Faculty Profiles - TANAKA Akihito

Papers - TANAKA Akihito

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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

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

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

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

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

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

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

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

Language：English Publishing type：Research paper (scientific journal) Publisher：Medicine (United States)

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

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

Language：English Publisher：The Japanese Circulation Society

<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

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

Language：English Publisher：Journal of Interventional Cardiac Electrophysiology

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

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

Language：English Publisher：The Japanese Circulation Society

<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

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

Authorship：Corresponding author Language：English Publisher：Archives of Gerontology and Geriatrics

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.

DOI： 10.1016/j.archger.2022.104737

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

Language：English Publisher：Heart and Vessels

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.

DOI： 10.1007/s00380-022-02150-8

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

Language：English Publisher：The Japanese Circulation Society

<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>

DOI： 10.1253/circrep.cr-22-0031

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

Authorship：Lead author Language：English Publisher：The Japanese Circulation Society

<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>

DOI： 10.1253/circrep.cr-22-0002

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

Authorship：Corresponding author Language：English Publisher：Journal of Cardiac Surgery

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.

DOI： 10.1111/jocs.16504

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

Authorship：Corresponding author Language：English Publisher：Cardiovascular Revascularization Medicine

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.

DOI： 10.1016/j.carrev.2022.02.008

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

Language：English Publisher：The Japanese Circulation Society

<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>

DOI： 10.1253/circrep.cr-22-0001

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

Language：English Publisher：The Japanese Circulation Society

<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>

DOI： 10.1253/circrep.cr-22-0003

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

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

Language：English Publisher：Nagoya Journal of Medical Science

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.

DOI： 10.18999/nagjms.84.2.352

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

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

Language：English Publisher：The Japanese Circulation Society

<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>

DOI： 10.1253/circrep.cr-21-0160

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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