of Cardiology  

    DOI: 10.1016/j.ijcard.2023.131390

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  4. Impact of proteinuria on long-term prognosis in patients with coronary artery disease Reviewed International journal

    Funakubo H., Tanaka A., Tobe A., Kunieda T., Kubota Y., Yoshioka N., Otsuka S., Kudo N., Shirai Y., Furusawa K., Ishii H., Murohara T.

    Journal of Cardiovascular Medicine   Vol. 24 ( 12 ) page: 900 - 905   2023.12

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Journal of Cardiovascular Medicine  

    BackgroundThis study aimed to investigate the association between proteinuria and long-term prognosis in patients with coronary artery disease.MethodsThis was a single-center observational study. A total of 1351 patients were identified who underwent percutaneous coronary intervention, and whose urine data were available. Patients were divided into two groups according to the presence (n = 245) or absence (n = 1106) of proteinuria. All-cause and cardiovascular deaths were primarily evaluated.ResultsThe prevalence rates of hypertension and diabetes were significantly higher, and the baseline estimated glomerular filtration rate (eGFR) was lower in patients with proteinuria than in those without proteinuria. During the median follow-up of 4.1 years (interquartile range, 1.7-6.8 years), the occurrences of all-cause and cardiovascular deaths were significantly higher in patients with proteinuria. Multivariable Cox regression analysis indicated that the presence of proteinuria was a significant predictor of cardiovascular death as well as age, BMI, reduced eGFR, and left ventricular ejection fraction. When stratified into four groups based on eGFR category (eGFR <60 or ≥60 ml/min/1.73 m2) and absence or presence of proteinuria, the incidence rates of all-cause and cardiovascular deaths were highest in patients with proteinuria and eGFR less than 60 ml/min/1.73 m2. Furthermore, the incidence rates of all-cause and cardiovascular deaths were significantly higher in patients with proteinuria among both diabetic and nondiabetic patients.ConclusionProteinuria is associated with the long-term prognosis, and all-cause and cardiovascular deaths in patients with coronary artery disease, regardless of eGFR and the presence or absence of diabetes mellitus.

    DOI: 10.2459/JCM.0000000000001573

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  5. Lethal ventricular arrhythmia due to entrectinib-induced Brugada syndrome: a case report and literature review Reviewed

    Futamura Keisuke, Hase Tetsunari, Tanaka Akihito, Sakai Yoshinori, Okachi Shotaro, Shibata Hirofumi, Ushijima Futoshi, Hashimoto Takahiko, Nakashima Kuniya, Ito Katsuki, Yamamoto Takanori, Numaguchi Atsushi, Inden Yasuya, Ishii Makoto

    INTERNATIONAL CANCER CONFERENCE JOURNAL   Vol. 12 ( 4 ) page: 299 - 304   2023.10

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  6. Author's reply.

    Iwama M, Noda T, Takagi K, Tanaka A, Murohara T

    Journal of cardiology     2023.9

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    Language:English  

    DOI: 10.1016/j.jjcc.2023.08.015

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  7. 特集 血行再建の適応を見直そう 診る4b 血行再建適応を考えるb.急性冠症候群

    田中 哲人

    Heart View   Vol. 27 ( 7 ) page: 640 - 644   2023.7

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    Authorship:Lead author, Corresponding author   Language:Japanese   Publisher:メディカルレビュー社  

    DOI: 10.18885/hv.0000001275

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  8. Executive Summary ― Acute Coronary Syndrome in the Japan Resuscitation Council Guidelines for Resuscitation 2020 ― Reviewed

    Kikuchi Migaku, Tahara Yoshio, Yamaguchi Junichi, Nakashima Takahiro, Nomura Osamu, Tanaka Akihito, Kojima Sunao, Hashiba Katsutaka, Nakayama Naoki, Hanada Hiroyuki, Mano Toshiaki, Yamamoto Takeshi, Matsuo Kunihiro, Takeuchi Ichiro, Matoba Tetsuya, Nonogi Hiroshi, for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

    Circulation Journal   Vol. 87 ( 6 ) page: 866 - 878   2023.5

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    Language:English   Publisher:The Japanese Circulation Society  

    DOI: 10.1253/circj.cj-23-0096

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  9. Ischemic and Bleeding Outcomes in Patients Who Underwent Percutaneous Coronary Intervention With Chronic Kidney Disease or Dialysis (from a Japanese Nationwide Registry) Reviewed International journal

    Tobe A., Sawano M., Kohsaka S., Ishii H., Tanaka A., Numasawa Y., Amano T., Nakamura M., Ikari Y., Murohara T.

    American Journal of Cardiology   Vol. 195   page: 37 - 44   2023.5

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:American Journal of Cardiology  

    The relation between chronic kidney disease (CKD) and outcomes in patients receiving percutaneous coronary intervention (PCI) is thought to be bidirectional; these patients are at a higher risk of ischemic and bleeding events. From a Japanese nationwide PCI registry, ischemic (cardiovascular death, nonfatal myocardial infarction, or nonfatal ischemic stroke) and bleeding events (fatal or nonfatal major bleeding) 1 year after discharge among patients who had second- or newer-generation drug-eluting stent implantation were analyzed. Patients on oral anticoagulants were excluded. Patients were stratified according to their preprocedural renal function: CKD stages 1 to 2 (estimated glomerular filtration rate [eGFR] ≥60 ml/min/1.73 m2), 3 (eGFR 30 to 59), or 4 to 5 (eGFR <30), or those receiving dialysis. Overall, 23,349 patients, including 2,798 patients with CKD 3 to 5 (12.0%) and 1,464 patients on dialysis (6.3%), were investigated. One-year ischemic events were observed in 1.5%, 5.2%, 9.7%, and 5.3% in the CKD stages 1-to-2, 3, 4-to-5, and dialysis groups, respectively; patients with CKD stages 3 or 4 to 5 and those receiving dialysis were associated with higher risks of ischemic events after adjustment of covariates than were patients without CKD. Compared with ischemic events, 1-year bleeding events were low, with incidence rates of 1.5%, 2.0%, 3.4%, and 2.3%, respectively. Furthermore, the presence of CKD or dialysis was not associated with a higher risk of bleeding events after adjustment of covariates. In conclusion, in the contemporary nationwide PCI registry, the presence of CKD and dialysis was independently associated with a higher risk of ischemic events but not with bleeding events, and this suggests a need to alter the models of care delivery in these patients.

    DOI: 10.1016/j.amjcard.2023.02.027

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  10. Clinical implications of the cardio-ankle vascular index before and after transcatheter aortic valve implantation. Reviewed

    Miki Y, Tanaka A, Tokuda Y, Tobe A, Shirai Y, Yuhara S, Akita S, Furusawa K, Ishii H, Mutsuga M, Murohara T

    Journal of cardiovascular medicine (Hagerstown, Md.)   Vol. 24 ( 5 ) page: 302 - 307   2023.5

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)  

    DOI: 10.2459/JCM.0000000000001456

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  11. Relationship between the volume of cases and in-hospital mortality in patients with cardiogenic shock receiving short-term mechanical circulatory support. Reviewed International journal

    Araki T, Kondo T, Imaizumi T, Sumita Y, Nakai M, Tanaka A, Okumura T, Yang M, Butt JH, Petrie MC, Murohara T

    American heart journal     2023.4

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    Language:English   Publishing type:Research paper (scientific journal)  

    DOI: 10.1016/j.ahj.2023.03.017

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  12. Impact of right coronary artery dominance on the long-term mortality in the patients with acute Total/ subtotal occlusion of unprotected left Main coronary artery. Reviewed

    Iwama M, Noda T, Takagi K, Tanaka A, Uemura Y, Umemoto N, Shibata N, Negishi Y, Ohashi T, Tanaka M, Yoshida R, Shimizu K, Tashiro H, Yoshioka N, Morishima I, Watarai M, Tanaka T, Tatami Y, Takada Y, Ishii H, Murohara T, N-registry investigators

    Journal of cardiology     2023.4

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    DOI: 10.1016/j.jjcc.2023.04.003

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  13. JCS/CVIT/JCC 2023 Guideline Focused Update on Diagnosis and Treatment of Vasospastic Angina (Coronary Spastic Angina) and Coronary Microvascular Dysfunction

    Hokimoto Seiji, Kaikita Koichi, Yasuda Satoshi, Tsujita Kenichi, Ishihara Masaharu, Matoba Tetsuya, Matsuzawa Yasushi, Mitsutake Yoshiaki, Mitani Yoshihide, Murohara Toyoaki, Noda Takashi, Node Koichi, Noguchi Teruo, Suzuki Hiroshi, Takahashi Jun, Tanabe Yasuhiko, Tanaka Atsushi, Tanaka Nobuhiro, Teragawa Hiroki, Yasu Takanori, Yoshimura Michihiro, Asaumi Yasuhide, Godo Shigeo, Ikenaga Hiroki, Imanaka Takahiro, Ishibashi Kohei, Ishii Masanobu, Ishihara Takayuki, Matsuura Yunosuke, Miura Hiroyuki, Nakano Yasuhiro, Ogawa Takayuki, Shiroto Takashi, Soejima Hirofumi, Takagi Ryu, Tanaka Akihito, Taruya Akira, Tsuda Etsuko, Wakabayashi Kohei, Yokoi Kensuke, Minamino Toru, Nakagawa Yoshihisa, Sueda Shozo, Shimokawa Hiroaki, Ogawa Hisao, on behalf of the Japanese Circulation Society and Japanese Association of Cardiovascular Intervention and Therapeutics and Japanese College of Cardiology Joint Working Group

    Circulation Journal   Vol. advpub ( 0 )   2023.3

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    Language:English   Publisher:The Japanese Circulation Society  

    DOI: 10.1253/circj.cj-22-0779

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  14. Prognosis in Patients With Cardiogenic Shock Who Received Temporary Mechanical Circulatory Support. International journal

    Toru Kondo, Takashi Araki, Takahiro Imaizumi, Yoko Sumita, Michikazu Nakai, Akihito Tanaka, Takahiro Okumura, Jawad H Butt, Mark C Petrie, John J V McMurray, Toyoaki Murohara

    JACC. Asia   Vol. 3 ( 1 ) page: 122 - 134   2023.2

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    BACKGROUND: Temporary mechanical circulatory support (MCS) is often used in patients with cardiogenic shock (CS), and the type of MCS may vary by cause of CS. OBJECTIVES: This study sought to describe the causes of CS in patients receiving temporary MCS, the types of MCS used, and associated mortality. METHODS: This study used a nationwide Japanese database to identify patients receiving temporary MCS for CS between April 1, 2012, and March 31, 2020. RESULTS: Of 65,837 patients, the cause of CS was acute myocardial infarction (AMI) in 77.4%, heart failure (HF) in 10.9%, valvular disease in 2.7%, fulminant myocarditis (FM) in 2.5%, arrhythmia in 4.5%, and pulmonary embolism (PE) in 2.0% of cases. The most commonly used MCS was an intra-aortic balloon pump alone in AMI (79.2%) and in HF (79.0%) and in valvular disease (66.0%), extracorporeal membrane oxygenation with intra-aortic balloon pump in FM (56.2%) and arrhythmia (43.3%), and extracorporeal membrane oxygenation alone in PE (71.5%). Overall in-hospital mortality was 32.4%; 30.0% in AMI, 32.6% in HF, 33.1% in valvular disease, 34.2% in FM, 60.9% in arrhythmia, and 59.2% in PE. Overall in-hospital mortality increased from 30.4% in 2012 to 34.1% in 2019. After adjustment, valvular disease, FM, and PE had lower in-hospital mortality than AMI: valvular disease, OR: 0.56 (95% CI: 0.50-0.64); FM: OR: 0.58 (95% CI: 0.52-0.66); PE: OR: 0.49 (95% CI: 0.43-0.56); whereas HF had similar in-hospital mortality (OR: 0.99; 95% CI: 0.92-1.05) and arrhythmia had higher in-hospital mortality (OR: 1.14; 95% CI: 1.04-1.26). CONCLUSIONS: In a Japanese national registry of patients with CS, different causes of CS were associated with different types of MCS and differences in survival.

    DOI: 10.1016/j.jacasi.2022.10.004

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  15. Impact of Albuminuria on the Prognosis After Transcatheter Aortic Valve Implantation Reviewed International journal

    Tobe A., Tanaka A., Tokuda Y., Shirai Y., Miyazaki T., Yuhara S., Akita S., Furusawa K., Ishii H., Mutsuga M., Murohara T.

    American Journal of Cardiology   Vol. 186   page: 156 - 162   2023.1

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:American Journal of Cardiology  

    The impact of preoperative albuminuria on the prognosis after transcatheter aortic valve implantation (TAVI) has not been studied. A total of 228 patients who underwent TAVI for severe aortic stenosis (AS) and for whom preoperative urinary data was available were retrospectively investigated. Patients were divided into two groups according to the urinary albumin-to-creatinine ratio (ACR): high (ACR≥ 30 mg/g) and low (ACR<30 mg/g). The urinary total protein-to-creatinine ratio (PCR) and dipstick proteinuria were also evaluated. The primary outcome was the composite outcome of all-cause death and readmission for heart failure. In total, 117 patients had a high ACR and 111 patients had a low ACR. During the median follow-up period of 467 days, patients with a high ACR had a higher incidence of the primary outcome than those with a low ACR (p<0.001). Patients with a high PCR or positive dipstick proteinuria were also at a higher risk for the primary outcome (p<0.001 and p=0.008, respectively). Multivariable Cox proportional hazards analysis showed a high ACR was independently associated with a primary outcome (hazard ratio, 4.98; 95% confidence interval, 1.84–13.49; p=0.002). In conclusion, preoperative albuminuria is an independent predictor of cardiac events in patients with severe AS undergoing TAVI.

    DOI: 10.1016/j.amjcard.2022.09.020

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  16. Impact of C-Reactive Protein on Long-Term Cardiac Events in Stable Coronary Artery Disease Patients with Chronic Kidney Disease Reviewed

    Tokuda Kotaro, Tanaka Akihito, Tobe Akihiro, Shirai Yoshinori, Kurobe Masanari, Kubota Yoshiaki, Kunieda Takeshige, Miyazaki Tatsuya, Mizutani Koji, Furusawa Kenji, Ishii Hideki, Murohara Toyoaki

    Journal of Atherosclerosis and Thrombosis   Vol. advpub ( 0 )   2023

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Japan Atherosclerosis Society  

    <p><b>Aim: </b>Chronic inflammation is associated with atherosclerosis development. Chronic kidney disease (CKD) is an independent risk factor for cardiovascular events and is associated with chronic inflammation. We aimed to investigate the influence of C-reactive protein (CRP), an important marker of inflammation, on the clinical outcomes of patients with CKD and stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).<b> </b></p><p><b>Methods: </b>Among patients with stable CAD and CKD who underwent PCI, 516 patients whose CRP levels were available before the PCI procedure were identified. The patients were divided into two groups according to the CRP levels: those with CRP ≥ 2.0 mg/L (high-CRP group) and those with CRP <2.0 mg/L (low-CRP group). The primary endpoint of this study was the occurrence of major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, and unplanned revascularization.<b> </b></p><p><b>Results: </b>Overall, the mean age of the patients was 72.5±9.7 years, and 20.7% were female. The median CRP level was 1.43 mg/L (0.6–4.9 mg/L). The median follow-up period was 3.6 years. The occurrence of MACE was significantly higher in the high-CRP group than in the low-CRP group (log-rank <i>p</i><0.001). Notably, the incidence rate of cardiac death was significantly higher in the high-CRP group (log-rank <i>p</i><0.001). According to the multivariable analysis, CRP level ≥ 2.0 mg/L was found to be a significant predictor of MACE (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.04–2.28, <i>p</i>=0.003), as well as estimated glomerular filtration rate (HR: 0.98, 95% CI: 0.97–0.99, <i>p</i><0.01).<b> </b></p><p><b>Conclusion: </b>High-CRP levels adversely affect long-term cardiac events in patients with stable CAD and CKD.</p>

    DOI: 10.5551/jat.64047

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  17. Comparative study of fractional flow reserve and diastolic pressure ratio using a guidewire with a sensor for measuring intravascular pressure Reviewed International journal

    Kojima Hiroki, Ishii Hideki, Tanaka Akihito, Funakubo Hiroshi, Kato Toshiaki, Shimbo Yusaku, Kawamiya Toshiki, Kuwatsuka Yachiyo, Ando Masahiko, Murohara Toyoaki

    MEDICINE   Vol. 101 ( 52 ) page: e32578   2022.12

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    Purpose: This study aimed to evaluate the correlation and diagnostic agreement between diastolic pressure ratio (dPR) and fractional flow reserve (FFR) in a Japanese real-world setting. Design: Prospective multicenter observational study Methods: This study included 100 patients with intermediate coronary artery stenosis at 4 Japanese hospitals. For these lesions, FFR and dPR were measured using a guidewire with a sensor and a monitor to measure intravascular pressure. The correlation and diagnostic agreement between FFR and dPR were assessed. When both FFR and dPR were negative or positive, the results were considered to be concordant. When one was positive and the other was negative, the result was regarded as discordant (positive discordance, FFR > 0.80 and dPR ≤ 0.89; negative discordance, FFR ≤ 0.80 and dPR > 0.89). Results: Overall, the FFR and dPR were well-correlated (R = 0.841). FFR and dPR were concordant in 89% of cases (concordant normal, 43%; concordant abnormal, 46%) and discordant in 11% (positive discordance, 7%; negative discordance, 4%). No significant difference was observed in the rate of concordant results between patients with and without diabetes mellitus. The diagnostic concordance rate was significantly different among the 3 coronary arteries (right coronary artery, 93.3%; left anterior descending artery, 93.2%; and left circumflex artery, 58.3%; P = .001). Additionally, the rate of concordant results tended to be higher when using intravenous administration of adenosine than when using intracoronary bolus injection of nicorandil (adenosine, 95.1%; nicorandil, 84.7%; P = .103). Conclusion: We found that dPR was highly correlated with FFR, and diagnostic discordance was observed in 11% of the lesions. Several factors, including lesion location and medication for hyperemia, may cause the diagnostic discordance between dPR and FFR.

    DOI: 10.1097/MD.0000000000032578

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  18. Prehospital Administration of Aspirin and Nitroglycerin for Patients With Suspected Acute Coronary Syndrome ― A Systematic Review ― Reviewed

    Nakayama Naoki, Yamamoto Takeshi, Kikuchi Migaku, Hanada Hiroyuki, Mano Toshiaki, Nakashima Takahiro, Hashiba Katsutaka, Tanaka Akihito, Matsuo Kunihiro, Nomura Osamu, Kojima Sunao, Yamaguchi Junichi, Matoba Tetsuya, Tahara Yoshio, Nonogi Hiroshi, for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

    Circulation Reports   Vol. 4 ( 10 ) page: 449 - 457   2022.10

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    <p><b><i>Background:</i></b> Recent guidelines for acute coronary syndrome (ACS) recommend prehospital administration of aspirin and nitroglycerin for ACS patients. However, there is no clear evidence to support this. We investigated the benefits and harms of prehospital administration of aspirin and nitroglycerin by non-physician healthcare professionals in patients with suspected ACS.</p><p><b><i>Methods and Results:</i></b> We searched the PubMed database and used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence. Three retrospective studies for aspirin and 1 for nitroglycerin administered in the prehospital setting to patients with acute myocardial infarction were included. Prehospital aspirin administration was associated with significantly lower 30-day and 1-year mortality compared with aspirin administration after arrival at hospital, with odds ratios (OR) of 0.59 (95% confidence interval [CI] 0.35–0.99) and 0.47 (95% CI 0.36–0.62), respectively. Prehospital nitroglycerin administration was also associated with significantly lower 30-day and 1-year mortality compared with no prehospital administration (OR 0.34 [95% CI 0.24–0.50] and 0.38 [95% CI 0.29–0.50], respectively). The certainty of evidence was very low in both systematic reviews.</p><p><b><i>Conclusions:</i></b> Our systematic reviews suggest that prehospital administration of aspirin and nitroglycerin by non-physician healthcare professionals is beneficial for patients with suspected ACS, although the certainty of evidence is very low. Further investigation is needed to determine the benefit of the prehospital administration of these agents.</p>

    DOI: 10.1253/circrep.cr-22-0060

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  19. The ridge line of left pulmonary vein isolation from left atrial appendage can subsequently increase the completion rate of the mitral isthmus block line Reviewed

    Hori Hitomi, Kaneko Shinji, Fujita Masaya, Nagai Shin, Ito Ryota, Shirai Yoshinori, Adachi Kentaro, Suzuki Noriyuki, Suzuki Junya, Kondo Kiyota, Yamauchi Ryota, Haga Tomoaki, Tatami Yosuke, Ohashi Taiki, Kubota Ryuji, Shinoda Masanori, Tanaka Akihito, Inden Yasuya, Murohara Toyoaki

    JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY     2022.10

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    Background and objectives: Mitral isthmus (MI) ablation for mitral flutter is technically difficult, and incomplete block line is not uncommon. The objective of this study is to investigate the effect of the ridge line of left pulmonary vein isolation (LPVI) from left atrial appendage (LAA) on completion rate of mitral isthmus (MI) block line and recurrence rate of atrial tachycardia (AT) or atrial flutter (AFL) after the first MI ablation. Methods: We identified 611 patients who underwent first MI ablation for mitral flutter during the study period. Finally, 559 patients were enrolled and divided into two groups according to the method of ridge line ablation of LPVI (LAA group, n = 467, conventional group, n = 92). Outcome measures were the completion of MI block line by first MI ablation, the recurrence of AT/AFL, and repeat MI ablation after the first MI ablation. Results: The first MI block line completion rate was significantly higher in the LAA group than the conventional group (95% vs. 85%, p < 0.001). The recurrence rate of AT/AFL after 3 months from first MI ablation was significantly lower in the LAA group. The requirement of additional MI ablation tended to be lower in the LAA group. Conclusions: Our novel approach of ablating LPV-LAA ridge from the LAA side during PVI can increase the success rate of MI block line completion, and reduce the recurrence rate of AT/AFL and the need for additional MI block line ablation. [Figure not available: see fulltext.].

    DOI: 10.1007/s10840-022-01382-y

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  20. Prehospital Activation of the Catheterization Laboratory Among Patients With Suspected ST-Elevation Myocardial Infarction Outside of a Hospital ― Systematic Review and Meta-Analysis ― Reviewed

    Hashiba Katsutaka, Nakashima Takahiro, Kikuchi Migaku, Kojima Sunao, Hanada Hiroyuki, Mano Toshiaki, Yamamoto Takeshi, Tanaka Akihito, Yamaguchi Junichi, Matsuo Kunihiro, Nakayama Naoki, Nomura Osamu, Matoba Tetsuya, Tahara Yoshio, Nonogi Hiroshi, for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

    Circulation Reports   Vol. 4 ( 9 ) page: 393 - 398   2022.9

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    <p><b><i>Background:</i></b> In the management of patients with ST-elevation myocardial infarction (STEMI), system delays for reperfusion therapy are still a matter of concern. We investigated the impact of prehospital activation of the catheterization laboratory in the management of STEMI patients.</p><p><b><i>Methods and Results:</i></b> This is a systematic review of observational studies. A search was conducted of the PubMed database from inception to July 2020 to identify articles for inclusion in the study. The critical outcomes were short- and long-term mortality. The important outcome was door-to-balloon time. The GRADE approach was used to assess the certainty of the evidence. Seven studies assessed short-term mortality; 1,541 were assigned to the prehospital activation (PH) group and 1,191 were assigned to the emergency department activation (ED) group. There were 26 fewer deaths per 1,000 patients in the PH group. Three studies assessed long-term mortality; 713 patients were assigned to the PH group and 1,026 were assigned to the ED group. There were 54 fewer deaths per 1,000 patients among the PH group. Five studies assessed door-to-balloon time; 959 were assigned to the PH group and 631 to the ED group. Door-to-balloon time was 33.1 min shorter in the PH group.</p><p><b><i>Conclusions:</i></b> Prehospital activation of the catheterization laboratory resulted in lower mortality and shorter door-to-balloon time for patients with suspected STEMI outside of a hospital.</p>

    DOI: 10.1253/circrep.cr-22-0034

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  21. Incidence and predictors of frailty progression among octogenarians with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention Reviewed International journal

    Tashiro H., Tanaka A., Takagi K., Uemura Y., Inoue Y., Umemoto N., Negishi Y., Shibata N., Yoshioka N., Shimizu K., Morishima I., Watarai M., Asano H., Ishii H., Murohara T.

    Archives of Gerontology and Geriatrics   Vol. 102   page: 104737   2022.9

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    Background: Frailty is one of the most serious health problems in older individuals with cardiovascular disease. Moreover, frailty progression is associated with subsequent adverse outcomes; therefore, the prevention of frailty progression is an important clinical issue. However, the incidence and predictors of frailty progression following acute myocardial infarction have not yet been fully elucidated. Methods: The present study is a sub-analysis of an observational multicenter registry retrospectively evaluating clinical outcomes of 288 octogenarians who underwent primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) between January 2014 and December 2016 at five hospitals. We identified 244 patients who survived until discharge and evaluated frailty at baseline and discharge using the Clinical Frailty Scale (CFS). We defined frailty progression as an increase of at least one level in the CFS score at discharge from baseline and assessed the predictors of frailty progression. Results: Frailty progression was observed in 29.5% of patients. Patients with frailty progression were older, had more severe conditions with a higher prevalence of Killip 4 status and mechanical circulatory support use, more frequently experienced in-hospital events such as stroke (4/72, 6% vs. 0/172, 0%, p = 0.007), and had longer hospital stays than those without frailty progression [19 (11–35) vs. 13 (9–19) days, p<0.01]. Multivariate analysis showed that age (odds ratio 1.08, 95% confidence interval 1.00–1.17, p = 0.046) and Killip 4 status at baseline (odds ratio 3.34, 95% confidence interval 1.26–8.85, p = 0.01) were significant predictors of frailty progression. Conclusions: In-hospital frailty progression was commonly observed in octogenarians with STEMI who underwent primary PCI and survived until discharge, and was associated with more severe clinical conditions.

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  22. Long-term outcomes of percutaneous revascularization for internal mammary artery-left anterior descending artery bypass failure Reviewed International journal

    Yamaguchi Shogo, Uemura Yusuke, Tanaka Akihito, Takagi Kensuke, Ohashi Taiki, Tanaka Miho, Umemoto Norio, Yoshida Ruka, Negishi Yosuke, Iwama Makoto, Takemoto Kenji, Watarai Masato, Kudo Nobutaka, Morishima Itsuro, Tatami Yosuke, Takada Yasunobu, Shimizu Kiyokazu, Yoshida Yukihiko, Tanaka Toshikazu, Noda Toshiyuki, Ishii Hideki, Murohara Toyoaki

    HEART AND VESSELS     2022.8

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    Despite the excellent long-term results of internal mammary artery (IMA)–left anterior descending (LAD) bypass, percutaneous revascularization of IMA is sometimes required for IMA-LAD bypass failure. However, its clinical outcomes have not been fully elucidated. The aim of this study was to investigate the long-term clinical outcomes, including target lesion revascularization (TLR) following contemporary percutaneous revascularization of failed IMA bypass graft. We examined data of 59 patients who had undergone percutaneous revascularization of IMA due to IMA-LAD bypass failure at nine hospitals. Patients with IMA graft used for Y-composite graft or sequential bypass graft were excluded. The incidence of TLR was primarily examined, whereas other clinical outcomes including cardiac death, myocardial infarction, and target vessel revascularization were also evaluated. Mean age of the enrolled patients was 67.4 ± 11.3 years, and 74.6% were men. Forty patients (67.8%) had anastomotic lesions, and 17 (28.8%) underwent revascularization within three months after bypass surgery. Procedural success was achieved in 55 (93.2%) patients. Stent implantation was performed in 13 patients (22.0%). During a median follow-up of 1401 days (interquartile range, 282–2521 days), TLR was required in six patients (8.5% at 1, 3, and 5 years). Patients who underwent percutaneous revascularization within 3 months after surgery tended to have a higher incidence of TLR. Clinical outcomes of IMA revascularization for IMA-LAD bypass failure were acceptable.

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  23. Supplemental Oxygen and Acute Myocardial Infarction ― A Systematic Review and Meta-Analysis ― Reviewed

    Kojima Sunao, Yamamoto Takeshi, Kikuchi Migaku, Hanada Hiroyuki, Mano Toshiaki, Nakashima Takahiro, Hashiba Katsutaka, Tanaka Akihito, Yamaguchi Junichi, Matsuo Kunihiro, Nakayama Naoki, Nomura Osamu, Matoba Tetsuya, Tahara Yoshio, Nonogi Hiroshi, for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

    Circulation Reports   Vol. 4 ( 8 ) page: 335 - 344   2022.8

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    <p><b><i>Background:</i></b> In Japan, oxygen is commonly administered during the acute phase of myocardial infarction (MI) to patients without oxygen saturation monitoring. In this study we assessed the effects of supplemental oxygen therapy, compared with ambient air, on mortality and cardiac events by synthesizing evidence from randomized controlled trials (RCTs) of patients with suspected or confirmed acute MI.</p><p><b><i>Methods and Results:</i></b> PubMed was systematically searched for full-text RCTs published in English before June 21, 2020. Two reviewers independently screened the search results and appraised the risk of bias. The estimates for each outcome were pooled using a random-effects model. In all, 2,086 studies retrieved from PubMed were screened. Finally, 7,322 patients from 9 studies derived from 4 RCTs were analyzed. In-hospital mortality in the oxygen and ambient air groups was 1.8% and 1.6%, respectively (risk ratio [RR] 0.90; 95% confidence interval [CI] 0.38–2.10]); 0.8% and 0.5% of patients, respectively, experienced recurrent MI (RR 0.44; 95% CI 0.12–1.54), 1.5% and 1.6% of patients, respectively, experienced cardiac shock (RR 1.10; 95% CI 0.77–1.59]), and 2.4% and 2.0% of patients, respectively, experienced cardiac arrest (RR 0.91; 95% CI 0.43–1.94).</p><p><b><i>Conclusions:</i></b> Routine supplemental oxygen administration may not be beneficial or harmful, and high-flow oxygen may be unnecessary in normoxic patients in the acute phase of MI.</p>

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  24. Systematic Review and Meta-Analysis of Diagnostic Accuracy to Identify ST-Segment Elevation Myocardial Infarction on Interpretations of Prehospital Electrocardiograms

    Tanaka Akihito, Matsuo Kunihiro, Kikuchi Migaku, Kojima Sunao, Hanada Hiroyuki, Mano Toshiaki, Nakashima Takahiro, Hashiba Katsutaka, Yamamoto Takeshi, Yamaguchi Junichi, Nakayama Naoki, Nomura Osamu, Matoba Tetsuya, Tahara Yoshio, Nonogi Hiroshi, for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

    Circulation Reports   Vol. 4 ( 7 ) page: 289 - 297   2022.7

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    <p><b><i>Background:</i></b> The aim of this study was to assess and discuss the diagnostic accuracy of prehospital ECG interpretation through systematic review and meta-analyses.</p><p><b><i>Methods and Results:</i></b> Relevant literature published up to July 2020 was identified using PubMed. All human studies of prehospital adult patients suspected of ST-segment elevation myocardial infarction in which prehospital electrocardiogram (ECG) interpretation by paramedics or computers was evaluated and reporting all 4 (true-positive, false-positive, false-negative, and true-negative) values were included. Meta-analyses were conducted separately for the diagnostic accuracy of prehospital ECG interpretation by paramedics (Clinical Question [CQ] 1) and computers (CQ2). After screening, 4 studies for CQ1 and 6 studies for CQ2 were finally included in the meta-analysis. Regarding CQ1, the pooled sensitivity and specificity were 95.5% (95% confidence interval [CI] 82.5–99.0%) and 95.8% (95% CI 82.3–99.1%), respectively. Regarding CQ2, the pooled sensitivity and specificity were 85.4% (95% CI 74.1–92.3%) and 95.4% (95% CI 87.3–98.4%), respectively.</p><p><b><i>Conclusions:</i></b> This meta-analysis suggests that the diagnostic accuracy of paramedic prehospital ECG interpretations is favorable, with high pooled sensitivity and specificity, with an acceptable estimated number of false positives and false negatives. Computer-assisted ECG interpretation showed high pooled specificity with an acceptable estimated number of false positives, whereas the pooled sensitivity was relatively low.</p>

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  25. Large interventricular membranous septal aneurysm renders the anatomy unsuitable for transcatheter aortic valve replacement Reviewed International journal

    Shirai Yoshinori, Tanaka Akihito, Tokuda Yoshiyuki, Tobe Akihiro, Furusawa Kenji, Usui Akihiko, Murohara Toyoaki

    JOURNAL OF CARDIAC SURGERY   Vol. 37 ( 7 ) page: 2103 - 2104   2022.7

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    An interventricular membranous septal aneurysm, though rare, can coexist with aortic valve stenosis. In this report, we present an unsuitable anatomy for transcatheter aortic valve replacement (TAVR) due to large interventricular membranous septal aneurysm. This case suggests that the feasibility of TAVR would depend on the location and size of the aneurysm and its relationship with the aortic root.

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  26. Percutaneous Treatment for Venous Stenosis Caused by a Vascular Closure Device Reviewed

    Tachi M., Tanaka A., Riku S., Furuta T., Tobe A., Hayashi K., Murohara T.

    Cardiovascular Revascularization Medicine   Vol. 40   page: 157 - 158   2022.7

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    Vascular closure devices (VCDs) are widely used as an alternative to manual compression of femoral puncture sites. In this report, we present a 73-year-old man who developed symptomatic venous stenosis related to VCD after pulmonary vein isolation. We performed percutaneous treatment with balloon angioplasty. This case suggests that balloon angioplasty with proper safety measures can be an option for treating venous stenosis related to VCDs.

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  27. Performance of the 0-Hour/1-Hour Algorithm for Diagnosing Myocardial Infarction in Patients With Chest Pain in the Emergency Department ― A Systematic Review and Meta-Analysis ― Reviewed

    Nomura Osamu, Hashiba Katsutaka, Kikuchi Migaku, Kojima Sunao, Hanada Hiroyuki, Mano Toshiaki, Yamamoto Takeshi, Nakashima Takahiro, Tanaka Akihito, Nakayama Naoki, Yamaguchi Junichi, Matsuo Kunihiro, Matoba Tetsuya, Tahara Yoshio, Nonogi Hiroshi, for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

    Circulation Reports   Vol. 4 ( 6 ) page: 241 - 247   2022.6

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    <p><b><i>Background:</i></b> This study assessed the diagnostic performance of the 0-hour/1-hour (0/1-h) algorithm to rule in and rule out acute myocardial infarction (MI) in patients presenting to the emergency department (ED) for suspected acute coronary syndrome without ST-segment elevation, as recommended in the 2015 European Society of Cardiology (ESC) guideline.</p><p><b><i>Methods and Results:</i></b> Following the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy (PRISMA-DTA) guidelines, a systematic review was conducted using the PubMed database from inception to March 31, 2020. We included any article published in English investigating the diagnostic performance of the ESC 0/1-h algorithm for diagnosing MI in patients with chest pain visiting the ED. Of 651 studies identified as potentially available for the study, 7 studies including 16 databases were analyzed. A meta-analysis of the diagnostic accuracy of the 0/1-h algorithm using high-sensitivity cardiac troponin I (hs-cTn) with 6 observational databases showed a pooled sensitivity of 99.3% (95% confidence interval [CI] 98.5–99.7%) and a pooled specificity of 90.1% (95% CI 80.7–95.2%). A meta-analysis of the diagnostic accuracy of 10 observational databases of the ESC 0/1-h algorithm using hs-cTn revealed a pooled sensitivity of 99.3% (95% CI 96.9–99.9%) and a pooled specificity of 91.7% (95% CI 83.5–96.1%).</p><p><b><i>Conclusions:</i></b> Our results demonstrate that the ESC 0/1-h algorithm can effectively rule in and rule out patients with non-ST-segment elevation MI.</p>

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  28. Impact of Prehospital 12-Lead Electrocardiography and Destination Hospital Notification on Mortality in Patients With Chest Pain ― A Systematic Review ― Reviewed

    Nakashima Takahiro, Hashiba Katsutaka, Kikuchi Migaku, Yamaguchi Junichi, Kojima Sunao, Hanada Hiroyuki, Mano Toshiaki, Yamamoto Takeshi, Tanaka Akihito, Matsuo Kunihiro, Nakayama Naoki, Nomura Osamu, Matoba Tetsuya, Tahara Yoshio, Nonogi Hiroshi, for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

    Circulation Reports   Vol. 4 ( 5 ) page: 187 - 193   2022.5

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    <p><b><i>Background:</i></b> To achieve early reperfusion therapy for ST-elevation myocardial infarction (STEMI), proper and prompt patient transportation and activation of the catheterization laboratory are required. We investigated the efficacy of prehospital 12-lead electrocardiogram (ECG) acquisition and destination hospital notification in patients with STEMI.</p><p><b><i>Methods and Results:</i></b> This is a systematic review of observational studies. We searched the PubMed database from inception to March 2020. Two reviewers independently performed literature selection. The critical outcome was short-term mortality. The important outcome was door-to-balloon (D2B) time. We used the GRADE approach to assess the certainty of the evidence. For the critical outcome, 14 studies with 29,365 patients were included in the meta-analysis. Short-term mortality was significantly lower in the group with prehospital 12-lead ECG acquisition and destination hospital notification than in the control group (odds ratio 0.72; 95% confidence interval [CI] 0.61–0.85; P<0.0001). For the important outcome, 10 studies with 2,947 patients were included in the meta-analysis. D2B time was significantly shorter in the group with prehospital 12-lead ECG acquisition and destination hospital notification than in the control group (mean difference −26.24; 95% CI −33.46, −19.02; P<0.0001).</p><p><b><i>Conclusions:</i></b> Prehospital 12-lead ECG acquisition and destination hospital notification is associated with lower short-term mortality and shorter D2B time than no ECG acquisition or no notification among patients with suspected STEMI outside of a hospital.</p>

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  29. Albuminuria predicts worsening renal function after transcatheter aortic valve replacement Reviewed International journal

    Akihiro Tobe, Akihito Tanaka, Yoshiyuki Tokuda, Taro Fujii, Kenji Furusawa, Hideki Ishii, Akihiko Usui, Toyoaki Murohara

    Journal of Cardiology   Vol. 79 ( 5 ) page: 648 - 654   2022.5

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  30. Very long-term clinical outcomes after percutaneous coronary intervention for complex vs non-complex lesions: 10-year outcomes following sirolimus-eluting stent implantation Reviewed

    Riku Shuro, Suzuki Susumu, Yokoi Tsuyoshi, Sakaguchi Teruhiro, Yamamoto Toshihiko, Jinno Yasushi, Tanaka Akihito, Ishii Hideki, Inden Yasuya, Murohara Toyoaki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 84 ( 2 ) page: 352 - 365   2022.5

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    Few studies have reported the long-term outcomes (>10 years) following first-generation drug-eluting stent implantation. In this single-center retrospective study, we investigated the very long-term clinical outcomes after first-generation sirolimus-eluting stent (SES) implantation in patients with complex lesions. The study included 383 consecutive patients who underwent initial SES implantation between July 2004 and January 2006; 84 and 299 of these patients reported a history of percutaneous coronary intervention (PCI) for complex and noncomplex lesions, respectively. Complex PCI was defined as having at least one of the following features: left main trunk PCI, implantation of ≥3 stents, bifurcation lesions with implantation of 2 stents, total stent length >60 mm, or chronic total occlusion. The target lesion revascularization (TLR) rate was significantly higher in the complex PCI than in the noncomplex PCI group (29.4% vs 13.0%, P=0.001), and we observed a significant intergroup difference in the late TLR (>1 year) rates (21.6% vs 9.5%, P=0.008). Late TLR continued over 10 years at a rate of 2.4%/year in the complex PCI and 1.1%/year in the noncomplex PCI group. Cox regression analysis revealed that complex PCI was related to TLR both over 10 years (hazard ratio 2.29, P=0.003) and beyond 1 year (hazard ratio 2.32, P=0.01). Cardiac death was more common in the complex PCI than in the noncomplex PCI group, particularly 4 years after PCI (15.8% vs 7.5%, P=0.031). Sudden death was the major cause of cardiac death beyond 4 years in the complex PCI group. These data indicate that long-term careful follow-up is essential for patients implanted with SES, especially those treated for complex lesions.

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  31. Clinical outcomes and predictors of restenosis in patients with femoropopliteal artery disease treated using polymer-coated paclitaxel-eluting stents or drug-coated balloons Reviewed

    Naoki Yoshioka, Takahiro Tokuda, Akio Koyama, Takehiro Yamada, Ryusuke Nishikawa, Kiyotaka Shimamura, Kensuke Takagi, Yasuhiro Morita, Akihito Tanaka, Hideki Ishii, Itsuro Morishima, Toyoaki Murohara

    Heart and Vessels   Vol. 37 ( 4 ) page: 555 - 566   2022.4

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  32. Effects of Door-In to Door-Out Time on Mortality Among ST-Segment Elevation Myocardial Infarction Patients Transferred for Primary Percutaneous Coronary Intervention ― Systematic Review and Meta-Analysis ― Reviewed

    Yamaguchi Junichi, Matoba Tetsuya, Kikuchi Migaku, Minami Yuichiro, Kojima Sunao, Hanada Hiroyuki, Mano Toshiaki, Nakashima Takahiro, Hashiba Katsutaka, Yamamoto Takeshi, Tanaka Akihito, Matsuo Kunihiro, Nakayama Naoki, Nomura Osamu, Tahara Yoshio, Nonogi Hiroshi, for the Japan Resuscitation Council (JRC) Acute Coronary Syndrome (ACS) Task Force and the Guideline Editorial Committee on Behalf of the Japanese Circulation Society (JCS) Emergency and Critical Care Committee

    Circulation Reports   Vol. 4 ( 3 ) page: 109 - 115   2022.3

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    <p><b><i>Background:</i></b>Primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is now widely accepted. Recent guidelines have focused on total ischemic time, because shorter total ischemic time is associated with a more favorable prognosis. The door-in to door-out (DIDO) time, defined as time from arrival at a non-PCI-capable hospital to leaving for a PCI-capable hospital, may affect STEMI patient prognosis. However, a relevant meta-analysis is lacking.</p><p><b><i>Methods and Results:</i></b>We searched PubMed for clinical studies comparing short-term (30-day and in-hospital) mortality rates of STEMI patients undergoing primary PCI with DIDO times of ≤30 vs. >30 min. Two investigators independently screened the search results and extracted the data. Random effects estimators with weights calculated by the inverse variance method were used to determine pooled risk ratios. The search retrieved 1,260 studies; of these, 2 retrospective cohort studies (15,596 patients) were analyzed. In the DIDO time ≤30 and >30 min groups, the primary endpoint (i.e., in-hospital or 30-day mortality) occurred for 51 of 1,794 (2.8%) and 831 of 13,802 (6.0%) patients, respectively. The incidence of the primary endpoint was significantly lower in the DIDO time ≤30 min group (odds ratio 0.45; 95% confidence interval 0.34–0.60).</p><p><b><i>Conclusions:</i></b>Our findings suggest that a DIDO time ≤30 min is associated with a lower short-term mortality rate. However, further larger systematic reviews and meta-analyses are needed to validate our findings.</p>

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  33. Fifteen-Year Mortality and Cardiac, Thrombotic, and Bleeding Events in Survivors of ST-Elevation Myocardial Infarction Reviewed

    Kensuke Takagi, Akihito Tanaka, Itsuro Morishima, Yasuhiro Morita, Naoki Yoshioka, Ruka Yoshida, Yasunori Kanzaki, Naoki Watanabe, Ryota Yamauchi, Shotaro Komeyama, Hiroki Sugiyama, Kazuki Shimojo, Takuro Imaoka, Gaku Sakamoto, Takuma Ohi, Hiroki Goto, Hideki Ishii, Toyoaki Murohara

    Cardiovascular Revascularization Medicine   Vol. 36   page: 43 - 50   2022.3

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  34. Bedside cannulation for veno-venous extracorporeal membrane oxygenation using portable X-ray system in a coronavirus disease patient Reviewed

    Kondo T., Kuwayama T., Hiraiwa H., Kasugai D., Goto Y., Numaguchi A., Katsu T., Matsui T., Hashimoto N., Tanaka A., Morimoto R., Okumura T., Murohara T.

    Journal of Cardiology Cases   Vol. 25 ( 3 ) page: 185 - 187   2022.3

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    Transportation of patients with coronavirus disease (COVID)-19 outside isolation rooms should be avoided to prevent further spread of the disease. Here, we report a safe and accurate bedside cannulation method for veno-venous extracorporeal membrane oxygenation (VV-ECMO) in a COVID-19 patient in the intensive care unit. A 71-year-old man was admitted to our hospital and diagnosed as having COVID-19 pneumonia. We decided to initiate VV-ECMO therapy because maintaining blood oxygen saturation was difficult despite the mechanical ventilation. We placed two flat-panel detectors behind the patient's chest and the right inguinal area. We repeatedly imaged and monitored insertion of wires and cannulas using a portable X-ray system. Cannulas were successfully inserted in the appropriate position, and VV-ECMO was initiated without any complications. <Learning objective: Transportation of patients with coronavirus disease outside isolation rooms carries the risk of further spread of the disease. By repeatedly acquiring images using a portable X-ray system, safe and accurate cannulation for veno-venous extracorporeal membrane oxygenation cannulation can be performed at the bedside in the intensive care unit.>

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  35. Albuminuria predicts short-term worsening renal function after transcatheter aortic valve replacement Reviewed International journal

    Akihiro Tobe, Akihito Tanaka, Yoshiyuki Tokuda, Yoshinori Shirai, Satoshi Otsuka, Toshikuni Yamamoto, Masayoshi Tokoro, Kenji Furusawa, Hideki Ishii, Akihiko Usui, Toyoaki Murohara

    Cardiovascular Revascularization Medicine   Vol. 42   page: 178 - 181   2022.3

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  36. Assessment of appropriate body mass index cut-off points for long-term mortality among ST-elevation myocardial infarction survivors in Asian population using machine learning algorithm Reviewed International journal

    Naoki Yoshioka, Kensuke Takagi, Akihito Tanaka, Yasuhiro Morita, Ruka Yoshida, Hiroaki Nagai, Yasunori Kanzaki, Naoki Watanabe, Ryota Yamauchi, Shotaro Komeyama, Hiroki Sugiyama, Kazuki Shimojo, Takuro Imaoka, Gaku Sakamoto, Takuma Ohi, Hiroki Goto, Hideki Ishii, Itsuro Morishima, Toyoaki Murohara

    Heart and Vessels   Vol. 37 ( 2 ) page: 219 - 228   2022.2

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  37. Computed tomography imaging using split-bolus contrast injection with volume scan of aortic root and heart for preoperative evaluation of transcatheter aortic valve implantation Reviewed

    Koyanagi Hitomi, Tsutsumi Yoshinori, Tokuda Yoshiyuki, Tanaka Akihito, Endo Maki, Furukawa Yasushi, Abe Shinji

    HEART AND VESSELS   Vol. 37 ( 1 ) page: 132 - 141   2022.1

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    The purpose of this study was to investigate using split-bolus contrast injection (SPBI) with volume scanning of the heart and aortic root with helical scanning of the access route, compared to single bolus contrast injection (SI) with variable helical pitch scanning (VHP) of the heart and aortic root and access route in a preoperative evaluation before transcatheter aortic valve implantation (TAVI). Thirty-five patients who underwent preoperative CT before TAVI using SPBI (contrast media: 24.5 mgI /kg/s, injected for 12 s for heart scan and then injected for 8 s for access route) were examined. Electrocardiogram (ECG) gated scans of the heart were performed by volume scan, after a period of time, non-gated helical scans of the aorto-iliac were performed (SPBI method). For comparison, 40 patients who had a single bolus injection (26.5 mg I/kg/s, injected for period of the scan time plus 3 s) and a VHP scan (SI method) before the SPBI method was performed were included in the study. The image qualities of the coronary arteries, aortic root, and access route (aorta-iliac), as well as radiation and iodine doses, were assessed. In visual assessment, image quality of coronary artery was significantly better with the SPBI method (grade; excellent: 57.1% in SPBI vs. 24.3% in SI, p = 0.03). There was no significant difference in image quality of the aortic root by visual assessment. The signal-to-noise (SNR) and contrast-to-noise ratio (CNR) of coronary and aortic root were not significantly different between the two methods. The access route showed significantly higher SNR (45.7 ± 11.5 vs. 34.3 ± 9.8, p < 0.001) and CNR (36.0 ± 9.7 vs. 28.0 ± 8.8, p < 0.001) for the SPBI method. The SPBI method compared to SI method reduced iodine dose by 10% and radiation dose by 45%. Preoperative CT imaging before TAVI using SPBI with volume scan is useful and can reduce iodine and radiation doses.

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  38. Clinical Significance of the Left Atrial Appendage Orifice Area Reviewed

    Yusuke Miki, Yasuhiro Uchida, Akihito Tanaka, Akihiro Tobe, Keisuke Sakakibara, Takashi Kataoka, Kiyoshi Niwa, Kenji Furusawa, Hitoshi Ichimiya, Junji Watanabe, Masaaki Kanashiro, Hideki Ishii, Satoshi Ichimiya, Toyoaki Murohara

    Internal Medicine   Vol. 61 ( 12 ) page: 1801 - 1807   2022

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    <p><b>Objective </b>The left atrial appendage (LAA) is one of the major sources of cardiac thrombus formation. Three-dimensional transesophageal echocardiography (TEE) made it possible to perform a detailed evaluation of the LAA morphologies. This study aimed to evaluate the clinical implications of the LAA orifice area. </p><p><b>Methods </b>A total of 149 patients who underwent TEE without significant valvular disease were studied. The LAA orifice area was measured using three-dimensional TEE. The patients were divided into two groups according to the LAA orifice area (large LAA orifice group, ≥median value, and small LAA orifice group). The clinical characteristics and echocardiographic findings were evaluated. </p><p><b>Results </b>The median LAA orifice area among all patients was 4.09 cm<sup>2</sup> (interquartile range 2.92-5.40). The large LAA orifice group were older (67.2±10.4 vs. 62.4±15.3 years, p=0.02), more often had hypertension (66.7% vs. 44.6%, p=0.007), and atrial fibrillation (70.7% vs. 39.2%, p<0.001) than the small LAA orifice group. Regarding the TEE findings, the LAA flow velocity was significantly lower (33.7±20.0 vs. 50.2±24.3, p<0.001) and spontaneous echo contrast was more often observed (21.3% vs. 8.1%, p=0.02) in the large LAA orifice group. Multivariate models demonstrated that atrial fibrillation was an independent predictor of the LAA orifice area. In the analysis of atrial fibrillation duration, the LAA orifice area tended to be larger as patients had a longer duration of atrial fibrillation. </p><p><b>Conclusion </b>Our findings indicated that a larger LAA orifice area was associated with the presence of atrial fibrillation and high thromboembolic risk based on TEE findings. A continuation of the atrial fibrillation rhythm might lead to the gradual expansion of the LAA orifice. </p>

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  39. Transcatheter aortic valve replacement for bicuspid aortic stenosis with a severely calcified raphe using an under-sized SAPIEN 3 valve: Sizing by the circle method and deployment by the pressure-regulated method Reviewed

    Tobe A., Tanaka A., Tokuda Y., Shirai Y., Miyazaki T., Yuhara S., Akita S., Furusawa K., Ishii H., Mutsuga M., Murohara T.

    Cardiovascular Revascularization Medicine     2022

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    Transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve stenosis is challenging, and the absence of established methods for sizing the bicuspid aortic valve (BAV) complicates TAVR. We report a case of successful TAVR for bicuspid aortic stenosis with a severely calcified raphe. We used an undersized SAPIEN 3 valve, with three safety measures based on assessment of structural characteristics, sizing by the circle method, and deployment of the valve by the pressure-regulated method.

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  40. Spontaneous dissection of left internal mammary artery graft: A case report and literature review Reviewed

    Riku S., Suzuki S., Tanaka A., Murohara T.

    Cardiovascular Revascularization Medicine     2022

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    Spontaneous left internal mammary artery (LIMA) graft dissection is a rare condition, and clinical findings remain to be elucidated. We report a case of LIMA graft dissection diagnosed by a coronary computed tomography and intravascular ultrasound. The patient was successfully treated with percutaneous intervention. We also conducted a literature review of published cases and summarized the clinical presentation, pathophysiology, diagnosis, and treatment.

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  41. Heterogeneous Carotid Plaque Predicts Cardiovascular Events after Percutaneous Coronary Intervention Reviewed

    Tobe Akihiro, Tanaka Akihito, Furusawa Kenji, Shirai Yoshinori, Funakubo Hiroshi, Otsuka Satoshi, Kubota Yoshiaki, Kunieda Takeshige, Yoshioka Naoki, Sato Sara, Kudo Nobutaka, Ishii Hideki, Murohara Toyoaki

    Journal of Atherosclerosis and Thrombosis   Vol. advpub ( 0 )   2022

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    <p><b>Aim: </b>The relationship between carotid artery ultrasound findings and clinical outcomes in patients who undergo percutaneous coronary intervention (PCI) has not been completely elucidated.<b> </b></p><p><b>Methods: </b>This single-center retrospective study investigated 691 patients who underwent PCI and carotid ultrasound testing. Maximum carotid intima-media thickness (CIMT) was defined as the greatest CIMT at the maximally thick point among the common carotid artery, carotid bulb, and internal carotid artery. A carotid plaque was defined as vessel wall thickening with a CIMT ≥ 1.5 mm. The characteristics of carotid plaque (heterogeneity, calcification, or irregular/ulcerated surface) were evaluated visually. Patients were divided into those with and without heterogeneous carotid plaque (maximum CIMT ≥ 1.5 mm and heterogeneous texture). The endpoint was the incidence of a major adverse cardiovascular event (MACE) defined as a composite of cardiovascular (CV) death, myocardial infarction, and ischemic stroke.<b> </b></p><p><b>Results: </b>Among 691 patients, 309 were categorized as having a heterogeneous plaque. Patients with heterogeneous plaques were at a higher risk of MACE than those without (<i>p</i>=0.002). A heterogeneous plaque was independently associated with MACE after adjusting for covariates (hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.01–2.90; <i>p</i>=0.046). Calcified or irregular/ulcerated plaques were correlated with a higher incidence of MACE, but both were not independently associated with MACE (HR, 1.35; 95% CI, 0.69–2.64, <i>p</i>=0.38 and HR, 0.98; 95% CI, 0.57–1.69; <i>p</i>=0.95, respectively).<b> </b></p><p><b>Conclusion: </b>The presence of a heterogeneous carotid plaque in patients who underwent PCI predicted future CV events. These patients may require more aggressive medical therapy and careful follow-up.</p>

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  42. Impact of Handgrip Strength on Clinical Outcomes after Percutaneous Coronary Intervention Reviewed

    Tobe Akihiro, Tanaka Akihito, Shirai Yoshinori, Kubota Yoshiaki, Kunieda Takeshige, Sato Sara, Furusawa Kenji, Ishii Hideki, Murohara Toyoaki

    Journal of Atherosclerosis and Thrombosis   Vol. advpub ( 0 )   2022

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    <p><b>Aim: </b>The relationship between handgrip strength (HGS) and clinical outcomes after percutaneous coronary intervention (PCI) has not yet been thoroughly investigated.<b> </b></p><p><b>Methods: </b>This was a single-center, observational study. A total of 469 patients who underwent PCI and whose periprocedural HGS was measured were included. Patients were divided into two groups: the low HGS group (men, <28 kg; women, <18 kg) and the high HGS group (men, ≥ 28 kg; women, ≥ 18 kg). The primary outcome was the composite endpoint of all-cause death, myocardial infarction (MI), and heart failure readmission.<b> </b></p><p><b>Results: </b>There were 151 patients in the low HGS group and 318 patients in the high HGS group. The age of patients in the low HGS group was significantly higher (median [interquartile range]: 78 [71–82] vs. 70 [61–75] years, <i>p</i><0.001), while the body mass index and serum albumin level were significantly lower (body mass index: 22.5 [20.2–24.3] vs. 24.3 [22.3–26.6] kg/m<sup>2</sup>, <i>p</i><0.001; serum albumin: 3.6 [3.1–3.9] vs. 4.0 [3.7–4.3] g/dL, <i>p</i>< 0.001)than those in the high HGS group. During the median follow-up period of 778 days, the low HGS group had a higher incidence of composite endpoint than the high HGS group (<i>p</i><0.001). The low HGS group had a higher risk of all-cause, cardiac, and non-cardiac death (<i>p</i><0.001). Multivariable Cox proportional hazards analysis showed that low handgrip strength was an independent predictor for the composite endpoint (hazard ratio 1.80, 95% confidence interval 1.04–3.12, <i>p</i>=0.04).<b> </b></p><p><b>Conclusions: </b>Low HGS was independently associated with adverse outcomes after PCI.</p>

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  43. Prevalence of acute coronary syndrome during the pandemic of COVID-19 in the Tokai Region of Japan Reviewed

    Kudo Nobutaka, Tanaka Akihito, Ishii Hideki, Uemura Yusuke, Takagi Kensuke, Iwama Makoto, Yoshida Ruka, Ohashi Taiki, Kawai Hideki, Negishi Yosuke, Umemoto Norio, Tanaka Miho, Watarai Masato, Yoshioka Naoki, Morishima Itsuro, Noda Toshiyuki, Yoshida Yukihiko, Tatami Yosuke, Muramatsu Takashi, Tanaka Toshikazu, Tashiro Hiroshi, Takada Yasunobu, Izawa Hideo, Watanabe Eiichi, Murohara Toyoaki

    NAGOYA JOURNAL OF MEDICAL SCIENCE   Vol. 83 ( 4 ) page: 697 - 703   2021.11

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    The outbreak of coronavirus disease 19 (COVID-19) has had a great impact on medical care. During the COVID-19 pandemic, the rate of hospital admissions has been lower and the rate of in-hospital mortality has been higher in patients with acute coronary syndrome (ACS) in Western countries. However, in Japan, it is unknown whether the COVID-19 pandemic has affected the incidence of ACS. In the study, eleven hospitals in the Tokai region participated. Among enrolled hospital, we compared the incidence of ACS during the COVID-19 pandemic (April and May, 2020) with that in equivalent months in the preceding year as the control. During the study period; April and May 2020, 248 patients with ACS were admitted. Compared to April and May 2019, a decline of 8.1% [95% confidence interval (CI) 5.2–12.1; P = 0.33] in admissions for ACS was observed between April and May 2020. There was no significant difference in the strategy for revascularization and in-hospital deaths between 2019 and 2020. In conclusion, the rate of admission for ACS slightly decreased during the COVID-19 pandemic, compared to the same months in the preceding year. Moreover, degeneration of therapeutic procedures for ACS did not occur.

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  44. Clinical Outcomes Following Emergent Percutaneous Coronary Intervention for Acute Total/Subtotal Occlusion of the Left Main Coronary Artery Reviewed

    Naoki Shibata, Norio Umemoto, Akihito Tanaka, Kensuke Takagi, Makoto Iwama, Yusuke Uemura, Yosuke Inoue, Yosuke Negishi, Taiki Ohashi, Miho Tanaka, Ruka Yoshida, Kiyokazu Shimizu, Hiroshi Tashiro, Naoki Yoshioka, Itsuro Morishima, Toshiyuki Noda, Masato Watarai, Hiroshi Asano, Toshikazu Tanaka, Yosuke Tatami, Yasunobu Takada, Hideki Ishii, Toyoaki Murohara

    Circulation Journal   Vol. 85 ( 10 ) page: 1789 - 1796   2021.9

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    <p><b><i>Background:</i></b>Data regarding the clinical features, outcomes and prognostic factors in patients presenting with acute total/subtotal occlusion of the unprotected left main coronary artery (LMCA) remain limited.</p><p><b><i>Methods and Results:</i></b>From a multi-center registry, 134 patients due to acute total/subtotal occlusion of the unprotected LMCA were reviewed. Emergency room (ER) status classification was defined according to the presence of cardiogenic shock and cardiopulmonary arrest (CPA) in the ER (class 1=no cardiogenic shock; class 2= cardiogenic shock but not CPA; and class 3=CPA). In-hospital mortality and cerebral performance category (CPC) as the endpoints were evaluated. One-half (67/134) of the enrolled patients presented with total occlusion of the unprotected LMCA. Regarding ER status classification, class 1, 2, and 3 were observed in 30.6%, 45.5%, and 23.9% of the patients, respectively. In-hospital mortality occurred in 73 (54.5%) patients; of the remaining patients, 52 (85.3%) could be discharged with a CPC 1 or 2. ER status classification (odds ratio 4.4 [95% confidence interval: 2.33–10.67]; P<0.001) and total occlusion of the unprotected LMCA (odds ratio 8.29 [95% confidence interval 2.93–23.46]; P<0.001) were strong predictors of in-hospital mortality.</p><p><b><i>Conclusions:</i></b>Acute total/subtotal occlusion involving the unprotected LMCA appeared to be associated with high in-hospital mortality. ER status classification and initial flow in the unprotected LMCA were significant predictive factors of in-hospital mortality.</p>

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  45. In-hospital mortality among consecutive patients with ST-Elevation myocardial infarction in modern primary percutaneous intervention era ~ Insights from 15-year data of single-center hospital-based registry ~ Reviewed International journal

    Kensuke Takagi, Akihito Tanaka, Naoki Yoshioka, Yasuhiro Morita, Ruka Yoshida, Yasunori Kanzaki, Naoki Watanabe, Ryota Yamauchi, Shotaro Komeyama, Hiroki Sugiyama, Kazuki Shimojo, Takuro Imaoka, Gaku Sakamoto, Takuma Ohi, Hiroki Goto, Hideki Ishii, Itsuro Morishima, Toyoaki Murohara

    PLOS ONE   Vol. 16 ( 6 ) page: e0252503 - e0252503   2021.6

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    Objective

    To clarify the association of detailed angiographic findings with in-hospital outcome after primary percutaneous coronary intervention (p-PCI) for ST-elevation myocardial infarction (STEMI) in Japan.

    Background

    Data regarding the association of detailed angiographic findings with in-hospital outcome after STEMI are limited in the p-PCI era.

    Methods

    Between January-2004 and December-2018, 1735 patients with STEMI (mean age, 68.5 years; female, 24.6%) who presented to the hospital in the 24-hours after symptom onset and underwent p-PCI were evaluated using the disease registries. The registry is an ongoing, retrospective, single-center hospital-based registry.

    Results

    The 30-day mortality rate and in-hospital mortality rate were 7.7% and 9.2%, respectively. Independent predictors of in-hospital mortality were ejection fraction (EF) &lt; 40% [adjusted Odds Ratio (aOR), 4.446, p &lt; 0.001], culprit lesions in the left coronary artery (LCA) (aOR, 2.940, p &lt; 0.001) compared with those in the right coronary artery, Killip class &gt; II (aOR, 7.438; p &lt; 0.001), chronic kidney disease (CKD) (aOR, 4.056; p &lt; 0.001), final thrombolysis in myocardial infarction (TIMI) grades 0/1/2 (aOR, 1.809; p = 0.03), absence of robust collaterals (aOR, 17.309; p = 0.01) and hypertension (aOR, 0.449; p = 0.01).

    Conclusions

    Among the consecutive patients with STEMI, the in-hospital mortality rate after p-PCI significantly improved in the second half. Not only CKD, Killip class &gt; II, and EF &lt; 40%, but also the angiographic findings such as culprit lesions in the LCA, absence of very robust collaterals, and final TIMI grades &lt;3 were associated with an increased risk of in-hospital mortality.

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  46. Clinical characteristics and treatment of Spontaneous Coronary Artery Dissection in Young Women Undergoing Percutaneous Coronary Intervention Reviewed

    Yosuke Inoue, Akihito Tanaka, Hiroshi Asano, Yusuke Uemura, Kensuke Takagi, Taiki Ohashi, Miho Tanaka, Norio Umemoto, Masayoshi Ajioka, Hiroshi Tashiro, Masato Watarai, Itsuro Morishima, Yosuke Tatami, Yasunobu Takada, Kiyokazu Shimizu, Hideki Ishii, Toyoaki Murohara

    Journal of Cardiovascular Medicine   Vol. 22 ( 1 ) page: 14 - 19   2021.1

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  47. Association between discharge destination and mid-term mortality in octogenarian patients with ST-elevation myocardial infarction Reviewed International journal

    Yoshioka, N., Takagi, K., Morishima, I., Morita, Y., Uemura, Y., Inoue, Y., Umemoto, N., Shibata, N., Negishi, Y., Yoshida, R., Tanaka, A., Asano, H., Watarai, M., Ishii, H., Murohara, T.

    Journal of Cardiology   Vol. 77 ( 2 ) page: 116 - 123   2021

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  48. Cholesterol Crystal Embolization After Transcatheter Aortic Valve Replacement Reviewed

    Nishi Toshihiko, Tokuda Yoshiyuki, Tanaka Akihito, Furusawa Kenji, Miki Yusuke, Tobe Akihiro, Murohara Toyoaki, Usui Akihiko

    Circulation Reports   Vol. 2 ( 11 ) page: 701 - 702   2020.11

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  49. Clinical outcomes following percutaneous coronary intervention for bifurcation lesions: kissing balloon inflation vs. sequential dilation Reviewed

    Hitora, Y., Teraoka, T., Tanaka, A., Uemura, Y., Tobe, A., Sakakibara, K., Miki, Y., Kataoka, T., Niwa, K., Tashiro, H., Furusawa, K., Takemoto, K., Watarai, M., Kimura, A., Ishii, H., Murohara, T.

    Cardiovascular Intervention and Therapeutics   Vol. 36 ( 4 ) page: 436 - 443   2020.11

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    DOI: 10.1007/s12928-020-00728-5

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  50. Ablation effect of additional low-speed rotational atherectomy following high-speed rotational atherectomy Reviewed International journal

    Ruka Yoshida, Hideki Ishii, Itsuro Morishima, Akihito Tanaka, Takuma Tsuda, Kensuke Takagi, Yasuhiro Morita, Takashi Kataoka, Kiyoshi Niwa, Kenji Furusawa, Naoki Yoshioka, Hideyuki Tsuboi, Toyoaki Murohara

    AsiaIntervention   Vol. 6 ( 1 ) page: 52 - 55   2020.7

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  51. Coronary Drug-Eluting Stent Infection Complicated by Coronary Artery Aneurysm and Purulent Pericarditis: Complete Resolution Without Surgery Reviewed

    Riku, S., Suzuki, S., Jinno, Y., Tanaka, A., Ishii, H., Murohara, T.

    Canadian Journal of Cardiology   Vol. 36 ( 6 ) page: 967.e1 - 967.e3   2020.6

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  52. Comparison of Anti-factor Xa Activity Among Three Different Factor Xa Inhibitors in Non-valvular Atrial Fibrillation Patients with Renal Impairment Reviewed

    Tobe, A., Osanai, H., Tanaka, A., Sakaguchi, T., Kambara, T., Nakashima, Y., Asano, H., Ishii, H., Ajioka, M., Murohara, T.

    Clinical Drug Investigation   Vol. 40 ( 6 ) page: 567 - 573   2020.6

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  53. Heparin 'flush' induced thrombocytopenia triggered by total hip replacement: a case report

    Yoshida Ruka, Tanaka Akihito, Yoshioka Naoki, Yokote Jun

    EUROPEAN HEART JOURNAL-CASE REPORTS   Vol. 4 ( 2 ) page: 1 - 5   2020.6

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    Background Heparin-induced thrombocytopenia (HIT) typically responds to heparin termination. Some types of HIT can persist after heparin discontinuation. Case summary A 95-year-old woman was referred to the cardiology from orthopaedics because of acute limb ischaemia (ALI) 1 day after surgery of a femoral neck fracture. Despite thrombectomy, ALI relapsed the next day. She had been treated with intravenous antibiotics with a diagnosis of aspiration pneumonia for 1 week until 3 days before surgery, together with heparin flush twice a day. Of note, no intra-/post-operative heparin was administered, no cell salvage device, central venous, nor arterial catheters were used before development of ALI. The patient and her family refused reattempting invasive therapies; consequently, the patient continued to worsen and died on post-operative day 3. Diagnosis of autoimmune HIT, which was prompted by surgery without re-exposure to heparin, was confirmed posthumously. Discussion This case emphasizes the significance of suspecting autoimmune HIT in any patient presenting with thrombosis, even if the heparin exposure dates back more than a few days or even without heparin exposure.

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  54. Impact of diabetes mellitus on the aortic wall changes as atherosclerosis progresses: Aortic dilatation and calcification Reviewed

    Iwakawa, N., Tanaka, A., Ishii, H., Kataoka, T., Niwa, K., Hitora, Y., Tashiro, H., Mitsuda, T., Kojima, H., Hirayama, K., Furusawa, K., Yoshida, R., Suzuki, S., Murohara, T.

    Journal of Atherosclerosis and Thrombosis   Vol. 27 ( 6 ) page: 509 - 515   2020

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    <p><b>Aim:</b> An inverse association between diabetes mellitus (DM) and aortic dilatation has recently been reported. However, little is known about the association between DM and the progression of aortic dilatation/calcification as atherosclerosis progresses.<b> </b></p><p><b>Methods: </b>We identified 216 patients who had undergone percutaneous coronary intervention (PCI) and abdominal computed tomography (CT) during the PCI and follow-up phases. The patients were classified into two groups: those with DM (DM+ group; <i>n</i>=107) and those without DM (DM− group; <i>n</i>=109). The infrarenal aortic diameter and aortic calcification index (ACI) were measured, and annual changes were calculated using measurement results obtained during the PCI and follow-up phases.<b> </b></p><p><b>Results:</b> Infrarenal aortic diameters were significantly shorter in the DM+ group than in the DM- group during the PCI phase, and no significant ACI differences were observed between the DM+ and DM− groups. The median duration between the PCI and follow-up phase CT was 3.0 years. The growth rate of the infrarenal aortic dilatation from the PCI phase in the DM+ group was similar to that in the DM− group. Annual ACI changes were significantly larger in the DM+ group than in the DM− group. Multivariate logistic regression analysis indicated that the prevalence of DM was an independent predictor of rapid aortic calcification progression (odds ratio: 2.51; 95% confidence interval: 1.23-5.14; <i>p</i>=0.01).<b> </b></p><p><b>Conclusion: </b>Our findings suggest that DM negatively affects aortic dilatation during an earlier phase of atherosclerosis progression and positively affects the progression of aortic calcification in a later phase.</p>

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  55. Reduced exercise capacity and clinical outcomes following acute myocardial infarction

    Tashiro H., Tanaka A., Ishii H., Motomura N., Arai K., Adachi T., Okajima T., Hitora Y., Hayashi M., Furusawa K., Imai H., Ogawa Y., Kawaguchi K., Murohara T.

    EUROPEAN HEART JOURNAL   Vol. 40   page: 2813 - 2813   2019.10

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  56. Accumulative impact of poor nutrition and frailty on 1-year mortality among acute decompensated heart failure patients

    Sumi T., Oguri M., Takahara K., Umemoto N., Shimizu K., Tanaka A., Ishii H., Murohara T.

    EUROPEAN HEART JOURNAL   Vol. 40   page: 1490 - 1490   2019.10

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  57. Accuracy and Safety of Newly Developed Optical-based FFR Device Compared to Conventional FFR Device

    Suzuki Akihiro, Takashima Hiroaki, Saka Yuki, Waseda Katsuhisa, Ando Hirohiko, Nakano Yusuke, Sakurai Shinichiro, Fujimoto Masanobu, Ohashi Hirofumi, Tanaka Akihito, Ishii Hideki, Amano Tetsuya

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   Vol. 73 ( 15 ) page: S68 - S68   2019.4

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  58. Saphenous Vein Graft Aneurysm 10 Years After Paclitaxel-Eluting Stent Implantation. Reviewed

    Tanaka A, Jabbour RJ, Giannini F, Latib A, Colombo A

    The Journal of invasive cardiology   Vol. 29 ( 5 ) page: E63   2017.5

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  59. A Comparison Between First-Generation and Second-Generation Transcatheter Aortic Valve Implantation (TAVI) Devices: A Propensity-Matched Single-Center Experience. Reviewed International journal

    Ruparelia N, Latib A, Kawamoto H, Buzzatti N, Giannini F, Figini F, Mangieri A, Regazzoli D, Stella S, Sticchi A, Tanaka A, Ancona M, Agricola E, Monaco F, Spagnolo P, Chieffo A, Montorfano M, Alfieri O, Colombo A

    Journal of Invasive Cardiology   Vol. 28 ( 5 ) page: 210 - 6   2016.5

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  60. Influence of the false lumen status on acute type A aortic dissection without urgent surgical repair

    Tanaka A., Ishii H., Suzuki S., Ota T., Oshima H., Usui A., Murohara T.

    EUROPEAN HEART JOURNAL   Vol. 36   page: 1161 - 1161   2015.8

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  61. Association of estimated glomerular filtration rate and proteinuria with lipid-rich plaque in coronary artery disease Reviewed

    Shimbo, Y., Suzuki, S., Ishii, H., Shibata, Y., Tatami, Y., Harata, S., Osugi, N., Ota, T., Tanaka, A., Shibata, K., Mizukoshi, T., Yasuda, Y., Maruyama, S., Murohara, T.

    Circulation Journal   Vol. 79 ( 10 ) page: 2263 - 2270   2015

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    <b><i>Background:</i></b>Estimated glomerular filtration rate (eGFR) and proteinuria are both important determinants of the risk of cardiovascular disease and mortality. The aim of the present study was to investigate the independent and combined effects of eGFR and proteinuria on tissue characterization of the coronary plaques of culprit lesions.<b><i>Methods and Results:</i></b>Conventional intravascular ultrasound and 3-D integrated backscatter intravascular ultrasound (IB-IVUS) were performed in 555 patients undergoing elective percutaneous coronary intervention. They were divided into 2 groups according to the absence or presence of proteinuria (dipstick result ≥1+). Patients with proteinuria had coronary plaque with significantly greater percentage lipid volume compared with those without (43.6±14.8% vs. 48.6±16.1%, P=0.005). Combined analysis was done using eGFR and absence or presence of proteinuria. Subjects with eGFR 45–59 ml/min/1.73 m<sup>2</sup>and proteinuria were significantly more likely to have higher percent lipid volume compared with those with eGFR >60 ml/min/1.73 m<sup>2</sup>without proteinuria. After multivariate adjustment for confounders, the presence of proteinuria proved to be an independent predictor for lipid-rich plaque (OR, 1.85; 95% CI: 1.12–3.06, P=0.016).<b><i>Conclusions:</i></b>The addition of proteinuria to eGFR level may be of value in the risk stratification of patients with coronary artery disease. (<i>Circ J</i> 2015; <b>79:</b> 2263–2270)

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  62. Inverse association between diabetes and aortic dilatation in patients with advanced coronary artery disease Reviewed

    Tanaka, A., Ishii, H., Oshima, H., Narita, Y., Kodama, A., Suzuki, S., Komori, K., Usui, A., Murohara, T.

    Atherosclerosis   Vol. 242 ( 1 ) page: 123 - 127   2015

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    DOI: 10.1016/j.atherosclerosis.2015.07.016

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  63. Impact of airflow limitation on carotid atherosclerosis in coronary artery disease patients Reviewed

    Hamrah, M.S., Suzuki, S., Ishii, H., Shibata, Y., Tatami, Y., Osugi, N., Ota, T., Kawamura, Y., Tanaka, A., Aso, H., Takeshita, K., Sakamoto, J., Hasegawa, Y., Murohara, T.

    Respiration   Vol. 89 ( 4 ) page: 322 - 328   2015

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  64. Assessment of in-stent restenosis using high-definition computed tomography with a new gemstone detector Reviewed International journal

    Tsuda, T., Ishii, H., Ichimiya, S., Kanashiro, M., Watanabe, J., Takefuji, M., Aoyama, T., Suzuki, S., Tanaka, A., Matsubara, T., Murohara, T.

    Circulation Journal   Vol. 79 ( 7 ) page: 1542 - 1548   2015

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    <b><i>Background:</i></b>Until now, there have been few reports on the accuracy of in-stent restenosis (ISR) detection using high-definition computed tomography (HDCT). The purpose of this study was to assess ISR using HDCT with a new gemstone detector and to examine the diagnostic accuracy compared with invasive coronary angiography.<b><i>Methods and Results:</i></b>We evaluated 162 consecutive patients with 316 stents and the image quality (IQ) scores used to assess ISR, and analyzed whether stent strut thickness and diameter affected IQ score and assessability. In the 316 stents, 278 were diagnosed as assessable with HDCT (88.0%). IQ score for stent diameter ≥3 mm was significantly higher than that for stent diameter <3 mm, for stents with both thick struts ≥140 μm in thickness (mean IQ: 2.04±0.97 vs. 2.83±1.06, P<0.001) and thin struts <140 μm (mean IQ: 1.92±0.87 vs. 2.64±0.96, P=0.01). Assessability for stent diameter ≥3 mm was significantly higher than that for stent diameter <3 mm only for stents with thick struts (92.8% vs. 76.1%, P<0.001). Stent strut thickness, however, was not statistically significantly associated with either IQ score or assessability.<b><i>Conclusions:</i></b>In-stent lumens have high HDCT assessability, and HDCT is useful to evaluate thick-strut stents with diameter <3 mm.

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  65. Impact of low-grade albuminuria on left ventricular diastolic dysfunction Reviewed

    Nagai, H., Suzuki, S., Ishii, H., Shibata, Y., Harata, S., Takayama, Y., Tatami, Y., Shimbo, Y., Osugi, N., Ota, T., Kawamura, Y., Tanaka, A., Takeshita, K., Murohara, T.

    IJC Metabolic and Endocrine   Vol. 6   page: 13 - 16   2015

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  66. Relation of airflow limitation and smoking status to carotid atherosclerosis in patients with coronary artery disease

    Suzuki S., Ishii H., Shibata Y., Tatami Y., Osugi N., Ota T., Kawamura Y., Tanaka A., Murohara T.

    EUROPEAN HEART JOURNAL   Vol. 35   page: 902 - 902   2014.9

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  67. Impact of albuminuria on the incidence of peri-procedural myocardial injury in patients undergoing elective stent implantation

    Suzuki S., Ishii H., Shibata Y., Tatami Y., Osugi N., Ota T., Kawamura Y., Tanaka A., Murohara T.

    EUROPEAN HEART JOURNAL   Vol. 35   page: 130 - 130   2014.9

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  68. Impact of albuminuria on the incidence of periprocedural myocardial injury in patients undergoing elective coronary stent implantation Reviewed

    Osugi, N., Suzuki, S., Ishii, H., Yasuda, Y., Shibata, Y., Tatami, Y., Ota, T., Kawamura, Y., Okumura, S., Tanaka, A., Inoue, Y., Matsuo, S., Murohara, T.

    American Journal of Cardiology   Vol. 114 ( 1 ) page: 42 - 46   2014

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  69. Accelerated decline in renal function after acute myocardial infarction in patients with high low-density lipoprotein-cholesterol to high-density lipoprotein-cholesterol ratio Reviewed International journal

    Okumura, S., Sakakibara, M., Hayashida, R., Jinno, Y., Tanaka, A., Okada, K., Hayashi, M., Ishii, H., Murohara, T.

    Heart and Vessels   Vol. 29 ( 1 ) page: 7 - 14   2014

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  70. Influence of the false lumen status on clinical outcomes in patients with acute type B aortic dissection Reviewed International journal

    Tanaka, A., Sakakibara, M., Ishii, H., Hayashida, R., Jinno, Y., Okumura, S., Okada, K., Murohara, T.

    Journal of Vascular Surgery   Vol. 59 ( 2 ) page: 321 - 326   2014

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  71. Impact of chronic obstructive pulmonary disease on composition of left main coronary artery plaque with intermediate stenosis Reviewed

    Kumagai, S., Ishii, H., Takashima, H., Waseda, K., Kurita, A., Ando, H., Gosho, M., Yoshikawa, D., Suzuki, S., Tanaka, A., Matsubara, T., Murohara, T., Amano, T.

    International Journal of Cardiology   Vol. 174 ( 3 ) page: 865 - 866   2014

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  72. Impact of serum bilirubin levels on carotid atherosclerosis in patients with coronary artery disease Reviewed

    Tatami, Y., Suzuki, S., Ishii, H., Shibata, Y., Osugi, N., Ota, T., Kawamura, Y., Tanaka, A., Takeshita, K., Murohara, T.

    IJC Metabolic and Endocrine   Vol. 5   page: 24 - 27   2014

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  73. Elevated Fasting Glucose is an Important Risk Factor for Contrast-Induced Nephropathy in Non-Diabetic Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

    Okumura Satoshi, Sakakibara Masaki, Havashida Ryo, Tanaka Akihito, Jinno Yasushi, Okada Koji, Murohara Toyoaki

    CIRCULATION   Vol. 126 ( 21 )   2012.11

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  74. Comparison of short and long term clinical outcomes according to status of the false lumen in patients with acute type B aortic dissection

    Tanaka A., Sakakibara M., Hayashida R., Jinno Y., Okumura S., Okada K., Murohara T.

    EUROPEAN HEART JOURNAL   Vol. 33   page: 243 - 243   2012.8

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  75. Comparison of early outcomes after primary stenting in Japanese patients with acute myocardial infarction between clopidogrel and ticlopidine in concomitant use with proton-pump inhibitor Reviewed

    Tanaka, A., Sakakibara, M., Okumura, S., Okada, K., Ishii, H., Murohara, T.

    Journal of Cardiology   Vol. 60 ( 1 ) page: 7 - 11   2012

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    DOI: 10.1016/j.jjcc.2012.02.003

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  76. Does N-acetylcysteine reduce the incidence of contrast-induced nephropathy and clinical events in patients undergoing primary angioplasty for acute myocardial infarction? Reviewed

    Tanaka, A., Suzuki, Y., Suzuki, N., Hirai, T., Yasuda, N., Miki, K., Fujita, M., Tanaka, T.

    Internal Medicine   Vol. 50 ( 7 ) page: 673 - 677   2011

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    <b>Objectives</b> We examined oral N-acetylcysteine effects on contrast-induced nephropathy (CIN) and clinical events in patients undergoing primary angioplasty for acute myocardial infarction.<br> <b>Background</b> Recent studies have reported that N-acetylcysteine reduces CIN and improves the clinical outcome in patients undergoing primary angioplasty. However, additional investigations are warranted to further support these findings.<br> <b>Methods</b> We randomly assigned 76 patients undergoing primary angioplasty into two groups: 38 patients were assigned to N-acetylcysteine (NAC, 705 mg orally administration before and 12, 24, 36 hours after primary angioplasty), and 38 patients to placebo. CIN was defined as an increase in the serum creatinine concentration of 25 percent or more from baseline value within the 72-hour period after primary angioplasty.<br> <b>Results</b> CIN occurred in 7 patients (9.2%). In the NAC group, the incidence of CIN tended to be lower than in the placebo group (NAC; 2/38; 5.3% vs. Placebo; 5/38; 13.2%, p=0.21). The composite endpoints such as death, acute renal failure requiring temporary renal replacement therapy, or need for mechanical ventilation did not occur in either group.<br> <b>Conclusion</b> While N-acetylcysteine might have the possibility to reduce the incidence of contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction, the in-hospital mortality and morbidity were not significantly different between the two groups.<br>

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  77. Percutaneous coronary intervention with a virtual 2-Fr system Reviewed

    Tanaka, A., Saito, S.

    Catheterization and Cardiovascular Interventions   Vol. 76 ( 5 ) page: 684 - 6   2010

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  78. The Influence of Eicosapentaenoic Acid to Arachidonic Acid Ratio on Long-term Cardiovascular Events Following Percutaneous Coronary Intervention Reviewed

    Kiyoshi Niwa, Akihito Tanaka, Hiroshi Funakubo, Satoshi Otsuka, Naoki Yoshioka, Nobutaka Kudo, Akihiro Tobe, Keisuke Sakakibara, Yusuke Miki, Takashi Kataoka, Kenji Furusawa, Hideki Ishii, Toyoaki Murohara

    Internal Medicine   Vol. 60 ( 24 ) page: 3865 - 3871   2021.12

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    <p><b>Objective </b>The relationship between cardiovascular disease and the serum polyunsaturated fatty acid parameters has been reported. The aim of the present study was to investigate the association between the eicosapentaenoic acid and arachidonic acid (EPA/AA) ratio and long-term cardiovascular events in patients with coronary artery disease. </p><p><b>Methods </b>We identified a total of 831 patients who underwent percutaneous coronary intervention and whose EPA/AA ratio was available. The patients were divided into two groups according to their serum EPA/AA ratio (median, 0.29; interquartile range 0.19-0.47): those in the lower quartile of EPA/AA ratios (Low EPA/AA group; n=231) and all other subjects (High EPA/AA group; n=600). The primary endpoints included a composite of cardiovascular death, myocardial infarction, and ischemic stroke. </p><p><b>Results </b>Patients in the Low EPA/AA group were significantly younger (66.0±12.6 years vs. 69.9±9.3 years, p<0.001), current smokers (33.3% vs. 22.7%, p=0.002), and had a history of myocardial infarction (20.3% vs. 12.3%, p=0.003). During the follow-up (median, 1,206 days; interquartile range, 654-1,910 days), the occurrence of the primary endpoint was significantly higher in the Low EPA/AA group than in the High EPA/AA group. Of note, the rate of cardiovascular death was significantly higher in the Low EPA/AA group, and the rates of myocardial infarction and stroke tended to be higher. </p><p><b>Conclusion </b>A low EPA/AA ratio was associated with long-term adverse cardiovascular events in Japanese patients with coronary artery disease. </p>

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  79. Incidental findings on computed tomography for preoperative assessment before transcatheter aortic valve implantation in Japanese patients Reviewed

    Akihiro Tobe, Akihito Tanaka, Yoshiyuki Tokuda, Yusuke Miki, Kenji Furusawa, Sho Akita, Taro Fujii, Yoshinori Tsutsumi, Hideki Ishii, Shingo Iwano, Shinji Naganawa, Akihiko Usui, Toyoaki Murohara

    Heart and Vessels   Vol. 36 ( 12 ) page: 1911 - 1922   2021.12

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  80. High-output Heart Failure Caused by a Tumor-related Arteriovenous Fistula: A Case Report and Literature Review Reviewed

    Akihiro Tobe, Akihito Tanaka, Satoya Yoshida, Toru Kondo, Ryota Morimoto, Kenji Furusawa, Takahiro Okumura, Yasuko K Bando, Hideki Ishii, Toyoaki Murohara

    Internal Medicine   Vol. 60 ( 18 ) page: 2979 - 2984   2021.9

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    <p>High-output heart failure caused by a tumor-related arteriovenous fistula in adults is a rare clinical condition. We herein report a case of high-output heart failure caused by an arteriovenous fistula associated with renal cell carcinoma and a literature review of 29 published cases to date. Renal cell carcinoma seems to be the most common underlying tumor. For the diagnosis, right heart catheterization and enhanced computed tomography (CT) are considered useful. The removal of the underlying tumor and arteriovenous fistula is the best treatment for heart failure. </p>

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  81. Improvement in the nutritional status after transcatheter aortic valve implantation Reviewed

    Akihiro Tobe, Akihito Tanaka, Yoshiyuki Tokuda, Sho Akita, Yusuke Miki, Kenji Furusawa, Hideki Ishii, Akihiko Usui, Toyoaki Murohara

    Journal of Cardiology   Vol. 78 ( 3 ) page: 250 - 254   2021.9

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  82. Worsening renal function after transcatheter aortic valve replacement and surgical aortic valve replacement Reviewed

    Akihiro Tobe, Akihito Tanaka, Yoshiyuki Tokuda, Toshihiko Nishi, Yusuke Miki, Kenji Furusawa, Hideki Ishii, Akihiko Usui, Toyoaki Murohara

    Heart and Vessels   Vol. 36 ( 7 ) page: 1080 - 1087   2021.7

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  83. Regression of Electrocardiographic Left Ventricular Hypertrophy After Transcatheter Aortic Valve Implantation for Aortic Stenosis

    Akihiro Tobe, Akihito Tanaka, Yoshiyuki Tokuda, Sho Akita, Taro Fujii, Yusuke Miki, Kenji Furusawa, Hideki Ishii, Akihiko Usui, Toyoaki Murohara

    Circulation Journal   Vol. 85 ( 7 ) page: 1093 - 1098   2021.6

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    <p><b><i>Background:</i></b>The changes in electrocardiographic left ventricular hypertrophy (ECG-LVH) after transcatheter aortic valve implantation (TAVI) are not fully elucidated.</p><p><b><i>Methods and Results:</i></b>The study group included 64 patients who underwent TAVI for aortic stenosis. Their 12-lead ECGs before and at 2 days and 1, 6 and 12 months after TAVI were analyzed, and ECG-LVH was evaluated using various definitions. Values and prevalence of each ECG-LVH parameter significantly decreased between 1 and 6 months after TAVI. Values of ECG-LVH parameters decreased especially in patients with ECG-LVH at baseline.</p><p><b><i>Conclusions:</i></b>Regression of ECG-LVH was observed between 1 and 6 months after TAVI.</p>

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  84. The Mid-term Mortality and Mode of Death in Survivors with ST-elevation Myocardial Infarction Reviewed

    Naoki Yoshioka, Kensuke Takagi, Akihito Tanaka, Yasuhiro Morita, Ruka Yoshida, Yasunori Kanzaki, Hiroaki Nagai, Naoki Watanabe, Ryota Yamauchi, Shotaro Komeyama, Hiroki Sugiyama, Kazuki Shimojo, Takuro Imaoka, Gaku Sakamoto, Takuma Ohi, Hiroki Goto, Hideki Ishii, Itsuro Morishima, Toyoaki Murohara

    Internal Medicine   Vol. 60 ( 11 ) page: 1665 - 1674   2021.6

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    <p><b>Objective </b>The popularity of primary percutaneous coronary intervention (p-PCI) for ST-elevation myocardial infarction (STEMI) has increased over the past decades. Despite improvements in in-hospital mortality rates, it is clinically important to investigate the prognoses after discharge. However, data on the mode of death and prognostic factors are limited. We analyzed these factors in a Japanese cohort in the modern p-PCI era. </p><p><b>Methods </b>Between January 2004 and December 2017, a total of 1,222 patients who underwent p-PCI within 24 hours from the onset of STEMI and were alive at discharge (mean age, 67.7 years old; men, 75.5%), were evaluated. The two-year mortality was analyzed using a Cox regression model, and the mode of death was evaluated. </p><p><b>Results </b>The rate of mortality at 2 years was 5.7%. Non-cardiac death was more frequent than cardiac death (62.6% vs. 37.4%). A Cox multivariate analysis identified the following as independent predictors of the 2-year mortality: hemoglobin (log-transformed) [adjusted hazard ratio (HR), 0.048; 95% confidence interval (CI), 0.008-0.29; p<0.001], age above 80 years old (adjusted HR, 2.26; 95% CI, 1.30-3.91; p=0.004), Killip class ≥II (adjusted HR, 1.99; 95% CI, 1.17-3.39; p=0.011), brain natriuretic peptide level (log-transformed) (adjusted HR, 1.47; 95% CI, 1.09-2.01; p=0.013), and body mass index (log-transformed) (adjusted HR, 0.16; 95% CI, 0.030-0.84; p=0.030). </p><p><b>Conclusion </b>This study demonstrated that the 2-year mortality was 5.7% in STEMI survivors after p-PCI. Non-cardiac death was more frequent than cardiac death. Compared to well-known clinical variables, angiographic findings did not have a significant influence on the mid-term mortality. </p>

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  85. Ten-Year Mortality in Patients With ST-Elevation Myocardial Infarction Reviewed

    Naoki Watanabe, Kensuke Takagi, Akihito Tanaka, Naoki Yoshioka, Yasuhiro Morita, Ruka Yoshida, Yasunori Kanzaki, Hiroaki Nagai, Ryota Yamauchi, Shotaro Komeyama, Hiroki Sugiyama, Kazuki Shimojo, Takuro Imaoka, Gaku Sakamoto, Takuma Ohi, Hiroki Goto, Takahiro Okumura, Hideki Ishii, Itsuro Morishima, Toyoaki Murohara

    The American Journal of Cardiology   Vol. 149   page: 9 - 15   2021.6

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  86. 待機的経カテーテル大動脈弁置換術後患者の術後在院長期化の要因;術前握力の有用性 Reviewed

    堀 将也, 小林 聖典, 高木 大地, 徳田 順之, 田中 哲人, 碓氷 章彦

    心臓リハビリテーション   Vol. 27 ( 2 ) page: 129 - 135   2021.6

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    【目的】待機的経カテーテル大動脈弁置換術(TAVI)後患者において、術後在院長期化の要因を検討する。【方法】2016年4月以降TAVI施行例119を対象として検討した。一般リスクに加え術前後に握力、歩行速度、認知機能を評価し、可能な限り術翌日より歩行を行うプロトコールで集中的理学療法を行った。術後在院の長期化を8日以上または転院例と定義し、危険因子を検討した。【結果】在院長期化群(n=51)では非長期化群(n=68)と比し術前握力低下例が多く(オッズ比=3.62、p=0.011)、non-TFアプローチが多く(オッズ比=20.6、p=0.009)、併発症としてのペースメーカー留置(オッズ比=15.9、p=0.010)が多かった。【結語】術前握力低下はTAVI後在院期間の長期化の独立危険因子であった。簡便に測定できる握力を評価に含めた理学療法計画の策定が有用であろう。(著者抄録)

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  87. Perioperative D-dimer levels after transcatheter aortic valve replacement: Comparison of patients with and without anticoagulant therapy Reviewed

    Akihiro Tobe, Akihito Tanaka, Yoshiyuki Tokuda, Toshihiko Nishi, Yusuke Miki, Kenji Furusawa, Hideki Ishii, Akihiko Usui, Toyoaki Murohara

    Cardiology Journal   Vol. 28 ( 1 ) page: 170 - 172   2021.2

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  88. Relationship between epicardial adipose tissue volume and coronary artery spasm Reviewed

    Kataoka, T., Harada, K., Tanaka, A., Onishi, T., Matsunaga, S., Funakubo, H., Harada, K., Nagao, T., Shinoda, N., Marui, N., Niwa, K., Tashiro, H., Hitora, Y., Furusawa, K., Ishii, H., Amano, T., Murohara, T.

    International Journal of Cardiology   Vol. 324   page: 8 - 12   2021

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  89. Serial Images of Aortic Plaque Rupture During Transfemoral Transcatheter Aortic Valve Replacement Reviewed

    Tobe, A., Tanaka, A., Tokuda, Y., Akita, S., Miki, Y., Furusawa, K., Ishii, H., Usui, A., Murohara, T.

    JACC: Cardiovascular Interventions   Vol. 13 ( 22 ) page: E203 - E204   2020.11

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  90. Multimodality imaging evaluation of saphenous vein graft peri-stent contrast staining enlargement Reviewed

    Shibata Naoki, Sugiura Tsuyoshi, Tanaka Akihito, Shimizu Kiyokazu

    INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING   Vol. 36 ( 11 ) page: 2105 - 2106   2020.11

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    A patient with Takayasu arteritis who underwent CABG using a saphenous vein graft (SVG) experienced ventricular fibrillation due to total SVG occlusion. A drug-eluting stent was implanted; however, follow-up CAG demonstrated an advanced expansion of peri-stent contrast staining. Coronary computed tomography angiography revealed contrast media extending around the SVG. An intravascular ultrasound indicated a worsening stent malapposition and a significant positive remodeling.

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  91. Impact of skeletal muscle mass on clinical outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement Reviewed

    Uchida Yasuhiro, Ishii Hideki, Tanaka Akihito, Yonekawa Jun, Satake Akinori, Makino Yuichiro, Suzuki Wataru, Kurobe Masanari, Mizutani Koji, Mizutani Yoshiaki, Fujimoto Masanobu, Ichimiya Hitoshi, Teramoto Chikao, Tamenishi Akinori, Okamoto Hiroshi, Watanabe Junji, Kanashiro Masaaki, Amano Tetsuya, Matsubara Tatsuaki, Ichimiya Satoshi, Murohara Toyoaki

    CARDIOVASCULAR INTERVENTION AND THERAPEUTICS   Vol. 36 ( 4 ) page: 514 - 522   2020.10

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    Low skeletal muscle mass is one of the components of sarcopenia. However, the prognostic impact of skeletal muscle mass on clinical outcomes in patients after transcatheter aortic valve replacement (TAVR) remains unclear. Therefore, we assessed the impact of skeletal muscle mass on future cardiovascular events in patients undergoing TAVR. We enrolled 71 consecutive patients who underwent TAVR for symptomatic severe aortic stenosis. We applied bilateral psoas muscles as an indicator of skeletal muscle mass. Psoas muscle volumes were measured from the origin of psoas at the level of the lumbar vertebrae to its insertion in the lesser trochanter on three-dimensional computed tomography datasets. Psoas muscle mass index (PMI) was calculated as psoas muscle volume/height2 (cm3/m2). According to the median value of PMIs (79.8 and 60.0 cm3/m2 for men and women), the enrolled patients were divided into two groups. During the follow-up, 11 (31.4%) patients in low PMI group and 4 (11.1%) in high PMI group experienced major adverse cardiovascular events (MACE) defined as a composite of death from any cause, myocardial infarction, heart failure hospitalization, and stroke. The proportion of MACE-free survival was significantly lower in low PMI group (log-rank P = 0.033), mainly due to the difference of hospital readmission for congestive heart failure. On multivariate Cox proportional hazard analysis, PMI remained an independent negative predictor of MACE [hazard ratio 0.95 (95% confidence interval 0.92–0.98, P = 0.002)]. In conclusion, low skeletal muscle mass independently predicted MACE in patients undergoing TAVR.

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  92. Rotational Atherectomy for Severely Calcified Lesions in Patients With Left Ventricular Systolic Dysfunction: One-Year Outcomes From aSingle-Center Registry Analysis Reviewed

    Yoshida, R., Ishii, H., Morishima, I., Tanaka, A., Takagi, K., Yoshioka, N., Morita, Y., Unno, K., Yoshida, Y., Tsuboi, H., Murohara, T.

    Cardiovascular Revascularization Medicine   Vol. 21 ( 10 ) page: 1220 - 1227   2020.10

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  93. Reduced exercise capacity and clinical outcomes following acute myocardial infarction Reviewed

    Tashiro, H., Tanaka, A., Ishii, H., Motomura, N., Arai, K., Adachi, T., Okajima, T., Iwakawa, N., Kojima, H., Mitsuda, T., Hirayama, K., Hitora, Y., Hayashi, M., Furusawa, K., Yoshida, R., Imai, H., Ogawa, Y., Kawaguchi, K., Murohara, T.

    Heart and Vessels   Vol. 35 ( 8 ) page: 1044 - 1050   2020.8

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  94. Prognostic impact of recanalizing chronic total occlusion in non-infarct related arteries on long-term clinical outcomes in acute myocardial infarction patients undergoing primary percutaneous coronary intervention Reviewed

    Yoshida, R., Ishii, H., Morishima, I., Tanaka, A., Takagi, K., Yoshioka, N., Kataoka, T., Tashiro, H., Hitora, Y., Niwa, K., Furusawa, K., Morita, Y., Tsuboi, H., Murohara, T.

    Cardiovascular Intervention and Therapeutics   Vol. 35 ( 3 ) page: 259 - 268   2020.7

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  95. Optical Coherence Tomography-Guided Stent Implantation for Woven Coronary Artery Anomaly Reviewed

    Yusuke Uemura, Akihito Tanaka, Kenji Takemoto, Hideki Ishii, Toyoaki Murohara, Masato Watarai

    Circulation Journal   Vol. 84 ( 6 ) page: 1044 - 1044   2020.6

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  96. Clinical comparison study between a newly developed optical-based fractional flow reserve device and the conventional fractional flow reserve device Reviewed

    Saka Yuki, Tanaka Akihito, Ishii Hideki, Takashima Hiroaki, Suzuki Akihiro, Nakano Yusuke, Sakurai Shinichiro, Ando Hirohiko, Murohara Toyoaki, Amano Tetsuya

    CORONARY ARTERY DISEASE   Vol. 31 ( 4 ) page: 342 - 347   2020.6

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    Background Fractional flow reserve (FFR) measurement is the gold standard for identifying the functional severity of coronary artery disease. Although we can use newly developed pressure wires with optical fibers are now available, their safety and accuracy for FFR measurement are not clear. Therefore, we planned a clinical comparison study between pressure wires with optical fibers and the conventional FFR device. Methods We prospectively enrolled 51 patients (51 lesions) with intermediate coronary artery stenosis. For these lesions, FFR measurements with pressure wires with optical fibers were compared with those obtained with a conventional wire. Results All procedures were successfully completed without any complications. The procedure time with pressure wires with optical fibers and a conventional wire was 6.8 ± 3.0 and 6.9 ± 2.6 minutes (P = 0.89), respectively. There was no significant difference in FFR values between pressure wires with optical fibers and a conventional wire (0.83 ± 0.10 vs. 0.83 ± 0.12, P = 0.66). An excellent correlation was observed between FFR obtained with pressure wires with optical fibers and FFR obtained with a conventional wire (r = 0.81, P < 0.001). The pressure drift before and after FFR measurements was not significantly different between pressure wires with optical fibers and a convention wire (-0.01 ± 0.02 vs. -0.02 ± 0.06, P = 0.42). There was no significant difference in pressure drift defined as >0.03 or <-0.03 between pressure wires with optical fibers and a convention wire (13.7 vs. 17.6%, P = 0.79). Conclusion Excellent correlations were observed between FFR values measured using pressure wires with optical fibers and a conventional wire. Furthermore, measurement of FFR with pressure wires with optical fibers was as well tolerated and reliable as that with a conventional wire.

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  97. Lipid-rich large plaques in a non-culprit left main coronary artery and long-term clinical outcomes Reviewed

    Tashiro, H., Tanaka, A., Ishii, H., Sakakibara, K., Tobe, A., Kataoka, T., Miki, Y., Hitora, Y., Niwa, K., Furusawa, K., Murohara, T.

    International Journal of Cardiology   Vol. 305   page: 5 - 10   2020.4

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  98. Influence of Preadmission Frailty on Short- and Mid-Term Prognoses in Octogenarians With ST-Elevation Myocardial Infarction Reviewed

    Yoshioka Naoki, Takagi Kensuke, Morishima Itsuro, Morita Yasuhiro, Uemura Yusuke, Inoue Yosuke, Umemoto Norio, Shibata Naoki, Negishi Yosuke, Yoshida Ruka, Tanaka Akihito, Ishii Hideki, Murohara Toyoaki

    CIRCULATION JOURNAL   Vol. 84 ( 4 ) page: 683 - 683   2020.4

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  99. Clinical outcomes after percutaneous coronary intervention in non-dialysis patients with acute coronary syndrome and advanced renal dysfunction Reviewed

    Uemura, Y., Ishikawa, S., Takemoto, K., Negishi, Y., Tanaka, A., Takagi, K., Yoshioka, N., Umemoto, N., Inoue, Y., Morishima, I., Shibata, N., Asano, H., Ishii, H., Watarai, M., Murohara, T.

    Clinical and Experimental Nephrology   Vol. 24 ( 4 ) page: 339 - 348   2020.4

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  100. Influence of Preadmission Frailty on Short- and Mid-Term Prognoses in Octogenarians With ST-Elevation Myocardial Infarction Reviewed

    Yoshioka Naoki, Takagi Kensuke, Morishima Itsuro, Morita Yasuhiro, Uemura Yusuke, Inoue Yosuke, Umemoto Norio, Shibata Naoki, Negishi Yosuke, Yoshida Ruka, Tanaka Akihito, Ishii Hideki, Murohara Toyoaki

    CIRCULATION JOURNAL   Vol. 84 ( 1 ) page: 109 - 118   2020.1

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  101. Differences in primary indication for guide-extension catheter usage among the three target vessels Reviewed

    Yoshida Ruka, Ishii Hideki, Tanaka Akihito, Inukai Iwana, Takagi Kensuke, Murohara Toyoaki

    POSTEPY W KARDIOLOGII INTERWENCYJNEJ   Vol. 16 ( 2 ) page: 192 - +   2020

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  102. Improved renal function after percutaneous coronary intervention in non-dialysis patients with acute coronary syndrome and advanced renal dysfunction Reviewed

    Uemura, Y., Ishikawa, S., Takemoto, K., Negishi, Y., Tanaka, A., Takagi, K., Yoshioka, N., Tashiro, H., Umemoto, N., Inoue, Y., Morishima, I., Shimizu, K., Shibata, N., Asano, H., Ishii, H., Watarai, M., Murohara, T.

    Cardiovascular Revascularization Medicine   Vol. 24   page: 26 - 30   2020

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  103. Long-term renal outcomes after elective percutaneous coronary intervention in patients with advanced renal dysfunction Reviewed

    Tashiro, H., Tanaka, A., Ishii, H., Takagi, K., Uemura, Y., Inoue, Y., Umemoto, N., Negishi, Y., Shibata, N., Yoshioka, N., Shimizu, K., Morishima, I., Watarai, M., Asano, H., Murohara, T.

    Heart and Vessels   Vol. 36 ( 4 ) page: 452 - 460   2020

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  104. Prognostic impact of lipoprotein(a) levels during lipid management with statins after ST-elevation acute myocardial infarction Reviewed

    Mitsuda, T., Uemura, Y., Ishii, H., Tanaka, A., Takemoto, K., Koyasu, M., Ishikawa, S., Shibata, R., Watarai, M., Murohara, T.

    Coronary Artery Disease   Vol. 30 ( 8 ) page: 600 - 607   2019.12

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  105. Late Stent Thrombosis Concurrent With Stent Fracture at Calcified Nodule Lesion in Saphenous Vein Graft Reviewed

    Uemura, Y., Tanaka, A., Takemoto, K., Koyasu, M., Mitsuda, T., Ishii, H., Murohara, T., Watarai, M.

    JACC: Cardiovascular Interventions   Vol. 12 ( 22 ) page: E199 - E200   2019.11

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    DOI: 10.1016/j.jcin.2019.07.057

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  106. What are the remaining lessons to be learnt from 1st-generation bioresorbable scaffolds? Invited Reviewed International coauthorship

    Tanaka, A., Jabbour, R.J., Colombo, A.

    International Journal of Cardiology   Vol. 293   page: 103 - 104   2019.10

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  107. Impact of adjunctive use of guide extension catheter for mid-term outcome of drug-coated balloon. Reviewed

    Yoshida R, Ishii H, Morishima I, Tanaka A, Takagi K, Iwakawa N, Tashiro H, Kojima H, Mitsuda T, Hirayama K, Hitora Y, Furusawa K, Murohara T

    EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology   Vol. 15 ( 8 ) page: 688 - 691   2019.10

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  108. Impact of Postdischarge Bleeding on Long-Term Mortality in Percutaneous Coronary Intervention Patients Taking Oral Anticoagulants Reviewed

    Yoshida, R., Ishii, H., Morishima, I., Tanaka, A., Morita, Y., Takagi, K., Yoshioka, N., Hirayama, K., Iwakawa, N., Tashiro, H., Kojima, H., Mitsuda, T., Hitora, Y., Furusawa, K., Tsuboi, H., Murohara, T.

    Journal of Cardiovascular Pharmacology   Vol. 74 ( 3 ) page: 210 - 217   2019.9

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  109. Temporary immobile leaflet following transcatheter aortic valve replacement of a SAPIEN-XT valve. Reviewed

    Aoki T, Tanaka A, Tokuda Y, Oshima H, Suzuki S, Ishii H

    Cardiovascular intervention and therapeutics   Vol. 34 ( 3 ) page: 277 - 278   2019.7

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  110. Performance of HAS-BLED, ORBIT, PRECISE-DAPT, and PARIS risk score for predicting long-term bleeding events in patients taking an oral anticoagulant undergoing percutaneous coronary intervention. Reviewed

    Yoshida R, Ishii H, Morishima I, Tanaka A, Morita Y, Takagi K, Yoshioka N, Hirayama K, Iwakawa N, Tashiro H, Kojima H, Mitsuda T, Hitora Y, Furusawa K, Tsuboi H, Murohara T

    Journal of cardiology   Vol. 73 ( 6 ) page: 479 - 487   2019.6

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  111. Contrast-Induced Nephropathy and Long-Term Clinical Outcomes Following Percutaneous Coronary Intervention in Patients With Advanced Renal Dysfunction (Estimated Glomerular Filtration Rate &lt;30 ml/min/1.73 m<sup>2</sup>). Reviewed

    Negishi Y, Tanaka A, Ishii H, Takagi K, Inoue Y, Uemura Y, Umemoto N, Yoshioka N, Morishima I, Asano H, Watarai M, Shibata N, Suzuki S, Murohara T

    The American journal of cardiology   Vol. 123 ( 3 ) page: 361 - 367   2019.2

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  112. Influence of chronic kidney disease and worsening renal function on clinical outcomes in patients undergoing primary percutaneous coronary intervention. Reviewed

    Aoki T, Ishii H, Tanaka A, Suzuki S, Ichimiya S, Kanashiro M, Murohara T

    Clinical and experimental nephrology   Vol. 23 ( 2 ) page: 182 - 188   2019.2

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  113. Coronary air embolism following transbronchial lung biopsy. Reviewed

    Sumi T, Tanaka A, Ishii H, Suzuki S, Kada K, Murohara T

    Cardiovascular intervention and therapeutics   Vol. 34 ( 1 ) page: 64 - 66   2019.1

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  114. Impact of Nutritional and Inflammation Status on Long-Term Bleeding in Patients Undergoing Percutaneous Coronary Intervention with an Oral Anticoagulant. Reviewed

    Yoshida R, Ishii H, Morishima I, Tanaka A, Morita Y, Takagi K, Yoshioka N, Hirayama K, Iwakawa N, Tashiro H, Kojima H, Mitsuda T, Hitora Y, Furusawa K, Tsuboi H, Murohara T

    Journal of atherosclerosis and thrombosis   Vol. 26 ( 8 ) page: 728 - 737   2019

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    <p><b>Aim:</b> Patients undergoing percutaneous coronary intervention (PCI) who require both oral anticoagulant (OAC) and antiplatelet therapy (APT) are exposed to a serious risk of bleeding. The aim of this study was to clarify the relationship among nutritional and inflammation status and long-term bleeding in patients requiring both OACs and APT after PCI.</p><p><b>Methods:</b> We performed PCI in 3,718 consecutive patients between April 2011 and March 2017, 302 of whom were treated with both OACs and APT. Patients were followed for up to 3 years for bleeding events, defined as the Bleeding Academic Research Consortium (BARC) class ≥3 bleeding. We retrospectively evaluated the ability of the Geriatric Nutritional Risk Index (GNRI) and high-sensitivity C-reactive protein (hs-CRP) to detect bleeding events.</p><p><b>Results:</b> During a median follow-up of 1,080 days, bleeding events were observed in 53 (17.5%) patients. Bleeding events were associated with a low GNRI (≤98) (hazard ratio [HR], 3.16; 95% confidence interval [CI], 1.84-5.45; <i>p</i><0.0001) and hs-CRP level ≥2.5 mg/L (HR, 2.75; 95% CI, 1.61-4.78; <i>p</i>=0.0003). A low GNRI+high hs-CRP showed a 5.12-fold increase in the incidence of BARC class ≥3 bleeding (95% CI, 2.68-9.91; <i>p</i><0.0001) compared with a normal GNRI+low hs-CRP. The addition of the GNRI and hs-CRP to the PRECISE-DAPT score improved C-statistics from 0.67 to 0.71 and enhanced the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI, 0.36, <i>p</i><0.0001; IDI, 0.066, <i>p</i><0.0001).</p><p><b>Conclusions:</b> The GNRI and hs-CRP were novel predictors of the long-term bleeding risk in patients requiring both OACs and APT after PCI.</p>

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  115. Early versus delayed invasive strategy in patients with non-ST-elevation acute coronary syndrome and concomitant congestive heart failure Reviewed

    Yoshida, R., Ishii, H., Morishima, I., Tanaka, A., Morita, Y., Takagi, K., Yoshioka, N., Hirayama, K., Iwakawa, N., Tashiro, H., Kojima, H., Mitsuda, T., Hitora, Y., Furusawa, K., Tsuboi, H., Murohara, T.

    Journal of Cardiology   Vol. 74 ( 3-4 ) page: 320 - 327   2019

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  116. Incidence, Technical Safety, and Feasibility of Coronary Angiography and Intervention Following Self-expanding Transcatheter Aortic Valve Replacement Reviewed

    Tanaka, A., Jabbour, R.J., Testa, L., Agnifili, M., Ettori, F., Fiorina, C., Adamo, M., Bruschi, G., Giannini, C., Petronio, A.S., Barbanti, M., Tamburino, C., De Felice, F., Reimers, B., Poli, A., Colombo, A., Latib, A.

    Cardiovascular Revascularization Medicine   Vol. 20 ( 5 ) page: 371 - 375   2019

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  117. JCS 2018 guideline on diagnosis and treatment of acute coronary syndrome

    Kimura, K., Kimura, T., Ishihara, M., Nakagawa, Y., Nakao, K., Miyauchi, K., Sakamoto, T., Tsujita, K., Hagiwara, N., Miyazaki, S., Ako, J., Arai, H., Ishii, H., Origuchi, H., Shimizu, W., Takemura, H., Tahara, Y., Morino, Y., Iino, K., Itoh, T., Iwanaga, Y., Uchida, K., Endo, H., Kongoji, K., Sakamoto, K., Shiomi, H., Shimohama, T., Suzuki, A., Takahashi, J., Takeuchi, I., Tanaka, A., Tamura, T., Nakashima, T., Noguchi, T., Fukamachi, D., Mizuno, T., Yamaguchi, J., Yodogawa, K., Kosuge, M., Kohsaka, S., Yoshino, H., Yasuda, S., Shimokawa, H., Hirayama, A., Akasaka, T., Haze, K., Ogawa, H., Tsutsui, H., Yamazaki, T.

    Circulation Journal   Vol. 83 ( 5 ) page: 1085 - 1196   2019

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  118. Myocardial salvage after ST-segment-elevation myocardial infarction: comparison between prasugrel and clopidogrel in the presence or absence of high-residual platelet reactivity Reviewed

    Yoshida, R., Takagi, K., Ishii, H., Morishima, I., Tanaka, A., Morita, Y., Kanzaki, Y., Nagai, H., Watanabe, N., Furui, K., Shibata, N., Yoshioka, N., Yamauchi, R., Komeyama, S., Sugiyama, H., Tsuboi, H., Murohara, T.

    Journal of Nuclear Cardiology   Vol. 28 ( 4 ) page: 1422 - 1434   2019

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  119. A survival case of a young adult patient with ST-elevated myocardial infarction with high levels of lipoprotein(a)

    Hiraiwa, H., Morimoto, R., Okumura, T., Arao, Y., Oishi, H., Kato, H., Yamaguchi, S., Kuwayama, T., Haga, T., Yokoi, T., Kondo, T., Watanabe, N., Mitsuda, T., Fukaya, K., Sawamura, A., Tanaka, A., Ishii, H., Morishima, I., Tsuboi, H., Murohara, T.

    Journal of Cardiology Cases   Vol. 19 ( 6 ) page: 207 - 210   2019

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  120. New-generation drug-eluting stents for left main coronary artery disease according to the EXCEL trial enrollment criteria: Insights from the all-comers, international, multicenter DELTA-2 registry. Reviewed International coauthorship

    Tanaka A, Giustino G, Briede I, Sawaya FJ, Daemen J, Kawamoto H, Meliga E, D'Ascenzo F, Cerrato E, Stefanini GG, Capodanno D, Mangiameli A, Templin C, Erglis A, Morice MC, Mehran R, Van Mieghem NM, Nakamura S, De Benedictis M, Pavani M, Varbella F, Pisaniello M, Sharma SK, Tamburino C, Tchetche D, Colombo A, Chieffo A, DELTA, Investigators

    International journal of cardiology   Vol. 280   page: 30 - 37   2018.12

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  121. New-Generation Drug-Eluting Stents for Left Main In-Stent Restenosis: The DELTA-2 Registry Reviewed International coauthorship

    Giustino, G., Tanaka, A., Erglis, A., Morice, M.C., Van Mieghem, N.M., Meliga, E., D'Ascenzo, F., Stefanini, G.G., Capodanno, D., Chieffo, A.

    JACC: Cardiovascular Interventions   Vol. 11 ( 23 ) page: 2438-2440 - 2440   2018.12

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  122. Long-term follow-up of BVS from a prospective multicenter registry: Impact of a dedicated implantation technique on clinical outcomes. Reviewed

    Regazzoli D, Latib A, Ezhumalai B, Tanaka A, Leone PP, Khan S, Kumar V, Rastogi V, Ancona MB, Mangieri A, Giannini F, Mitomo S, Seth A, Colombo A

    International journal of cardiology   Vol. 270   page: 113-117 - 117   2018.11

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  123. Vasospastic angina in a 16-year-old female. Reviewed

    Sumi T, Tanaka A, Ishii H, Suzuki S, Oguri M, Murohara T

    Cardiovascular intervention and therapeutics   Vol. 33 ( 4 ) page: 393 - 394   2018.10

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  124. Clinical Impact of Circulating Irisin on Classified Coronary Plaque Characteristics

    Hirayama Kenshi, Ishii Hideki, Kikuchi Ryosuke, Suzuki Susumu, Aoki Toshijiro, Harada Kazuhiro, Sumi Takuya, Negishi Yosuke, Shibata Yohei, Tatami Yosuke, Tanaka Akihito, Murohara Toyoaki

    JOURNAL OF APPLIED LABORATORY MEDICINE   Vol. 3 ( 1 ) page: 79 - 88   2018.7

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    BACKGROUND: Myokines are hormones secreted by skeletal muscles during physical activity. Low myokine levels may contribute to metabolic dysfunction and cardiovascular disorders. Irisin, a newly identified myokine, has been the focus of recent research. The aim of the present study was to analyze the association between circulating irisin levels and tissue characteristics of nonculprit left main coronary artery (LMCA) plaques with the use of integrated backscatter (IB) intravascular ultrasound (IVUS). METHODS: This observational study enrolled 55 Japanese patients following successful percutaneous coronary intervention for lesions in the left anterior descending arteries or left circumflex arteries. Circulating myokine levels, including myostatin, brain-derived neurotrophic factor, and irisin, were measured by an enzyme-linked immunosorbent assay. Tissue characteristics of LMCA plaque were evaluated by IB-IVUS. RESULTS: Circulating irisin levels were negatively associated with percent lipid volume (%LV) [r = -0.31 (95% CI, -2.52 to -0.21), P = 0.02] and positively associated with percent fibrous volume (%FV) [r = 0.32 (95% CI, 0.22-2.20), P = 0.02]. The optimal cutoff value of circulating irisin for the prediction of lipid-rich LMCA plaques was 6.02 μg/mL [area under the curve = 0.713, P < 0.01 (95% CI, 0.58-0.85)]. Multivariate linear regression analysis identified circulating irisin levels as independent predictors for %LV and %FV of the LMCA [β = -0.29 (95% CI, -2.53 to -0.07), P = 0.04 and β = 0.30 (95% CI, 0.10-2.23), P = 0.03, respectively]. CONCLUSIONS: Circulating irisin levels are significantly associated with tissue characteristics of nonculprit LMCA plaques.

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  125. Association between the ratio of anti-angiogenic isoform of VEGF-A to total VEGF-A and adverse clinical outcomes in patients after acute myocardial infarction

    Harada Kazuhiro, Kikuchi Ryosuke, Ishii Hideki, Shibata Yohei, Suzuki Susumu, Tanaka Akihito, Suzuki Atsuo, Hirayama Kenshi, Murohara Toyoaki

    IJC HEART & VASCULATURE   Vol. 19   page: 3 - 7   2018.6

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    DOI: 10.1016/j.ijcha.2018.03.004

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  126. Impact of high-density lipoprotein 3 cholesterol subfraction on periprocedural myocardial injury in patients who underwent elective percutaneous coronary intervention

    Harada Kazuhiro, Kikuchi Ryosuke, Suzuki Susumu, Tanaka Akihito, Aoki Toshijiro, Iwakawa Naoki, Kojima Hiroki, Hirayama Kenshi, Mitsuda Takayuki, Sumi Takuya, Negishi Yosuke, Ishii Hideki, Murohara Toyoaki

    LIPIDS IN HEALTH AND DISEASE   Vol. 17 ( 1 ) page: 21   2018.2

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    DOI: 10.1186/s12944-018-0670-3

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  127. Comparison of mid-term clinical outcomes after treatment of ostial right coronary artery lesions with early and new generation drug-eluting stents: Insights from an international multicenter registry Reviewed

    Mitomo, S., Jabbour, R.J., Watanabe, Y., Mangieri, A., Ancona, M., Regazzoli, D., Tanaka, A., Nakajima, A., Naganuma, T., Giannini, F., Latib, A., Nakamura, S., Colombo, A.

    International Journal of Cardiology   Vol. 254   page: 53 - 58   2018

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    DOI: 10.1016/j.ijcard.2017.10.066

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  128. Different behavior of bioresorbable vascular scaffold and metallic stent with positive vessel remodeling Reviewed

    Mitomo, S., Regazzoli, D., Candilio, L., Tanaka, A., Latib, A., Colombo, A.

    Circulation Journal   Vol. 82 ( 6 ) page: 1716 - 1717   2018

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    DOI: 10.1253/circj.CJ-17-0850

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  129. A comparison of the fully repositionable and retrievable Boston Lotus and direct flow medical valves for the treatment of severe aortic stenosis: A single center experience Reviewed

    Giannini, F., Latib, A., Montorfano, M., Ruparelia, N., Romano, V., Longoni, M., Ferri, L., Jabbour, R., Mangieri, A., Regazzoli, D., Ancona, M., Buzzatti, N., Azzalini, L., Tanaka, A., Agricola, E., Chieffo, A., Alfieri, O., Colombo, A.

    Catheterization and Cardiovascular Interventions   Vol. 91 ( 5 ) page: 966 - 974   2018

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  130. Bioresorbable vascular scaffold versus everolimus-eluting stents or drug eluting balloon for the treatment of coronary in-stent restenosis: 1-Year follow-up of a propensity score matching comparison (the BIORESOLVE-ISR Study) Reviewed

    Moscarella, E., Tanaka, A., Ielasi, A., Cortese, B., Coscarelli, S., De Angelis, M.C., Piraino, D., Latib, A., Grigis, G., Bianchi, R., Buccheri, D., Calabrò, P., Tespili, M., Silva Orrego, P., Colombo, A., Varricchio, A.

    Catheterization and Cardiovascular Interventions   Vol. 92 ( 4 ) page: 668 - 677   2018

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    DOI: 10.1002/ccd.27473

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  131. Impact of post-dilatation on longitudinal stent elongation: An in vitro study.

    Sumi T, Ishii H, Tanaka A, Suzuki S, Kojima H, Iwakawa N, Aoki T, Hirayama K, Mitsuda T, Harada K, Negishi Y, Ota T, Kada K, Murohara T

    Journal of cardiology   Vol. 71 ( 5-6 ) page: 464 - 470   2018

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    DOI: 10.1016/j.jjcc.2017.11.003

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  132. Different behaviors of bioresorbable vascular scaffold in different types of calcified lesion: Insights from intravascular imaging

    Mitomo, S., Tanaka, A., Candilio, L., Azzalini, L., Carlino, M., Latib, A., Colombo, A.

    Journal of Cardiology Cases   Vol. 17 ( 4 ) page: 126 - 129   2018

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  133. Delayed coronary occlusion after transcatheter aortic valve implantation: Implications for new transcatheter heart valve design and patient management

    Jabbour, R.J., Tanaka, A., Colombo, A., Latib, A.

    Interventional Cardiology Review   Vol. 13 ( 3 ) page: 137 - 139   2018

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    DOI: 10.15420/icr.2018.24.2

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  134. Delayed Coronary Obstruction After Transcatheter Aortic Valve Replacement

    Jabbour, R.J., Tanaka, A., Finkelstein, A., Mack, M., Tamburino, C., Van Mieghem, N., de Backer, O., Testa, L., Gatto, P., Purita, P., Rahhab, Z., Veulemans, V., Stundl, A., Barbanti, M., Nerla, R., Sinning, J.M., Dvir, D., Tarantini, G., Szerlip, M., Scholtz, W., Scholtz, S., Tchetche, D., Castriota, F., Butter, C., Søndergaard, L., Abdel-Wahab, M., Sievert, H., Alfieri, O., Webb, J., Rodés-Cabau, J., Colombo, A., Latib, A.

    Journal of the American College of Cardiology   Vol. 71 ( 14 ) page: 1513 - 1524   2018

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    DOI: 10.1016/j.jacc.2018.01.066

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  135. “Golden tube” with favorable vessel remodeling at four-year follow-up after bioresorbable vascular scaffold implantation for moderate to severe calcified lesions: Insights from intravascular imaging

    Mitomo, S., Candilio, L., Tanaka, A., Latib, A., Colombo, A.

    Cardiology Journal   Vol. 25 ( 4 ) page: 532 - 533   2018

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    DOI: 10.5603/CJ.2018.0084

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  136. Predictors of Advanced Conduction Disturbances Requiring a Late (≥48 H) Permanent Pacemaker Following Transcatheter Aortic Valve Replacement

    Mangieri, A., Lanzillo, G., Bertoldi, L., Jabbour, R.J., Regazzoli, D., Ancona, M.B., Tanaka, A., Mitomo, S., Garducci, S., Montalto, C., Pagnesi, M., Giannini, F., Giglio, M., Montorfano, M., Chieffo, A., Rodès-Cabau, J., Monaco, F., Paglino, G., Della Bella, P., Colombo, A., Latib, A.

    JACC: Cardiovascular Interventions   Vol. 11 ( 15 ) page: 1519 - 1526   2018

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    DOI: 10.1016/j.jcin.2018.06.014

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  137. Mid-term clinical outcomes after bailout drug-eluting stenting for suboptimal drug-coated balloon results: Insights from a Milan registry

    Mitomo, S., Jabbour, R.J., Mangieri, A., Ancona, M., Regazzoli, D., Tanaka, A., Giannini, F., Carlino, M., Montorfano, M., Chieffo, A., Latib, A., Colombo, A.

    International Journal of Cardiology   Vol. 263   page: 17 - 23   2018

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  138. The combination assessment of lipid pool and thrombus by optical coherence tomography can predict the filter no-reflow in primary PCI for ST elevated myocardial infarction

    Negishi Yosuke, Ishii Hideki, Suzuki Susumu, Aoki Toshijiro, Iwakawa Naoki, Kojima Hiroki, Harada Kazuhiro, Hirayama Kenshi, Mitsuda Takayuki, Sumi Takuya, Tanaka Akihito, Ogawa Yasuhiro, Kawaguchi Katsuhiro, Murohara Toyoaki

    MEDICINE   Vol. 96 ( 50 ) page: e9297   2017.12

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  139. Expansion in calcific lesions and overall clinical outcomes following bioresorbable scaffold implantation optimized with intravascular ultrasound Reviewed

    Kawamoto, H., Ruparelia, N., Latib, A., Miyazaki, T., Sato, K., Tanaka, A., Naganuma, T., Sticchi, A., Chieffo, A., Carlino, M., Montorfano, M., Colombo, A.

    Catheterization and Cardiovascular Interventions   Vol. 89 ( 5 ) page: 789 - 797   2017

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  140. Long-term outcome of full plastic jacket treatment for bare metal in-stent restenosis Reviewed

    Jabbour, R.J., Tanaka, A., Mangieri, A., Regazzoli, D., Ancona, M., Pagnesi, M., Giannini, F., Latib, A., Colombo, A.

    Cardiovascular Revascularization Medicine   Vol. 18 ( 2 ) page: 139 - 140   2017

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  141. The DELTA 2 Registry: A Multicenter Registry Evaluating Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents in Patients With Obstructive Left Main Coronary Artery Disease Reviewed

    Chieffo, A., Tanaka, A., Giustino, G., Briede, I., Sawaya, F.J., Daemen, J., Kawamoto, H., Meliga, E., D'Ascenzo, F., Cerrato, E., Stefanini, G.G., Capodanno, D., Mangiameli, A., Templin, C., Erglis, A., Morice, M.C., Mehran, R., Van Mieghem, N.M., Nakamura, S., De Benedictis, M., Pavani, M., Varbella, F., Pisaniello, M., Sharma, S.K., Tamburino, C., Tchetche, D., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 10 ( 23 ) page: 2401 - 2410   2017

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  142. How should i treat recurrent restenosis with underexpanded multilayered struts after repeated complex bifurcation stenting? Reviewed

    Tanaka, A., Ruparelia, N., Kawamoto, H., Latib, A., Colombo, A.

    EuroIntervention   Vol. 12 ( 14 ) page: 1795 - 1798   2017

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    DOI: 10.4244/EIJ-D-15-00246

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  143. Single-Antiplatelet Therapy in Patients with Contraindication to Dual-Antiplatelet Therapy After Transcatheter Aortic Valve Implantation Reviewed

    Mangieri, A., Jabbour, R.J., Montalto, C., Pagnesi, M., Regazzoli, D., Ancona, M.B., Giannini, F., Tanaka, A., Bertoldi, L., Monaco, F., Agricola, E., Giglio, M., Mattioli, R., Ferri, L., Montorfano, M., Chieffo, A., Alfieri, O., Colombo, A., Latib, A.

    American Journal of Cardiology   Vol. 119 ( 7 ) page: 1088 - 1093   2017

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    DOI: 10.1016/j.amjcard.2016.11.065

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  144. A hybrid strategy with bioresorbable vascular scaffolds and drug eluting stents for treating complex coronary lesions Reviewed

    Jabbour, R.J., Ielasi, A., Tanaka, A., Leoncini, M., Cortese, B., Grigis, G., Mitomo, S., Regazzoli, D., Di Palma, G., Rapetto, C., Tespili, M., Colombo, A., Latib, A.

    Cardiovascular Revascularization Medicine   Vol. 18 ( 5 ) page: S4 - S9   2017

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  145. Hybrid Percutaneous Coronary Intervention With Bioresorbable Vascular Scaffolds in Combination With Drug-Eluting Stents or Drug-Coated Balloons for Complex Coronary Lesions Reviewed

    Tanaka, A., Jabbour, R.J., Mitomo, S., Latib, A., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 10 ( 6 ) page: 539 - 547   2017

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    DOI: 10.1016/j.jcin.2016.12.285

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  146. Patent foramen ovale closure through inferior vena cava filter in a patient with deep venous thrombosis and recurrent ischemic events Reviewed

    Regazzoli, D., Ancona, M.B., Mangieri, A., Tanaka, A., Romano, V., Leone, P.P., Tresoldi, M., Lanzillo, G., Agricola, E., Latib, A., Colombo, A., Montorfano, M.

    Journal of Cardiovascular Medicine   Vol. 18 ( 10 ) page: 828 - 830   2017

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  147. Bioresorbable Vascular Scaffolds as a Treatment Option for Left Main Lesions Reviewed

    Jabbour, R.J., Tanaka, A., Capranzano, P., Cortese, B., Lesiak, M., Testa, L., Gatto, P., Suarez de Lezo, J., Mattesini, A., Geraci, S., Ielasi, A., Diletti, R., Capodanno, D., Buccheri, D., Iwanczyk, S., Bedogni, F., Tchetche, D., Di Mario, C., Caramanno, G., Van Mieghem, N.M., Tamburino, C., Colombo, A., Latib, A.

    JACC: Cardiovascular Interventions   Vol. 10 ( 7 ) page: 743 - 745   2017

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  148. Bioresorbable Vascular Scaffolds and Very Late Scaffold Thrombosis: Searching an Explanation and a Solution Reviewed

    Tanaka, A., Latib, A., Jabbour, R.J., Mitomo, S., Regazzoli, D., Leone, P.P., Chieffo, A., Carlino, M., Montorfano, M., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 10 ( 7 ) page: 745 - 746   2017

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  149. Advances in percutaneous interventional therapies: The tricuspid valve Reviewed

    Jabbour, R.J., Giannini, F., Tanaka, A., Mangieri, A., Mikhail, G.W., Latib, A., Colombo, A.

    Future Cardiology   Vol. 13 ( 3 ) page: 239 - 245   2017

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  150. Dual Antiplatelet Therapy After Bioresorbable Vascular Scaffold Implantation: Insights From the Milan Cohort Reviewed

    Mitomo, S., Latib, A., Tanaka, A., Jabbour, R.J., Regazzoli, D., Leone, P.P., Giannini, F., Chieffo, A., Carlino, M., Montorfano, M., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 10 ( 14 ) page: 1471 - 1472   2017

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  151. Mid-term clinical outcomes of ABSORB bioresorbable vascular scaffold versus everolimus-eluting stent for coronary bifurcation lesions Reviewed

    Naganuma, T., Kawamoto, H., Panoulas, V.F., Latib, A., Tanaka, A., Mitomo, S., Ruparelia, N., Jabbour, R.J., Chieffo, A., Carlino, M., Montorfano, M., Colombo, A.

    International Journal of Cardiology   Vol. 246   page: 26 - 31   2017

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  152. Impact of Mitral Annular Calcium on Outcomes after Transcatheter Aortic Valve Implantation Reviewed

    Ancona, M.B., Giannini, F., Mangieri, A., Regazzoli, D., Jabbour, R.J., Tanaka, A., Testa, L., Romano, V., Longoni, M., Giglio, M., Besana, F., Cacucci, M., Agricola, E., Chieffo, A., Alfieri, O., Montorfano, M., Colombo, A., Latib, A.

    American Journal of Cardiology   Vol. 120 ( 12 ) page: 2233 - 2240   2017

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  153. Influence of False Lumen Status on the Prognosis of Acute Type A Aortic Dissection without Urgent Surgical Treatment Reviewed

    Tanaka Akihito, Ishii Hideki, Suzuki Susumu, Ota Tomoyuki, Oshima Hideki, Usui Akihiko, Komori Kimihiro, Murohara Toyoaki

    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS   Vol. 24 ( 2 ) page: 169 - 175   2017

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    <p><b><i>Aim</i></b><b>: </b>Recently, much attention has been focused on partial thrombosis of the false lumen in patients with acute aortic dissection. However, its effect on clinical outcomes in these patients, especially in case of acute type A aortic dissection, has not been clearly elucidated. This study evaluated the influence of the false lumen status, including partial thrombosis, on short-term clinical outcomes in acute type A aortic dissection patients without urgent surgical treatment.</p><p><b><i>Methods</i></b><b>: </b>Sixty-two patients (29 males, mean age 73±13 years) with acute type A aortic dissection who did not receive urgent surgical treatment at four hospitals were enrolled. Patients were divided into three groups based on the false lumen status on enhanced computed tomography image (complete thrombosis, <i>n</i>=28; partial thrombosis, <i>n</i>=27; patent, <i>n</i>=7). Patients with partial thrombosis were further divided into two groups (thrombus-dominant, <i>n</i>=15; flow-dominant, <i>n</i>=12).</p><p><b><i>Results</i></b><b>: </b>The short-term mortality rate (in-hospital and 30-day) was significantly higher in patients with a patent false lumen, while no significant difference was seen between the other two groups. Patients with flow-dominant partial thrombosis had significantly higher short-term mortality rate than those with thrombus-dominant partial thrombosis (in-hospital, <i>p</i>=0.001 and 30-day, <i>p</i><0.001).</p><p><b><i>Conclusions</i></b><b>: </b>The short-term mortality rate in acute type A aortic dissection patients without urgent surgical treatment was lower in patients with partial thrombosis of the false lumen than in those with a patent false lumen. Furthermore, patients with flow-dominant partial thrombosis had higher mortality rate than those with thrombus-dominant partial thrombosis.</p>

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  154. Predictive Value of Aortic Valve Calcification for Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention Reviewed

    Shibata Yohei, Ishii Hideki, Suzuki Susumu, Tanaka Akihito, Tatami Yosuke, Harata Shingo, Ota Tomoyuki, Shimbo Yusaku, Takayama Yohei, Kunimura Ayako, Hirayama Kenshi, Harada Kazuhiro, Osugi Naohiro, Murohara Toyoaki

    JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS   Vol. 24 ( 5 ) page: 487 - 494   2017

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    <p><i><b>Aims</b></i><b>: </b>Previous studies have shown that aortic valve calcification (AVC) was associated with cardiovascular events and mortality. On the other hand, periprocedural myocardial injury (PMI) in percutaneous coronary intervention (PCI) is a well-known predictor of subsequent mortality and poor clinical outcomes. The purpose of the study was to assess the hypothesis that the presence of AVC could predict PMI in PCI.</p><p><i><b>Methods</b></i><b>: </b>This study included 370 patients treated with PCI for stable angina pectoris. AVC was defined as bright echoes >1 mm on one or more cusps of the aortic valve on ultrasound cardiography (UCG). PMI was defined as an increase in high-sensitivity troponin T level of >5 times the upper normal limit (>0.070 ng/ml) at 24 hours after PCI.</p><p><i><b>Results</b></i><b>: </b>AVC was detected in 45.9% of the patients (<i>n</i>=170). The incidence of PMI was significantly higher in the patients with AVC than in those without AVC (43.5% vs 21.0%, <i>p</i><0.001). The presence of AVC independently predicted PMI after adjusting for other significant variables (odds ratio 2.26, 95% confidence interval 1.37–3.74, <i>p</i>=0.002). Other predictors were male sex, age, estimated glomerular filtration rate, and total stent length. Furthermore to predict PMI, adding AVC to the established risk factors significantly improved the area under the receiver operating characteristic curves, from 0.68 to 0.72, of the PMI prediction model (<i>p</i>=0.025).</p><p><i><b>Conclusion</b></i><b>: </b>The presence of AVC detected in UCG could predict the incidence of PMI.</p>

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  155. Tips and tricks for implanting BRSs: Sizing, pre- and postdilatation Reviewed

    Tanaka, A., Jabbour, R.J., Colombo, A.

    Bioresorbable Scaffolds: From Basic Concept to Clinical Applications     2017

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  156. Clinical outcomes of a real world cohort following bioresorbable vascular scaffold implantation utilizing an optimized implantation strategy. Reviewed

    Tanaka A, Latib A, Kawamoto H, Jabbour RJ, Sato K, Miyazaki T, Naganuma T, Mangieri A, Pagnesi M, Montalto C, Chieffo A, Carlino M, Montorfano M, Colombo A

    EuroIntervention   Vol. 12 ( 14 ) page: 1730 - 1737   2016.10

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  157. Bioresorbable Scaffolds: What Does "Less Forgiving" Mean? Reviewed

    Tanaka A, Jabbour RJ, Latib A, Colombo A

    JACC: Cardiovascular Interventions   Vol. 9 ( 17 ) page: 1856 - 7   2016.9

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  158. T-Stenting With Small Protrusion: The Default Strategy for Bailout Provisional Stenting? Reviewed

    Jabbour RJ, Tanaka A, Pagnesi M, Regazzoli D, Mangieri A, Ancona M, Azzalini L, Giannini F, Montorfano M, Chieffo A, Carlino M, Latib A, Colombo A

    JACC: Cardiovascular Interventions   Vol. 9 ( 17 ) page: 1853 - 4   2016.9

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  159. Minimal Acute Recoil Following Bioresorbable Scaffold Implantation in Fibrocalcific Lesion Detected by Optical Frequency-Domain Imaging. Reviewed

    Kawamoto H, Ruparelia N, Tanaka A, Latib A, Colombo A

    Journal of Invasive Cardiology   Vol. 28 ( 3 ) page: E34 - 6   2016.3

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  160. Case illustration of the difference between bench test and in-vivo scaffold fracture thresholds Reviewed

    Tanaka, A., Jabbour, R.J., Latib, A., Colombo, A.

    International Journal of Cardiology   Vol. 225   page: 20 - 22   2016

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    DOI: 10.1016/j.ijcard.2016.09.097

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  161. Unfractionated heparin during the interruption of antiplatelet therapy for non-cardiac surgery after drug-eluting stent implantation Reviewed

    Tanaka, A., Ishii, H., Tatami, Y., Shibata, Y., Osugi, N., Ota, T., Kawamura, Y., Suzuki, S., Nagao, Y., Matsushita, T., Murohara, T.

    Internal Medicine   Vol. 55 ( 4 ) page: 333 - 337   2016

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    <b>Objective</b> Heparin is not recommended to be administered during the interruption of antiplatelet therapy for non-cardiac surgery. However, there are insufficient data to determine the value. The purpose of the present study was to evaluate the clinical results of the administration of unfractionated heparin during the interruption of antiplatelet therapy in non-cardiac surgery patients who had previously undergone drug-eluting stent (DES) implantation.<br> <b>Methods</b> We retrospectively identified 210 elective non-cardiac surgical procedures that were performed with the administration of unfractionated heparin during interruption of all antiplatelet therapies in patients who had previously undergone DES implantation. Heparin was administered during the perioperative period in accordance with the local practice guideline at out institution. We examined the clinical outcomes within 30 days of surgery.<br> <b>Results</b> The mean number of implanted DESs was 2.1±1.3. No major adverse cardiac events (including cardiac death, definite stent thrombosis, and non-fatal myocardial infarction) occurred in any of the 210 cases within 30 days of surgery. Four of the 210 cases (1.9%) required reoperation for bleeding within 30 days of surgery.<br> <b>Conclusion</b> Our data showed the potential for the perioperative management with unfractionated heparin administration in Japanese patients who had previously undergone DES implantation who required non-cardiac surgery with the interruption of all antiplatelet therapies.<br>

    DOI: 10.2169/internalmedicine.55.5495

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  162. Reverse association of omega-3/omega-6 polyunsaturated fatty acids ratios with carotid atherosclerosis in patients on hemodialysis Reviewed

    Umemoto, N., Ishii, H., Kamoi, D., Aoyama, T., Sakakibara, T., Takahashi, H., Tanaka, A., Yasuda, Y., Suzuki, S., Matsubara, T., Murohara, T.

    Atherosclerosis   Vol. 249   page: 65 - 69   2016

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    DOI: 10.1016/j.atherosclerosis.2016.03.037

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  163. Restored Physiological Vasomotion Imitating Intrascaffold Restenosis 3 Years After Bioresorbable Scaffold Implantation Reviewed

    Ancona, M.B., Tanaka, A., Latib, A., Jabbour, R.J., Kawamoto, H., Regazzoli, D., Mangieri, A., Colombo, A.

    Canadian Journal of Cardiology   Vol. 32 ( 12 ) page: 1574.e9 - 1574.e10   2016

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    DOI: 10.1016/j.cjca.2016.02.069

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  164. Preliminary Report of Clinical Outcomes After Single Crossover Bioresorbable Scaffold Implantation Without Routine Side Branch Strut Dilation Reviewed

    Tanaka, A., Jabbour, R.J., Kawamoto, H., Mangieri, A., Pagnesi, M., Montalto, C., Chieffo, A., Carlino, M., Montorfano, M., Latib, A., Colombo, A.

    Catheterization and Cardiovascular Interventions   Vol. 88 ( 6 ) page: 865 - 870   2016

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    DOI: 10.1002/ccd.26586

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  165. Left main “Culotte in Culotte” to manage a trapped broken balloon Reviewed

    Ancona, M.B., Giannini, F., Jabbour, R.J., Tanaka, A., Regazzoli, D., Mangieri, A., Carlino, M., Colombo, A.

    International Journal of Cardiology   Vol. 221   page: 347 - 9   2016

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    DOI: 10.1016/j.ijcard.2016.06.302

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  166. Impact of post-procedural hyperglycemia on acute kidney injury after transcatheter aortic valve implantation Reviewed

    Giannini, F., Latib, A., Jabbour, R.J., Ruparelia, N., Aurelio, A., Ancona, M.B., Figini, F., Mangieri, A., Regazzoli, D., Tanaka, A., Montalto, C., Azzalini, L., Monaco, F., Agricola, E., Chieffo, A., Montorfano, M., Alfieri, O., Colombo, A.

    International Journal of Cardiology   Vol. 221   page: 892 - 7   2016

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  167. Incidence and significance of side branch occlusions following bioresorbable scaffold implantation for long left anterior descending artery lesions Reviewed

    Tanaka, A., Jabbour, R.J., Kawamoto, H., Chieffo, A., Carlino, M., Montorfano, M., Latib, A., Colombo, A.

    International Journal of Cardiology   Vol. 222   page: 674 - 675   2016

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    DOI: 10.1016/j.ijcard.2016.08.060

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  168. Impact of Angiographic Result After Predilatation on Outcome After Drug-Coated Balloon Treatment of In-Stent Coronary Restenosis Reviewed

    Tanaka, A., Latib, A., Jabbour, R.J., Kawamoto, H., Giannini, F., Ancona, M., Regazzoli, D., Mangieri, A., Mattioli, R., Chieffo, A., Carlino, M., Montorfano, M., Colombo, A.

    American Journal of Cardiology   Vol. 118 ( 10 ) page: 1460 - 1465   2016

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    DOI: 10.1016/j.amjcard.2016.08.006

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  169. Progression from stenosis to occlusion in the proximal native coronary artery after coronary artery bypass grafting Reviewed

    Tanaka, A., Ishii, H., Oshima, H., Shibata, Y., Tatami, Y., Osugi, N., Ota, T., Kawamura, Y., Suzuki, S., Usui, A., Murohara, T.

    Heart and Vessels   Vol. 31 ( 7 ) page: 1056 - 1060   2016

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    DOI: 10.1007/s00380-015-0715-8

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  170. Multimodality evaluation of percutaneous closure of coronary fistula using AMPLATZER Vascular Plug IV Reviewed

    Regazzoli, D., Giglio, M., Besana, F., Leone, P.P., Tanaka, A., Ancona, M.B., Mangieri, A., Montorfano, M., Giannini, F., De Angelis, G., Colombo, A., Latib, A.

    International Journal of Cardiology   Vol. 225   page: 381 - 383   2016

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    DOI: 10.1016/j.ijcard.2016.09.100

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  171. Bioresorbable vascular scaffolds: From patient selection to optimal scaffold implantation; tips and tricks to minimize device failure Reviewed

    Tanaka, A., Jabbour, R.J., Latib, A., Colombo, A.

    Catheterization and Cardiovascular Interventions   Vol. 88 ( S1 ) page: 10 - 20   2016

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  172. Is Multislice Computed Tomography a Feasible Option for Follow-Up of Complex Coronary Lesions Treated With Bioresorbable Scaffolds? Reviewed

    Regazzoli, D., Latib, A., Tanaka, A., Di Marco, D., Giglio, M., Jabbour, R., Ancona, M.B., Leone, P.P., Mangieri, A., Montorfano, M., Giannini, F., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 9 ( 24 ) page: 2578 - 2581   2016

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  173. Excimer laser facilitated coronary angioplasty of a heavy calcified lesion treated with bioresorbable scaffolds Reviewed

    Mangieri, A., Jabbour, R.J., Tanaka, A., Aurelio, A., Colombo, A., Latib, A.

    Journal of Cardiovascular Medicine   Vol. 17   page: e149 - e150   2016

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  174. Clinical outcomes following target lesion revascularization for bioresorbable scaffold failure Reviewed

    Tanaka, A., Ruparelia, N., Kawamoto, H., Sticchi, A., Figini, F., Carlino, M., Chieffo, A., Montorfano, M., Latib, A., Colombo, A.

    Catheterization and Cardiovascular Interventions   Vol. 87 ( 5 ) page: 832 - 6   2016

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  175. A super high-pressure balloon solution for a non-dilatable in-stent restenosis Reviewed

    Tanaka, A., Jabbour, R.J., Kawamoto, H., Latib, A., Colombo, A.

    International Journal of Cardiology   Vol. 203   page: 357 - 9   2016

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  176. Very Late Restenosis after Bioresorbable Scaffold Implantation Due to Simultaneous External Compression of the Scaffold and Intrascaffold Tissue Growth Reviewed

    Tanaka, A., Ruparelia, N., Kawamoto, H., Latib, A., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 9 ( 2 ) page: e15 - 7   2016

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    DOI: 10.1016/j.jcin.2015.08.037

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  177. Long-term outcomes after transcatheter aortic valve implantation from a single high-volume center (The Milan Experience) Reviewed

    Ruparelia, N., Latib, A., Buzzatti, N., Giannini, F., Figini, F., Mangieri, A., Regazzoli, D., Stella, S., Sticchi, A., Kawamoto, H., Tanaka, A., Agricola, E., Monaco, F., Castiglioni, A., Ancona, M., Cioni, M., Spagnolo, P., Chieffo, A., Montorfano, M., Alfieri, O., Colombo, A.

    American Journal of Cardiology   Vol. 117 ( 5 ) page: 813 - 9   2016

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    DOI: 10.1016/j.amjcard.2015.12.014

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  178. Clinical outcomes following bioresorbable scaffold implantation in small vessels Reviewed

    Tanaka, A., Ruparelia, N., Kawamoto, H., Sticchi, A., Sato, K., Miyazaki, T., Naganuma, T., Chieffo, A., Carlino, M., Montorfano, M., Latib, A., Colombo, A.

    International Journal of Cardiology   Vol. 207   page: 59 - 61   2016

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    DOI: 10.1016/j.ijcard.2016.01.005

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  179. Vascular healing of a false lumen after bioresorbable scaffold implantation Reviewed

    Kawamoto, H., Jabbour, R.J., Tanaka, A., Latib, A., Colombo, A.

    Circulation: Cardiovascular Interventions   Vol. 9 ( 2 ) page: e003498   2016

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    DOI: 10.1161/CIRCINTERVENTIONS.115.003498

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  180. The Bioresorbable Scaffold: Will Oversizing Affect Outcomes? Reviewed

    Kawamoto, H., Jabbour, R.J., Tanaka, A., Latib, A., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 9 ( 3 ) page: 299 - 300   2016

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    DOI: 10.1016/j.jcin.2015.11.019

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  181. Contained coronary rupture following bioresorbable scaffold implantation in a small vessel Reviewed

    Kawamoto, H., Jabbour, R.J., Tanaka, A., Latib, A., Colombo, A.

    International Journal of Cardiology   Vol. 209   page: 24 - 5   2016

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    DOI: 10.1016/j.ijcard.2016.02.026

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  182. Transcatheter aortic valve implantation in intermediate- and low-risk populations: An inevitable progression? Reviewed

    Jabbour, R.J., Pagnesi, M., Kawamoto, H., Tanaka, A., Regazzoli, D., Mangieri, A., Ancona, M., Monaco, F., Agricola, E., Spagnolo, P., Castiglioni, A., De Angelis, G., Chieffo, A., Montorfano, M., Colombo, A., Latib, A.

    International Journal of Cardiology   Vol. 210   page: 35 - 7   2016

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    DOI: 10.1016/j.ijcard.2016.02.094

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  183. Long-term clinical outcomes after bioresorbable vascular scaffold implantation for the treatment of coronary in-stent restenosis Reviewed

    Moscarella, E., Ielasi, A., Granata, F., Coscarelli, S., Stabile, E., Latib, A., Cortese, B., Tespili, M., Tanaka, A., Capozzolo, C., Caliendo, L., Colombo, A., Varricchio, A.

    Circulation: Cardiovascular Interventions   Vol. 9 ( 4 ) page: e003148   2016

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    DOI: 10.1161/CIRCINTERVENTIONS.115.003148

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  184. Illustration of the Resorption Process Between 2 Different Overlapping Bioresorbable Scaffolds Reviewed

    Tanaka, A., Jabbour, R.J., Kawamoto, H., Latib, A., Colombo, A.

    JACC: Cardiovascular Imaging   Vol. 9 ( 12 ) page: 1469 - 1470   2016

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    DOI: 10.1016/j.jcmg.2015.12.013

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  185. Bioresorbable scaffold failure for recurrent restenosis at multi-layered stent fracture Reviewed

    Tanaka, A., Jabbour, R.J., Kawamoto, H., Latib, A., Colombo, A.

    International Journal of Cardiology   Vol. 214   page: 360 - 1   2016

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    DOI: 10.1016/j.ijcard.2016.03.207

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  186. Usefulness of predilation before transcatheter aortic valve implantation Reviewed

    Pagnesi, M., Jabbour, R.J., Latib, A., Kawamoto, H., Tanaka, A., Regazzoli, D., Mangieri, A., Montalto, C., Ancona, M.B., Giannini, F., Chieffo, A., Montorfano, M., Monaco, F., Castiglioni, A., Alfieri, O., Colombo, A.

    American Journal of Cardiology   Vol. 118 ( 1 ) page: 107 - 12   2016

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    DOI: 10.1016/j.amjcard.2016.04.018

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  187. Clinical outcomes following bifurcation double-stenting with bioresorbable scaffolds Reviewed

    Tanaka, A., Latib, A., Kawamoto, H., Jabbour, R.J., Mangieri, A., Pagnesi, M., Montalto, C., Regazzoli, D., Ancona, M., Chieffo, A., Carlino, M., Montorfano, M., Colombo, A.

    Catheterization and Cardiovascular Interventions   Vol. 88 ( 6 ) page: 854 - 862   2016

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    DOI: 10.1002/ccd.26579

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  188. Bioresorbable Scaffolds for the Management of Coronary Bifurcation Lesions Reviewed

    Kawamoto, H., Ruparelia, N., Tanaka, A., Chieffo, A., Latib, A., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 9 ( 10 ) page: 989 - 1000   2016

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    DOI: 10.1016/j.jcin.2016.02.038

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  189. Treatment with cilostazol improves clinical outcome after endovascular therapy in hemodialysis patients with peripheral artery disease Reviewed

    Ishii, H., Aoyama, T., Takahashi, H., Kumada, Y., Kamoi, D., Sakakibara, T., Umemoto, N., Suzuki, S., Tanaka, A., Ito, Y., Murohara, T.

    Journal of Cardiology   Vol. 67 ( 2 ) page: 199 - 204   2016

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    DOI: 10.1016/j.jjcc.2015.05.003

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  190. Impact of the statin escape phenomenon on long-term clinical outcomes in patients with acute myocardial infarction: Subgroup analysis of the Nagoya Acute Myocardial Infarction Study (NAMIS) Reviewed

    Ota, T., Ishii, H., Suzuki, S., Shibata, Y., Tatami, Y., Harata, S., Shimbo, Y., Takayama, Y., Tanaka, A., Kawamura, Y., Osugi, N., Maeda, K., Kondo, T., Murohara, T.

    Atherosclerosis   Vol. 242 ( 1 ) page: 155 - 160   2015

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    DOI: 10.1016/j.atherosclerosis.2015.07.012

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  191. Positive Vessel Remodeling and Appearance of Pulsatile Wall Motion at Long-Term Follow-Up After Bioresorbable Scaffold Implantation in a Chronic Total Occlusion Reviewed

    Tanaka, A., Ruparelia, N., Kawamoto, H., Latib, A., Colombo, A.

    JACC: Cardiovascular Interventions   Vol. 8 ( 12 ) page: 1635 - 7   2015

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    DOI: 10.1016/j.jcin.2015.06.022

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  192. Impact of cigarette smoking on coronary plaque composition Reviewed International journal

    Kumagai, S., Amano, T., Takashima, H., Waseda, K., Kurita, A., Ando, H., Maeda, K., Ito, Y., Ishii, H., Hayashi, M., Yoshikawa, D., Suzuki, S., Tanaka, A., Matsubara, T., Muroharab, T.

    Coronary Artery Disease   Vol. 26 ( 1 ) page: 60 - 65   2015

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    DOI: 10.1097/MCA.0000000000000168

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  193. Relation between paradoxical decrease in high-density lipoprotein cholesterol levels after statin therapy and adverse cardiovascular events in patients with acute myocardial infarction Reviewed

    Ota, T., Ishii, H., Suzuki, S., Tanaka, A., Shibata, Y., Tatami, Y., Harata, S., Shimbo, Y., Takayama, Y., Kawamura, Y., Osugi, N., Maeda, K., Kondo, T., Murohara, T.

    American Journal of Cardiology   Vol. 115 ( 4 ) page: 411 - 416   2015

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    DOI: 10.1016/j.amjcard.2014.11.043

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  194. Practical approach to evaluate asymptomatic coronary artery disease in end-stage renal disease patients at the initiation of dialysis Reviewed

    Tanaka, A., Sakakibara, M., Asada, H., Tanaka, T., Ishii, H., Murohara, T.

    Therapeutic Apheresis and Dialysis   Vol. 18 ( 2 ) page: 167 - 173   2014

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    DOI: 10.1111/1744-9987.12098

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  195. Evaluation for hypoperfusion distal to arteriovenous vascular access using skin perfusion pressure in fingers Reviewed

    Tanaka, A., Sakakibara, M., Nishimura, H., Asano, M., Kariya, T., Masamoto, D., Mizutani, M., Ishii, H., Murohara, T.

    Journal of Vascular Access   Vol. 15 ( 1 ) page: 29 - 32   2014

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    DOI: 10.5301/jva.5000170

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  196. The risk of adverse cardiac events following minor surgery under discontinuation of all antiplatelet therapy in patients with prior drug-eluting stent implantation Reviewed

    Tanaka, A., Sakakibara, M., Ishii, H., Okumura, S., Suzuki, S., Inoue, Y., Jinno, Y., Okada, K., Murohara, T.

    International Journal of Cardiology   Vol. 172 ( 1 ) page: E125 - E126   2014

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    DOI: 10.1016/j.ijcard.2013.12.114

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  197. Temporary adjunctive cilostazol vs clopidogrel loading for ST-segment elevation acute myocardial infarction Reviewed

    Tanaka, A., Ishii, H., Sakakibara, M., Okumura, S., Jinno, Y., Okada, K., Suzuki, S., Inoue, Y., Murohara, T.

    American Journal of Cardiovascular Drugs   Vol. 14 ( 2 ) page: 131 - 136   2014

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    DOI: 10.1007/s40256-013-0059-7

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  198. Impact of diabetic retinopathy on late cardiac events after percutaneous coronary intervention Reviewed

    Tanaka, A., Ishii, H., Tatami, Y., Shibata, Y., Osugi, N., Ota, T., Okumura, S., Suzuki, S., Inoue, Y., Murohara, T.

    Journal of Cardiology   Vol. 64 ( 3 ) page: 175 - 178   2014

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    DOI: 10.1016/j.jjcc.2013.12.006

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  199. Coronary subclavian steal from a left internal thoracic artery coronary bypass graft due to ipsilateral subclavian artery stenosis and an arteriovenous graft in a hemodialysis patient with left vertebral artery occlusion

    Tanaka, A., Sakakibara, M., Okada, K., Jinno, Y., Ishii, H., Murohara, T.

    Internal Medicine   Vol. 52 ( 11 ) page: 1195 - 1198   2013

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    Coronary subclavian steal syndrome is an unusual cause of myocardial ischemia, secondary to a reversed blood flow in patients with patent internal thoracic artery coronary bypass grafts. The causes of coronary subclavian steal are either ipsilateral subclavian artery stenosis or upper extremity arteriovenous hemodialysis fistula formation or both. This report involves a 68-year-old woman with left vertebral artery occlusion who developed severe coronary steal in the absence of vertebral subclavian steal due to left subclavian artery stenosis and an arteriovenous hemodialysis graft.<br>

    DOI: 10.2169/internalmedicine.52.8950

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  200. Treatment of sirolimus-eluting stent restenosis: Additional stent, balloon angioplasty, and coronary artery bypass graft Reviewed International journal

    Ishikawa, K., Aoyama, Y., Kato, K., Tanaka, A., Hiramatsu, M., Ajioka, M., Kamiya, H., Tanaka, T., Hirayama, H.

    Journal of Cardiac Surgery   Vol. 28 ( 2 ) page: 97 - 101   2013

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    OBJECTIVE: Sirolimus-eluting stent (SES) has shown a significant efficacy in reducing restenosis after percutaneous coronary interventions. However, an increase in total number of SES use along with targeting more complex lesions generated a large number of SES restenosis. This study aimed to investigate the clinical and angiographic outcomes of different revascularization strategies for SES restenosis. METHODS AND RESULTS: A total of 176 lesions in 149 patients were included in the study. Fifteen patients underwent coronary artery bypass graft surgery (CABG group) and the remaining patients were treated with percutaneous coronary intervention (PCI). Stent reimplantation was performed in 88 patients (Stent group), whereas 46 patients received balloon therapy (Balloon group). Among 176 lesions, major cardiac adverse event (MACE) occurred in 41 lesions (23.3%) during a median follow-up of 310 days (interquartile range: 146-517 days). The Kaplan-Meier method with a log-rank test revealed no significant difference in MACE rates between the three groups (6%, 25%, 26%, p = 0.13; CABG group, Stent group, Balloon group, respectively). However, when the Balloon group and Stent group were combined together as a PCI group, PCI group had a significantly higher rate of MACE compared with the CABG group (p = 0.04). In addition, angiographic restenosis was significantly less prevalent in the CABG group when compared with the other two groups (8%, 57%, 46%, p = 0.006; CABG group, Stent group, Balloon group, respectively). CONCLUSIONS: CABG surgery for patients with SES restenosis is associated with the better clinical outcomes as well as better angiographic outcomes when compared with that of PCI.

    DOI: 10.1111/jocs.12056

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  201. Migration of fractured renal artery stent Reviewed

    Tanaka, A., Takahashi, S., Saito, S.

    Catheterization and Cardiovascular Interventions   Vol. 77 ( 2 ) page: 305 - 7   2011

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    DOI: 10.1002/ccd.22736

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  202. Perioperative intra-aortic balloon pumping and staged coronary intervention for a patient with concurrent coronary artery disease and cancer

    Ishikawa, K., Tanaka, A., Kawase, H., Tanaka, T.

    Acta Cardiologica Sinica   Vol. 27 ( 4 )   2011

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  203. Short and mid-term outcomes of coronary intervention with the MULTI-LINK vision™ stent

    Tanaka, A., Suzuki, Y., Suzuki, N., Hirai, T., Yasuda, N., Miki, K., Fujita, M., Morishita, Y., Yanagisawa, S., Kawase, H., Tanaka, T.

    Japanese Journal of Interventional Cardiology   Vol. 24 ( 3 )   2009

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KAKENHI (Grants-in-Aid for Scientific Research) 4

  1. 冠動脈疾患進展の新規曝露危険因子と好中球を介した機序及び新規予防戦略の探索

    Grant number:22K16100  2022.4 - 2025.3

    科学研究費助成事業  若手研究

    田中 哲人

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    Authorship:Principal investigator 

    Grant amount:\4680000 ( Direct Cost: \3600000 、 Indirect Cost:\1080000 )

    心血管疾患に対する現行のアプローチによる一次、二次予防効果は近年頭打ちの状態であり、医療経済背景も考えた効果的な新たなアプローチが求められている。そのためには心血管疾患の残余リスクに対して、現存の介入方法に十分な上乗せ効果を得ることと同時に介入対象を正確に層別化していくことが重要であり、そのためには新たな視点が必要である。本研究では、新たな曝露危険因子となりうる PM2.5などの粒子状物質と体内炎症、心血管疾患との関連や、動脈硬化の進展に寄与する 血管内炎症を引き起こす好中球の活性化などに着目し、臨床的並びに基礎的検討の両面からその生体反応を追求する。

  2. Safe and Stable Transseptal Access for Trans-catheter Mitral Valve Replacement

    Grant number:22K08955  2022.4 - 2025.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

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    Authorship:Coinvestigator(s) 

  3. Medical Economics in Transcatheter Aortic Valve Implantation

    Grant number:19K08513  2019.4 - 2022.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

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    Authorship:Coinvestigator(s) 

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  4. 動脈硬化進展に伴う大動脈瘤発症のメカニズム並びに効果的な内科治療戦略の探索

    Grant number:19K17591  2019.4 - 2021.3

    科学研究費助成事業  若手研究

    田中 哲人

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    Authorship:Principal investigator 

    Grant amount:\4290000 ( Direct Cost: \3300000 、 Indirect Cost:\990000 )

    近年、糖尿病が大動脈径拡大に対して抑制的に働くというねじれの現象が観察され、糖尿病と大動脈瘤の負の相関関係が注目されている。糖尿病は、冠動脈疾患を始めとする動脈硬化性疾患の強力な危険因子であり、高血圧や脂質異常など動脈硬化のその他の危険因子を同時に有する事も多い。さらに冠動脈疾患や脳血管、末梢血管疾患の進行は大動脈瘤の有病率とも正の相関をすることがわかっている。それにもかかわらず、この負の相関関係が存在するが、その詳細なメカニズムは十分に明らかにされていない。本研究は、冠動脈疾患患者での糖尿病有無による大動脈径を比較検証することで、ねじれ現象の原因を詳細に解析し、そのメカニズムを探求する。
    近年、糖尿病が大動脈径拡大に対して抑制的に働くというねじれの現象が観察され、糖尿病と大動脈瘤の負の相関関係が注目されている。糖尿病は、冠動脈疾患を始めとする動脈硬化性疾患の強力な危険因子であり、高血圧や脂質異常など動脈硬化のその他の危険因子を同時に有する事も多い。さらに冠動脈疾患や脳血管、末梢血管疾患の進行は大動脈瘤の有病率とも正の相関をすることがわかっている。それにもかかわらず、この負の相関関係が存在するが、その詳細なメカニズムは十分に明らかにされていない。本研究においては、冠動脈疾患患者での糖尿病有無による大動脈径を比較検証することで、ねじれ現象を詳細に解析し、そのメカニズムを探求することを目的とした。
    今回カテーテル治療を受けた冠動脈疾患患者において、治療前後とその一年後以降の2点以上でCTを撮像した患者216名に関して、腹部大動脈径ならびに石灰化の程度、その時系列での変化を観察した。その結果、カテーテル治療前後の時点で、腹部大動脈径は糖尿病患者において有意に小さいことが確認されたが、石灰化の程度においては糖尿病の有無により有意な差を認めなかった。一方、その後の変化率においては、径の年次変化率については、糖尿病の有無により有意な差を認めなかったが、石灰化の進行については糖尿病患者において有意に大きかった。これらの結果から、糖尿病の血管壁に対する影響は、その血管の動脈硬化進展の過程の中で変化しうることが考えられた。これらの内容については、Journal of Atherosclerosis and Thrombosis誌に受理された。現在、さらに生理活性物質などを含めた検討を進めている。
    ここまでに、カテーテル治療を受けた冠動脈疾患患者において、治療前後とその一年後以降の2点以上でCTを撮像した患者216名に関して、腹部大動脈径ならびに石灰化の程度、その時系列での変化を観察した。その結果、カテーテル治療前後の時点で、腹部大動脈径は糖尿病患者において有意に小さいことが確認されたが、石灰化の程度においては糖尿病の有無により有意な差を認めなかった。一方、その後の変化率においては、径の年次変化率については、糖尿病の有無により有意な差を認めなかったが、石灰化の進行については糖尿病患者において有意に大きかった。これらの結果から、糖尿病の血管壁に対する影響は、その血管の動脈硬化進展の過程の中で変化しうることが考えられた。現在、さらに生理活性物質を含めた検討についても準備を進めている。
    糖尿病患者、非糖尿病患者において生理活性物質(大動脈壁の変性に関わると言われている物質など)と、大動脈径、石灰化、その経時変化などとの関わりを検討する。さらに糖尿病患者の中で、大動脈径などをエンドポイントとし、生理活性物質や薬剤などを含めた何がそれらと密接に関わっているかを検討する。

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