研究者詳細 - 田中　哲人

論文 - 田中　哲人

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Clinical implications of cerebral microbleeds in patients who undergo transcatheter aortic valve replacement 査読有り

Uemura Y., Tanaka A., Ozaki Y., Yamaguchi S., Okajima T., Mitsuda T., Ishikawa S., Takemoto K., Murohara T., Watarai M.

Cardiovascular Revascularization Medicine 2025年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular Revascularization Medicine

Background: The prognostic implications of cerebral microbleeds (CMBs) in patients who undergo transcatheter aortic valve replacement (TAVR) have not been fully elucidated. Therefore, we aimed to investigate the association between the presence of CMBs and adverse outcomes post-TAVR. Methods: In this single-center retrospective study, we included 124 patients who underwent brain magnetic resonance imaging before TAVR. The outcomes of interest were the subsequent incidences of stroke and all-cause death or admission for heart failure. Results: CMBs were identified in 32.2 % of the included patients. The median follow-up duration was 954 (interquartile range, 553–1306) days. The incidence of stroke after TAVR was comparable between patients with and without CMBs. Conversely, all-cause death or admission for heart failure was significantly higher in patients with CMBs than in those without (log-rank P = 0.010). Multivariate Cox regression analysis revealed that the presence of CMBs was independently correlated with the occurrence of all-cause death or admission for heart failure after adjusting for other prognostic predictors (hazard ratio 4.016, 95 % confidence interval 1.572–10.259, P = 0.007). Conclusion: The presence of CMBs predicts the incidence of all-cause death or admission for heart failure in patients undergoing TAVR. Evaluating CMBs could provide useful information for post-TAVR management.

DOI： 10.1016/j.carrev.2024.12.013

Feasibility and efficacy of real-time ultrasound-guided venous closure with suture-mediated vascular closure device 査読有り国際誌

Tachi M., Tanaka A., Teraoka T., Furuta T., Matsushita E., Hayashi K., Shimojo M., Yanagisawa S., Inden Y., Murohara T.

Heart Rhythm 21 巻 ( 10 ) 頁： 2028 - 2036 2024年10月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart Rhythm

Background: Venous vascular access complications are usually nonfatal but are the most common complications after transvenous catheter intervention. Vascular closure devices (VCDs) have recently become available for venous closure. Objective: This study aimed to evaluate the feasibility and efficacy of real-time ultrasound-guided venous closure with suture-mediated VCDs in patients who underwent catheter ablation. Methods: This single-center observational study enrolled 226 consecutive patients who underwent elective catheter ablation with femoral venipuncture. For hemostasis, vessel closure by VCD was performed with real-time ultrasound guidance after 2022 (n = 123) and without ultrasound guidance in 2021 (n = 103). The occurrence of venous access site–related complications (major, minor, or other) was compared. Results: The rate of device failure was significantly lower in patients with ultrasound guidance than in those without (1.6% vs 6.3%; P = .048). The occurrence of all venous access site–related complications was significantly lower in patients with ultrasound guidance than in those without (4.9% vs 18.4%; P = .001). Time to ambulation was shorter in patients with ultrasound guidance than in those without (2.0 ± 0.1 hours vs 2.2 ± 0.6 hours; P < .001). Conclusion: Real-time ultrasound guidance can reduce device failure, access site–related complications, and time to ambulation in performing venous closure with a VCD.

DOI： 10.1016/j.hrthm.2024.04.041

Predictability of noninvasive liver fibrosis score for cardiac events in patients with nonalcoholic fatty liver disease 査読有り国際誌

Shibata N., Ito T., Toyoda H., Tanaka A., Morita Y., Kanzaki Y., Watanabe N., Yoshioka N., Yasuda S., Morishima I.

Nutrition, Metabolism and Cardiovascular Diseases 34 巻 ( 9 ) 頁： 2115 - 2123 2024年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Nutrition, Metabolism and Cardiovascular Diseases

Background and aims: Patients with nonalcoholic fatty liver disease (NAFLD) have a higher risk of cardiac events. However, although the severity of liver fibrosis is related to worsening prognosis in patients with NAFLD, it is unclear whether the noninvasive liver fibrosis score has a predictive value for cardiac events. Methods and results: We evaluated 4071 patients with NAFLD diagnosed using ultrasonography. Liver fibrosis was assessed and divided into three groups based on the Fibrosis-4 (FIB4) index and NAFLD fibrosis score (NFS). The primary outcome of this study was major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, and revascularization due to coronary artery disease. The median age of the evaluated patients was 61 (52–69) years, and 2201 (54.1%) were male. During the median follow-up period of 6.6 years, 179 (4.4%) patients experienced MACE. Kaplan–Meier survival analysis demonstrated that MACE increased progressively with the FIB4 index (log-rank, p < 0.001) and NFS (log-rank, p < 0.001). Multivariable analysis showed that the higher the FIB4 index, the higher the risk for MACE (low group as reference vs. intermediate group, hazard ratio [HR]: 1.860 [95% confidence interval (CI), 1.326–2.610; p < 0.001]; vs. high group, HR:3.325 [95% CI, 2.017–5.479; p < 0.001]), as well as NFS (low NFS group as reference vs. intermediate group, HR: 1.938 [95% CI, 1.391–2.699; p < 0.001]; vs. high group, HR: 3.492 [95% CI, 1.997–6.105; p < 0.001]). Conclusions: The FIB4 index and NFS are associated with the probability of MACE in patients with NAFLD. Clinical trials: The study design was approved by the ethics review board of Ogaki Municipal Hospital (approval number: 20221124–12, registration date: November 28th, 2022). https://www.ogaki-mh.jp/chiken/kenkyu.html.

DOI： 10.1016/j.numecd.2024.03.025

Clinical Impacts of Urinary Neutrophil Gelatinase-Associated Lipocalin in Patients With Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention 査読有り国際誌

Ozaki Y., Uemura Y., Tanaka A., Yamaguchi S., Okajima T., Mitsuda T., Ishikawa S., Takemoto K., Murohara T., Watarai M.

Circulation Journal 88 巻 ( 6 ) 頁： 944 - 950 2024年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本循環器学会

Background: Chronic kidney disease (CKD) is associated with poor prognosis in patients undergoing percutaneous coronary intervention (PCI). Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker for renal injury. However, the association between urinary NGAL concentrations and renal and cardiovascular events in patients with CKD undergoing PCI has not been elucidated. This study investigated the clinical impact of urinary NGAL concentrations on renal and cardiovascular outcomes in patients with non-dialysis CKD undergoing PCI. Methods and Results: We enrolled 124 patients with non-dialysis CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) undergoing elective PCI. Patients were divided into low and high NGAL groups based on the median urinary NGAL concentration measured the day before PCI. Patients were monitored for renal and cardiovascular events during the 2-year follow-up period. Kaplan-Meier analyses showed that the incidence of renal and cardiovascular events was higher in the high than low NGAL group (log-rank P<0.001 and P=0.032, respectively). Multivariate Cox proportional hazards analyses revealed that urinary NGAL was an independent risk factor for renal (hazard ratio [HR] 4.790; 95% confidence interval [CI] 1.537–14.924; P=0.007) and cardiovascular (HR 2.938; 95% CI 1.034–8.347; P=0.043) events. Conclusions: Urinary NGAL could be a novel and informative biomarker for predicting subsequent renal and cardiovascular events in patients with CKD undergoing elective PCI.

DOI： 10.1253/circj.cj-24-0060

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 査読有り国際誌

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

Journal of Cardiology Cases 2024年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Clinical features, future cardiac events, and prognostic factors following percutaneous coronary intervention in young female patients 査読有り国際誌

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年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Long-term clinical outcomes following percutaneous coronary intervention in patients aged 90 years and older 査読有り国際誌

Tokuda K., Tanaka A., Uemura Y., Shibata N., Iwama M., Sakaguchi T., Yoshida R., Negishi Y., Tashiro H., Tanaka M., Tatami Y., Yamaguchi S., Yoshioka N., Umemoto N., Ohashi T., Takada Y., Asano H., Yoshida Y., Tanaka T., Noda T., Morishima I., Ishii H., Murohara T.

Journal of Cardiology 2024年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: In an aging society, percutaneous coronary intervention (PCI) for super-elderly patients is commonly performed in clinical practice. However, data are scarce regarding the clinical features and outcomes of this population. Methods: This multicenter observational study enrolled patients aged over 90 years who underwent PCI across 10 hospitals between 2011 and 2020. The study included patients presenting with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The occurrence of all-cause and cardiac deaths during hospitalization and after discharge was investigated. Results: In total, 402 patients (91.9 ± 2.0 years, 48.3 % male) participated in the study, of whom 77.9 % presented with ACS. The rate of in-hospital death was significantly higher in patients with ACS compared to patients with CCS (15.3 % vs. 2.2 %, p < 0.001). The estimated cumulative incidence rates of all-cause death were 24.3 %, 39.5 %, and 60.4 % at 1, 3, and 5 years, respectively. No significant difference was observed in the occurrence of all-cause death between patients with ACS and CCS. Regarding causes of death after discharge, non-cardiac deaths accounted for just over half of the cases. Conclusion: This study highlights the clinical features and long-term clinical course of patients aged over 90 years who underwent PCI in a real-world setting. Patients presenting with ACS exhibited a higher rate of in-hospital mortality compared to those with CCS. Following discharge, both ACS and CCS patients experienced comparable and substantial increases in the incidence rates of both cardiac and non-cardiac mortality over time, and a more holistic management approach is warranted.

DOI： 10.1016/j.jjcc.2024.07.004

The incidence and influencing factors of in-hospital frailty progression following transcatheter aortic valve implantation 査読有り

Miyazaki Tatsuya, Tanaka Akihito, Tokuda Yoshiyuki, Shirai Yoshinori, Mizutani Koji, Furusawa Kenji, Akita Sho, Ozeki Takahiro, Kobayashi Kiyonori, Ishii Hideki, Mutsuga Masato, Murohara Toyoaki

Internal Medicine advpub 巻 ( 0 ) 2024年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：The Japanese Society of Internal Medicine

<p><b>Objective </b>Patients undergoing transcatheter aortic valve implantation (TAVI) are generally older and frailty is therefore an important clinical issue. The baseline degree of frailty is associated with the prognosis in patients undergoing TAVI; however, the incidence of in-hospital frailty progression and its influencing factors have not yet been elucidated. </p><p><b>Methods </b>This observational, single-center study retrospectively evaluated 281 patients who underwent TAVI. The degree of frailty at baseline and discharge was evaluated using the Clinical Frailty Scale (CFS). In-hospital frailty progression was defined as an increase of at least one level in the CFS score at discharge from baseline, and predictors of frailty progression were assessed. </p><p><b>Results </b>The median baseline CFS score was 4.0 (interquartile range: 3.0-4.0). In-hospital frailty progression was observed in 49 patients (17.4%). No significant differences were observed in age, sex, comorbidities, or surgical risk scores between patients with and without frailty progression. Patients with frailty progression experienced stroke more frequently during hospitalization than those without (12.2% vs. 1.3%, p = 0.001). A multivariable logistic analysis showed that in-hospital stroke was a significant predictor of frailty progression (odds ratio, 10.7; 95% confidence interval: 2.34-49.2, p = 0.002). Patients with frailty progression had a longer hospital stay than those without frailty progression [7.0 (4.0-17.0) vs. 4.0 (4.0-8.0) days, p = 0.001]. </p><p><b>Conclusions </b>In-hospital frailty progression was not uncommon in patients undergoing TAVI. Stroke incidence was a significant influencing factor in frailty progression, whereas baseline comorbidities and surgical risks were not. </p>

DOI： 10.2169/internalmedicine.3146-23

Reply to the Editor —Additional value of venous flow pattern for ultrasound-guided venous closure with suture-mediated vascular closure device 招待有り査読有り国際誌

Tachi M., Tanaka A., Teraoka T., Furuta T., Matsushita E., Hayashi K., Shimojo M., Yanagisawa S., Inden Y., Murohara T.

Heart Rhythm 2024年

Can a new biomarker complement the current diagnostic gap in the management of patients with suspected acute coronary syndrome? 招待有り査読有り国際誌

Tanaka A., Ishii H.

International Journal of Cardiology 393 巻頁： 131390 2023年12月

Impact of proteinuria on long-term prognosis in patients with coronary artery disease 査読有り国際誌

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 24 巻 ( 12 ) 頁： 900 - 905 2023年12月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Lethal ventricular arrhythmia due to entrectinib-induced Brugada syndrome: a case report and literature review 査読有り

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 12 巻 ( 4 ) 頁： 299 - 304 2023年10月

Author's reply.

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

Journal of cardiology 2023年9月

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.急性冠症候群招待有り

田中哲人

Heart View 27 巻 ( 7 ) 頁： 640 - 644 2023年7月

Acute Coronary Syndrome in the Japan Resuscitation Council Guidelines for Resuscitation 2020 査読有り

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

日本循環器病學 87 巻 ( 6 ) 頁： 866 - 878 2023年5月

Ischemic and Bleeding Outcomes in Patients Who Underwent Percutaneous Coronary Intervention With Chronic Kidney Disease or Dialysis (from a Japanese Nationwide Registry) 査読有り国際誌

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

American Journal of Cardiology 195 巻頁： 37 - 44 2023年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Clinical implications of the cardio-ankle vascular index before and after transcatheter aortic valve implantation. 査読有り

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.) 24 巻 ( 5 ) 頁： 302 - 307 2023年5月

Relationship between the volume of cases and in-hospital mortality in patients with cardiogenic shock receiving short-term mechanical circulatory support. 査読有り国際誌

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年4月

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. 査読有り

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年4月

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

Hokimoto S, Kaikita K, Yasuda S, Tsujita K, Ishihara M, Matoba T, Matsuzawa Y, Mitsutake Y, Mitani Y, Murohara T, Noda T, Node K, Noguchi T, Suzuki H, Takahashi J, Tanabe Y, Tanaka A, Tanaka N, Teragawa H, Yasu T, Yoshimura M, Asaumi Y, Godo S, Ikenaga H, Imanaka T, Ishibashi K, Ishii M, Ishihara T, Matsuura Y, Miura H, Nakano Y, Ogawa T, Shiroto T, Soejima H, Takagi R, Tanaka A, Tanaka A, Taruya A, Tsuda E, Wakabayashi K, Yokoi K, Minamino T, Nakagawa Y, Sueda S, Shimokawa H, Ogawa H, Japanese Circulation Society and Japanese Association of Cardiovascular Intervention and Therapeutics and Japanese College of Cardiology Joint Working Group

日本循環器病學 advpub 巻 ( 0 ) 2023年3月

Prognosis in Patients With Cardiogenic Shock Who Received Temporary Mechanical Circulatory Support 国際誌

Kondo T., Araki T., Imaizumi T., Sumita Y., Nakai M., Tanaka A., Okumura T., Butt J.H., Petrie M.C., McMurray J.J.V., Murohara T.

JACC: Asia 3 巻 ( 1 ) 頁： 122 - 134 2023年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JACC: Asia

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 査読有り国際誌

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 186 巻頁： 156 - 162 2023年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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 査読有り

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 advpub 巻 ( 0 ) 2023年

Comparative study of fractional flow reserve and diastolic pressure ratio using a guidewire with a sensor for measuring intravascular pressure 査読有り国際誌

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

MEDICINE 101 巻 ( 52 ) 頁： e32578 2022年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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 ― 査読有り

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 4 巻 ( 10 ) 頁： 449 - 457 2022年10月

記述言語：英語出版者・発行元：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 査読有り

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年10月

記述言語：英語出版者・発行元：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. 査読有り

Hashiba K, Nakashima T, Kikuchi M, Kojima S, Hanada H, Mano T, Yamamoto T, Tanaka A, Yamaguchi J, Matsuo K, Nakayama N, Nomura O, Matoba T, Tahara Y, Nonogi H, 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 4 巻 ( 9 ) 頁： 393 - 398 2022年9月

Incidence and predictors of frailty progression among octogenarians with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention 査読有り国際誌

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 102 巻頁： 104737 2022年9月

担当区分：責任著者記述言語：英語出版者・発行元：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 査読有り国際誌

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年8月

記述言語：英語出版者・発行元：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. 査読有り

Kojima S, Yamamoto T, Kikuchi M, Hanada H, Mano T, Nakashima T, Hashiba K, Tanaka A, Yamaguchi J, Matsuo K, Nakayama N, Nomura O, Matoba T, Tahara Y, Nonogi H, 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 4 巻 ( 8 ) 頁： 335 - 344 2022年8月

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

Tanaka A, Matsuo K, Kikuchi M, Kojima S, Hanada H, Mano T, Nakashima T, Hashiba K, Yamamoto T, Yamaguchi J, Nakayama N, Nomura O, Matoba T, Tahara Y, Nonogi H, 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 4 巻 ( 7 ) 頁： 289 - 297 2022年7月

Large interventricular membranous septal aneurysm renders the anatomy unsuitable for transcatheter aortic valve replacement 査読有り国際誌

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

JOURNAL OF CARDIAC SURGERY 37 巻 ( 7 ) 頁： 2103 - 2104 2022年7月

担当区分：責任著者記述言語：英語出版者・発行元：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 査読有り

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

Cardiovascular Revascularization Medicine 40 巻頁： 157 - 158 2022年7月

担当区分：責任著者記述言語：英語出版者・発行元：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. 査読有り

Nomura O, Hashiba K, Kikuchi M, Kojima S, Hanada H, Mano T, Yamamoto T, Nakashima T, Tanaka A, Nakayama N, Yamaguchi J, Matsuo K, Matoba T, Tahara Y, Nonogi H, 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 4 巻 ( 6 ) 頁： 241 - 247 2022年6月

Impact of Prehospital 12-Lead Electrocardiography and Destination Hospital Notification on Mortality in Patients With Chest Pain　- A Systematic Review. 査読有り

Nakashima T, Hashiba K, Kikuchi M, Yamaguchi J, Kojima S, Hanada H, Mano T, Yamamoto T, Tanaka A, Matsuo K, Nakayama N, Nomura O, Matoba T, Tahara Y, Nonogi H, 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 4 巻 ( 5 ) 頁： 187 - 193 2022年5月

Albuminuria predicts worsening renal function after transcatheter aortic valve replacement 査読有り国際誌

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

JOURNAL OF CARDIOLOGY 79 巻 ( 5 ) 頁： 648 - 654 2022年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: The impact of albuminuria on worsening renal function (WRF) and clinical outcomes after transcatheter aortic valve replacement (TAVR) is unknown. Methods: Overall, 142 patients who underwent TAVR for severe aortic stenosis were divided into two groups based on the preoperative urinary albumin-to-creatinine ratio (ACR): high (ACR ≥30 mg/g) and low (ACR <30 mg/g). The incidence of WRF (an absolute increase in serum creatinine level of ≥0.3 mg/dL or ≥1.5-fold from baseline or dialysis initiation) at 6 months after TAVR and the incidence of all-cause death and heart failure readmission during follow-up were investigated. Results: Half of the examined patients [n=71/142 (50.0%)] had a high ACR. Patients with a high ACR more frequently had WRF at 6 months than those with a low ACR (17.6% vs. 2.9%, p=0.004). Multivariate analysis showed a high ACR was independently associated with WRF (odds ratio, 7.76; 95% confidence interval, 1.62–37.30; p=0.01), whereas baseline estimated glomerular filtration rate <60 mL/min/1.73m² was not (odds ratio, 0.34; 95% confidence interval, 0.08–1.50; p=0.15). Patients with a high ACR had a higher risk of composite outcomes of all-cause death and heart failure readmission (p=0.002). Conclusions: Preoperative albuminuria (ACR ≥30 mg/g) was independently associated with WRF at 6 months after TAVR. Furthermore, patients with an ACR ≥30 mg/g had higher risks of all-cause death and heart failure readmission than those with an ACR <30 mg/g.

DOI： 10.1016/j.jjcc.2021.11.014

Very long-term clinical outcomes after percutaneous coronary intervention for complex vs non-complex lesions: 10-year outcomes following sirolimus-eluting stent implantation 査読有り

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 84 巻 ( 2 ) 頁： 352 - 365 2022年5月

記述言語：英語出版者・発行元：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 査読有り

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

HEART AND VESSELS 37 巻 ( 4 ) 頁： 555 - 566 2022年4月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

Both polymer-coated paclitaxel-eluting stents (PC-PESs) and drug-coated balloons (DCBs) are used in conjunction with endovascular therapy (EVT) for the treatment of peripheral artery disease (PAD). We aimed to identify the risk factors for the loss of patency following the use of PC-PES and DCB in a real clinical setting. We assessed the multi-center registry data of 151 lesions from 151 patients who underwent EVT for symptomatic PAD in the superficial femoral and proximal popliteal arteries using PC-PES or DCB. One-year primary patency (PP) and clinically driven target lesion revascularization (CD-TLR) were evaluated using Kaplan–Meier analysis. The predictive risk factors for 1-year outcomes were analyzed using the random survival forest method. PC-PES and DCB were used in 65 (43.0%) and 86 (57.0%) cases, respectively. There were no significant differences in 1-year PP or freedom from CD-TLR between PC-PES and DCB. PP occurred in 85.4% and 80.2% of cases in the PC-PES and DCB groups, respectively (log-rank p = 0.65), while freedom from CD-TLR was noted in 92.7% and 94.1% of cases in the PC-PES and DCB groups, respectively (log-rank p = 0.73). In order of importance, a Clinical Frailty Scale score ≥ 6, female sex, lower proximal vessel diameter, lower body mass index, and younger and older age were identified as predictive risk factors of restenosis in the PC-PES group. Peripheral artery calcification scoring system grade of ≥ 2, post-dissection pattern ≥ D, lower proximal and distal vessel diameter, and lesion length ≥ 100 mm were identified as predictive risk factors of restenosis, in order of importance, in the DCB group. Both PC-PES and DCB were associated with favorable clinical outcomes within 1 year in patients with femoropopliteal artery disease. Furthermore, several factors that could predict restenosis within 1 year following the use of each device were detected.

DOI： 10.1007/s00380-021-01941-9

その他リンク： https://link.springer.com/article/10.1007/s00380-021-01941-9/fulltext.html

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. 査読有り

Yamaguchi J, Matoba T, Kikuchi M, Minami Y, Kojima S, Hanada H, Mano T, Nakashima T, Hashiba K, Yamamoto T, Tanaka A, Matsuo K, Nakayama N, Nomura O, Tahara Y, Nonogi H, 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 4 巻 ( 3 ) 頁： 109 - 115 2022年3月

Fifteen-Year Mortality and Cardiac, Thrombotic, and Bleeding Events in Survivors of ST-Elevation Myocardial Infarction 査読有り

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

CARDIOVASCULAR REVASCULARIZATION MEDICINE 36 巻頁： 43 - 50 2022年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular Revascularization Medicine

Background: Although short-term mortality in ST-elevation myocardial infarction (STEMI) has improved, data is limited regarding very long-term mortality and concomitant clinical events in STEMI survivors who undergo primary percutaneous coronary intervention (p-PCI). This study aimed to evaluate these parameters at 15 years and to determine the predictors of 15-year mortality in these patients. Methods: The study endpoints were all-cause mortality and cardiac mortality at 15 years. Independent predictors of all-cause mortality were also analyzed. Furthermore, each thrombotic and bleeding event was evaluated. Results: Between January 2004 and December 2006, 260 STEMI survivors who underwent p-PCI (median follow-up period: 3970 days) were evaluated from the Ogaki Municipal hospital registry. The rates of all-cause mortality (cardiac mortality) at 5, 10, and 15 years were 12.1% (4.9%), 23.4% (9.5%), and 34.9% (12.4%), respectively. The cumulative incidences of recurrent myocardial infarction, target vessel revascularization, ischemic stroke, hemorrhagic bleeding, and gastric bleeding at 15 years were 11.3%, 43.6%, 14.3%, 6.9%, and 10.9%, respectively. Cox regression analysis showed that age ≥ 75 years [adjusted hazard ratio (aHR), 7.074, p < 0.001], chronic kidney disease (aHR, 2.320, p = 0.001), left ventricular ejection fraction <40% (aHR, 2.930, p = 0.001), Killip class ≥II at admission (aHR, 2.639, p = 0.003), untreated chronic total occlusion (aHR, 2.090, p = 0.042), and final TIMI grade ≤ 2 (aHR, 1.736, p = 0.048) were independent predictors of all-cause mortality. Conclusion: This study demonstrated that all-cause and cardiac mortality at 15 years were 34.9% and 12.4%, respectively, in all-comers STEMI survivors after p-PCI, indicating that STEMI survivors might have a benign prognosis.

DOI： 10.1016/j.carrev.2021.04.023

Bedside cannulation for veno-venous extracorporeal membrane oxygenation using portable X-ray system in a coronavirus disease patient 査読有り

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 25 巻 ( 3 ) 頁： 185 - 187 2022年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology Cases

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.>

DOI： 10.1016/j.jccase.2021.09.008

Albuminuria Predicts Short-Term Worsening Renal Function After Transcatheter Aortic Valve Replacement 査読有り国際誌

Tobe A., Tanaka A., Tokuda Y., Shirai Y., Otsuka S., Yamamoto T., Tokoro M., Furusawa K., Ishii H., Usui A., Murohara T.

Cardiovascular Revascularization Medicine 42 巻頁： 178 - 181 2022年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular Revascularization Medicine

Albuminuria is a major risk factor of cardiovascular events, however, the impact of albuminuria on clinical outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) has not been fully investigated. This retrospective study included 206 patients who underwent TAVR for severe aortic stenosis. Patients were divided into two groups according to the preoperative urinary albumin-to-creatinine ratio (ACR): high (ACR ≥ 30 mg/g) and low (ACR < 30 mg/g). The incidence of 1-month worsening renal function (WRF), defined as a decrease in estimated glomerular filtration rate (eGFR) ≥10% from baseline after TAVR, was investigated. Patients with high ACR had acute kidney injury (8.5% vs. 1.0%, p = 0.01) and 1-month WRF (29.2% vs. 12.0%, p = 0.002) more frequently than those with low ACR. High ACR was independently associated with 1-month WRF (odds ratio, 3.72; 95% confidence interval, 1.72–8.08; p < 0.001). Albuminuria can be a useful predictor of deterioration of renal function at various time points after TAVR.

DOI： 10.1016/j.carrev.2022.03.014

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 査読有り国際誌

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

HEART AND VESSELS 37 巻 ( 2 ) 頁： 219 - 228 2022年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

Low body mass index (BMI) is a predictor of adverse events in patients with ST-elevated myocardial infarction (STEMI) in Western countries. Because the average BMI of Asians is significantly lower than that of the Western population, the appropriate cut-off BMI value and its role in long-term mortality are unclear in Asian patients. Between January 2006 and December 2017, 1215 patients who underwent percutaneous coronary intervention (PCI) for acute STEMI and were alive at discharge (mean age, 67.7 years; male, 75.4%) were evaluated. The cut-off BMI value, which could predict all-cause mortality within 10 years, was detected using a survival classification and regression tree (CART) model. The causes of death according to the BMI value were evaluated in each group. Based on the CART model, the patients were divided into three groups (BMI < 18 kg/m2: 54 patients, 18 kg/m2 ≤ BMI ≤ 20 kg/m2: 109 patients, and BMI > 20 kg/m2: 1052 patients). The BMI decreased with age; with an increased BMI, patients with dyslipidemia, diabetes mellitus, and smoking habit increased. During the study period (median, 4.9 years), 194 patients (26.8%) died (cardiac death, 59 patients; non-cardiac death, 135 patients). All-cause mortality was more frequent as the BMI decreased (BMI < 18 kg/m2; 72.8%, 18 kg/m2 ≤ BMI ≤ 20 kg/m2; 40.5%, and BMI > 20 kg/m2; 22.8%; log-rank p < 0.001). Non-cardiac deaths were more frequent than cardiac deaths in all groups, and the dominance of non-cardiac death was highest in the lowest BMI group. Cut-off BMI values of 18 kg/m2 and 20 kg/m2 can predict long-term mortality after PCI in Asian STEMI survivors, whose cut-off value is lower than that in the Western populations. The main causes of death in this cohort differed according to the BMI values.

DOI： 10.1007/s00380-021-01916-w

その他リンク： https://link.springer.com/article/10.1007/s00380-021-01916-w/fulltext.html

Computed tomography imaging using split-bolus contrast injection with volume scan of aortic root and heart for preoperative evaluation of transcatheter aortic valve implantation 査読有り

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

HEART AND VESSELS 37 巻 ( 1 ) 頁： 132 - 141 2022年1月

記述言語：英語出版者・発行元：Heart and Vessels

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.

DOI： 10.1007/s00380-021-01899-8

Clinical Significance of the Left Atrial Appendage Orifice Area 査読有り

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

Japanese Journal of Medicine 61 巻 ( 12 ) 頁： 1801 - 1807 2022年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本内科学会

Objective 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. Methods 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. Results The median LAA orifice area among all patients was 4.09 cm2 (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. Conclusion 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.

DOI： 10.2169/internalmedicine.8301-21

Spontaneous dissection of left internal mammary artery graft: A case report and literature review 査読有り

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

Cardiovascular Revascularization Medicine 2022年

担当区分：責任著者記述言語：英語出版者・発行元：Cardiovascular Revascularization Medicine

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.

DOI： 10.1016/j.carrev.2022.04.007

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 査読有り

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年

記述言語：英語出版者・発行元：Cardiovascular Revascularization Medicine

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.

DOI： 10.1016/j.carrev.2022.08.025

Heterogeneous Carotid Plaque Predicts Cardiovascular Events after Percutaneous Coronary Intervention 査読有り

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 advpub 巻 ( 0 ) 2022年

Impact of Handgrip Strength on Clinical Outcomes after Percutaneous Coronary Intervention 査読有り

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

Ｊｏｕｒｎａｌ　ｏｆ　Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ　ａｎｄ　Ｔｈｒｏｍｂｏｓｉｓ advpub 巻 ( 0 ) 2022年

Prevalence of acute coronary syndrome during the pandemic of COVID-19 in the Tokai Region of Japan 査読有り

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 83 巻 ( 4 ) 頁： 697 - 703 2021年11月

記述言語：英語出版者・発行元：Nagoya Journal of Medical Science

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.

DOI： 10.18999/nagjms.83.4.697

Clinical Outcomes Following Emergent Percutaneous Coronary Intervention for Acute Total/Subtotal Occlusion of the Left Main Coronary Artery 査読有り

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

日本循環器學誌 85 巻 ( 10 ) 頁： 1789 - 1796 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本循環器学会

Background: 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. Methods and Results: 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. Conclusions: 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.

DOI： 10.1253/circj.cj-20-0545

In-hospital mortality among consecutive patients with ST-Elevation myocardial infarction in modern primary percutaneous intervention era similar to Insights from 15-year data of single-center hospital-based registry similar to 査読有り国際誌

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

PLOS ONE 16 巻 ( 6 ) 頁： e0252503 - e0252503 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：PLoS ONE

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) < 40% [adjusted Odds Ratio (aOR), 4.446, p < 0.001], culprit lesions in the left coronary artery (LCA) (aOR, 2.940, p < 0.001) compared with those in the right coronary artery, Killip class > II (aOR, 7.438; p < 0.001), chronic kidney disease (CKD) (aOR, 4.056; p < 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 > II, and EF < 40%, but also the angiographic findings such as culprit lesions in the LCA, absence of very robust collaterals, and final TIMI grades <3 were associated with an increased risk of in-hospital mortality.

DOI： 10.1371/journal.pone.0252503

Clinical characteristics and treatment of Spontaneous Coronary Artery Dissection in Young Women Undergoing Percutaneous Coronary Intervention 査読有り

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

JOURNAL OF CARDIOVASCULAR MEDICINE 22 巻 ( 1 ) 頁： 14 - 19 2021年1月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of cardiovascular medicine (Hagerstown, Md.)

BACKGROUND: Spontaneous coronary artery dissection (SCAD) has recently been recognized as a cause of acute coronary syndrome (ACS), especially in young women. However, the characteristics, optimal treatment, and prognosis of patients who experience SCAD have not been fully described. METHODS: Data were retrospectively collected from a multicenter registry. Among 187 young women less than 60 years of age who underwent percutaneous coronary intervention, 19 (10.2%) with SCAD were identified through coronary angiography. Clinical characteristics and outcomes were investigated. RESULTS: Those with SCAD less frequently exhibited coronary risk factors, such as diabetes, dyslipidemia, and smoking, than those without SCAD. Intense emotional and/or physical stress was more frequently observed as a prominent precipitating factor in cases of SCAD. All 19 SCAD patients presented with ACS, 7 of whom were treated using stents, and the other 12 treated without stents. During a median follow-up of 960 days (interquartile range, 686-1504 days), two recurrent coronary artery dissections occurred within 7 days, both of which occurred in a vessel other than that in which primary dissection occurred. There were no deaths or recurrent dissection after 1 week. CONCLUSION: SCAD was not uncommon among young Japanese women requiring percutaneous coronary intervention. Patients with SCAD exhibited fewer coronary risk factors and more precipitating factors than those without SCAD, and long-term clinical outcomes after an early period appeared to be favorable.

DOI： 10.2459/jcm.0000000000001067

Association between discharge destination and mid-term mortality in octogenarian patients with ST-elevation myocardial infarction 査読有り国際誌

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

JOURNAL OF CARDIOLOGY 77 巻 ( 2 ) 頁： 116 - 123 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: Owing to an increasing aging population, the number of elderly patients undergoing percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is escalating. The onset of STEMI in elderly patients may lead to increased frailty, resulting in failure of discharge to home despite survival. However, the association of discharge destination with prognosis has not been fully evaluated in this population. Methods: Between January 2014 and December 2016, a total of 245 octogenarian STEMI survivors who underwent PCI (mean age, 84.4 years; male, 46.5%) were evaluated from a multicenter registry. The 2-year mortalities of the home discharge and non-home discharge groups were compared and analyzed using a Cox regression model. Results: Non-home discharge, which was defined as transfer to another hospital or nursing home after STEMI, was seen in 36 patients. During the 2 years, 37 patients died (home discharge, 27 patients; non-home discharge, 10 patients). The most frequent cause of death was due to infection (21.6%), followed by sudden death (18.9%) and heart failure (16.2%). The cumulative all-cause mortality was significantly higher in the non-home discharge group than in the home discharge group [36.4% vs. 14.8%; hazard ratio (HR), 2.95; 95% confidence interval (CI), 1.43−6.10; p = 0.003]. After multivariate analysis, non-home discharge (adjusted HR, 2.62; 95% CI, 1.20−5.75; p = 0.016) together with left ventricular ejection fraction <40% (adjusted HR, 3.15; 95% CI, 1.57−6.31; p = 0.001), prior heart failure (adjusted HR, 4.88; 95% CI, 1.82−13.13; p = 0.002), target lesion in the left anterior descending artery (adjusted HR, 2.20; 95% CI, 1.12−4.32; p = 0.022), and serum albumin level <3.5 g/dL (adjusted HR, 2.13; 95% CI, 1.06−4.27; p = 0.034) remained significant predictors of all-cause mortality. Conclusion: Non-home discharge was associated with an increased risk of mid-term mortality in octogenarian STEMI survivors.

DOI： 10.1016/j.jjcc.2020.06.011

Cholesterol Crystal Embolization After Transcatheter Aortic Valve Replacement. 査読有り

Nishi T, Tokuda Y, Tanaka A, Furusawa K, Miki Y, Tobe A, Murohara T, Usui A

Circulation Reports 2 巻 ( 11 ) 頁： 701 - 702 2020年11月

Clinical outcomes following percutaneous coronary intervention for bifurcation lesions: kissing balloon inflation vs. sequential dilation 査読有り

Hitora Yusuke, Teraoka Tsubasa, Tanaka Akihito, Uemura Yusuke, Tobe Akihiro, Sakakibara Keisuke, Miki Yusuke, Kataoka Takashi, Niwa Kiyoshi, Tashiro Hiroshi, Furusawa Kenji, Takemoto Kenji, Watarai Masato, Kimura Akira, Ishii Hideki, Murohara Toyoaki

CARDIOVASCULAR INTERVENTION AND THERAPEUTICS 36 巻 ( 4 ) 頁： 436 - 443 2020年11月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular Intervention and Therapeutics

Percutaneous coronary intervention for bifurcation lesions remains challenging, with there being several debatable issues, including the requirement for kissing balloon inflation (KBI). The objective of this study was to assess the clinical outcomes following single crossover stent implantation with KBI or sequential dilation alone. Data were examined for 255 non-left main bifurcation lesions (246 patients) treated with single crossover stent implantation, followed by side branch (SB) strut dilation with KBI (n = 74 lesions) or sequential dilation (n = 181 lesions) in three hospitals. Target lesion revascularization (TLR) was the primary endpoint. There was no significant difference in the pre-procedural reference diameter of both the main vessel (MV) and SB between the KBI and sequential dilation groups. However, MV post-dilation balloon size was smaller with lower pressure and post-procedural minimal lumen diameter was significantly smaller in the KBI group. During the median follow-up period of approximately 3 years, TLR incidence was significantly higher in the KBI group than in the sequential dilation group; in particular, the TLR rate at the distal MV was higher in the former. For bifurcation lesions treated with single crossover stent implantation, the TLR rate was higher after KBI than after sequential dilation; this was mainly due to higher revascularization in the distal MV. For bifurcation lesions treated with KBI, MV post-dilation balloon diameter tended to be smaller with lower pressure, which might lead to poorer stent expansion and a higher TLR rate.

DOI： 10.1007/s12928-020-00728-5

Ablation effect of additional low-speed rotational atherectomy following high-speed rotational atherectomy: Low-speed RA following high-speed RA. 査読有り国際誌

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

AsiaIntervention 6 巻 ( 1 ) 頁： 52 - 55 2020年7月

Coronary Drug-Eluting Stent Infection Complicated by Coronary Artery Aneurysm and Purulent Pericarditis: Complete Resolution Without Surgery 査読有り

Riku Shuro, Suzuki Susumu, Jinno Yasushi, Tanaka Akihito, Ishii Hideki, Murohara Toyoaki

CANADIAN JOURNAL OF CARDIOLOGY 36 巻 ( 6 ) 頁： 967.e1 - 967.e3 2020年6月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Canadian Journal of Cardiology

Coronary stent infection is considered to be a rare but catastrophic complication of percutaneous coronary intervention. In this report, we present a 72-year-old man who developed a coronary stent infection complicated by coronary aneurysm and purulent pericarditis. Coronary artery aneurysm resolved over a period of 8 months following the successful management of infection with intensive antibiotic therapy alone. This case suggests that conservative therapy can be a therapeutic option in patients with high operative risks.

DOI： 10.1016/j.cjca.2020.01.007

Comparison of Anti-factor Xa Activity Among Three Different Factor Xa Inhibitors in Non-valvular Atrial Fibrillation Patients with Renal Impairment 査読有り

Tobe Akihiro, Osanai Hiroyuki, Tanaka Akihito, Sakaguchi Teruhiro, Kambara Takahiro, Nakashima Yoshihito, Asano Hiroshi, Ishii Hideki, Ajioka Masayoshi, Murohara Toyoaki

CLINICAL DRUG INVESTIGATION 40 巻 ( 6 ) 頁： 567 - 573 2020年6月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Clinical Drug Investigation

Background: Factor-Xa inhibitors (FXaIs) are widely used for the treatment of non-valvular atrial fibrillation (NVAF). Although we have previously reported the distribution of the anti-factor Xa activity (AXA) values of three different FXaIs in NVAF patients, the differences in the distribution of AXA values among the different FXaIs in patients with renal impairment (RI) have not been fully elucidated. Methods: Trough and peak AXA values were measured in 94 patients taking rivaroxaban, 124 patients taking apixaban, and 66 patients taking edoxaban. Of them, we identified 26 patients with moderate RI [creatinine clearance (CrCl) 30–49 mL/min] and 17 patients with severe RI (CrCl 15–29 mL/min) in the rivaroxaban cohort, 37 patients with moderate RI and 17 patients with severe RI in the apixaban cohort, and 21 patients with moderate RI and 9 patients with severe RI in the edoxaban cohort. AXA values were measured using chromogenic AXA assays. Both trough and peak AXA values were compared between patients with moderate RI and those with severe RI in each cohort, and differences in the peak-to-trough ratio among the different drugs were assessed. Results: In the rivaroxaban cohort, the peak AXA value was significantly higher in patients with severe RI than in those with moderate RI. In the apixaban cohort, neither the trough nor peak AXA values significantly differed between patients with moderate RI and those with severe RI. In the edoxaban cohort, the trough AXA value was significantly higher in patients with severe RI than in those with moderate RI, and peak AXA tended to be higher in patients with severe RI. The peak-to-trough ratio of AXA values was significantly lower in patients taking apixaban than in those taking rivaroxaban and edoxaban. Conclusion: Among Japanese NVAF patients with RI, the peak or trough AXA values were higher in patients with severe RI than in those with moderate RI when taking rivaroxaban and edoxaban, whereas both the peak and trough AXA values were similar between patients with severe RI and those with moderate RI when taking apixaban. The peak-to-trough ratio of AXA values was the lowest in patients taking apixaban.

DOI： 10.1007/s40261-020-00912-8

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 4 巻 ( 2 ) 頁： 1 - 5 2020年6月

記述言語：日本語出版者・発行元：European Heart Journal - Case Reports

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.

DOI： 10.1093/ehjcr/ytaa036

Impact of Diabetes Mellitus on the Aortic Wall Changes as Atherosclerosis Progresses: Aortic Dilatation and Calcification 査読有り

Iwakawa Naoki, Tanaka Akihito, Ishii Hideki, Kataoka Takashi, Niwa Kiyoshi, Hitora Yusuke, Tashiro Hiroshi, Mitsuda Takayuki, Kojima Hiroki, Hirayama Kenshi, Furusawa Kenji, Yoshida Ruka, Suzuki Susumu, Murohara Toyoaki

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 27 巻 ( 6 ) 頁： 509 - 515 2020年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本動脈硬化学会

Aim: 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. Methods: 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; n=107) and those without DM (DM− group; n=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. Results: 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 aor-tic 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 indi-cated 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; p =0.01). Conclusion: 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.

DOI： 10.5551/jat.50930

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 40 巻頁： 2813 - 2813 2019年10月

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 40 巻頁： 1490 - 1490 2019年10月

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 73 巻 ( 15 ) 頁： S68 - S68 2019年4月

Saphenous Vein Graft Aneurysm 10 Years After Paclitaxel-Eluting Stent Implantation. 査読有り

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

The Journal of invasive cardiology 29 巻 ( 5 ) 頁： E63 2017年5月

A Comparison Between First-Generation and Second-Generation Transcatheter Aortic Valve Implantation (TAVI) Devices: A Propensity-Matched Single-Center Experience. 査読有り国際誌

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

The Journal of invasive cardiology 28 巻 ( 5 ) 頁： 210 - 6 2016年5月

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 36 巻頁： 1161 - 1161 2015年8月

Association of Estimated Glomerular Filtration Rate and Proteinuria With Lipid-Rich Plaque in Coronary Artery Disease 査読有り

Shimbo Yusaku, Suzuki Susumu, Ishii Hideki, Shibata Yohei, Tatami Yosuke, Harata Shingo, Osugi Naohiro, Ota Tomoyuki, Tanaka Akihito, Shibata Kanako, Mizukoshi Toshihiro, Yasuda Yoshinari, Maruyama Shoichi, Murohara Toyoaki

日本循環器學誌 79 巻 ( 10 ) 頁： 2263 - 2270 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本循環器学会

Background: 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. Methods and Results: 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 m2 and proteinuria were significantly more likely to have higher percent lipid volume compared with those with eGFR >60 ml/min/1.73 m2 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). Conclusions: The addition of proteinuria to eGFR level may be of value in the risk stratification of patients with coronary artery disease.

DOI： 10.1253/circj.CJ-15-0460

Impact of Airflow Limitation on Carotid Atherosclerosis in Coronary Artery Disease Patients 査読有り

Hamrah Mohammad Shoaib, Suzuki Susumu, Ishii Hideki, Shibata Yohei, Tatami Yosuke, Osugi Naohiro, Ota Tomoyuki, Kawamura Yoshihiro, Tanaka Akihito, Aso Hiromichi, Takeshita Kyosuke, Sakamoto Junichi, Hasegawa Yoshinori, Murohara Toyoaki

RESPIRATION 89 巻 ( 4 ) 頁： 322 - 328 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Respiration

Background: Both airflow limitation and smoking are established cardiovascular risk factors. However, their interaction as risk factors for the development of atherosclerosis in coronary artery disease patients remains unclear. Objectives: To evaluate the effect of the interaction between airflow limitation and smoking status on the severity of carotid atherosclerosis. Methods: We categorized the 234 enrolled patients with coronary artery disease into four groups: never-smokers with normal pulmonary function (group A), never-smokers with airflow limitation (group B), ever-smokers with normal pulmonary function (group C), and ever-smokers with airflow limitation (group D). Results: The prevalence of airflow limitation in the enrolled patients was 23.1% (ever-smokers: 15.8%, never-smokers: 7.3%). The prevalence of severe carotid atherosclerosis was 28.2, 29.4, 41.3, and 45.9%, respectively, in the four groups (group D vs. group A, p = 0.035). Even after multivariate adjusting for confounding factors, ever-smokers with airflow limitation were independently associated with severe carotid atherosclerosis (odds ratio 2.89, 95% confidence interval, 1.19-7.00, p = 0.019). Conclusions: Ever-smokers with airflow limitation were significantly associated with severe carotid atherosclerosis among patients with coronary artery disease. These findings also provide additional insight into the correlation between airflow limitation and poor cardiovascular clinical outcomes.

DOI： 10.1159/000375313

Assessment of In-Stent Restenosis Using High-Definition Computed Tomography With a New Gemstone Detector 査読有り国際誌

Tsuda Takuma, Ishii Hideki, Ichimiya Satoshi, Kanashiro Masaaki, Watanabe Jyunji, Takefuji Mikito, Aoyama Toru, Suzuki Susumu, Tanaka Akihito, Matsubara Tatsuaki, Murohara Toyoaki

Circulation Journal 79 巻 ( 7 ) 頁： 1542 - 1548 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：The Japanese Circulation Society

<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.

DOI： 10.1253/circj.CJ-14-1344

Inverse association between diabetes and aortic dilatation in patients with advanced coronary artery disease 査読有り

Tanaka Akihito, Ishii Hideki, Oshima Hideki, Narita Yuji, Kodama Akio, Suzuki Susumu, Komori Kimihiro, Usui Akihiko, Murohara Toyoaki

ATHEROSCLEROSIS 242 巻 ( 1 ) 頁： 123 - 127 2015年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Atherosclerosis

Background: A negative association between diabetes and abdominal aortic aneurysm has recently been reported. The purpose of this study was to assess the relationship between diabetes and aortic diameter, including non-aneurysmal aortic diameter, in patients with advanced coronary artery disease. Methods: We identified 351 consecutive patients who had undergone coronary artery bypass graft surgery. The patients were divided into two groups: those with diabetes mellitus (DM) (DM+ group; n=180), and those without DM (DM- group; n=171). Infrarenal and ascending aortic diameters were measured by preoperative computed tomography and corrected for body surface area. Results: Infrarenal and ascending aortic diameters were significantly shorter in the DM+ group than in the DM- group (21.3±5.0mm vs. 24.7±9.8mm, p<0.001 and 36.0±4.4mm vs. 37.8±5.5mm, p=0.001, respectively). The rates of infrarenal aortic diameter ≥30mm and ascending aortic diameter ≥40mm were significantly lower in the DM+ group than in the DM- group (3.5% vs. 13.3%, p=0.003 and 14.2% vs. 24.1%, p=0.025, respectively). Multivariate models demonstrated diabetes to be an independent predictor of both infrarenal and ascending aortic diameters even after correction for body surface area. Conclusion: Our findings indicated an inverse association between diabetes and aortic dilatation of both the infrarenal and ascending aorta in patients with advanced coronary artery disease.

DOI： 10.1016/j.atherosclerosis.2015.07.016

Impact of low-grade albuminuria on left ventricular diastolic dysfunction 査読有り

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 6 巻頁： 13 - 16 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：IJC Metabolic and Endocrine

Background: Albuminuria is an established risk factor for mortality and cardiovascular events in high-risk populations. However, few studies have evaluated the relationship between normoalbuminuria and left ventricular (LV) diastolic function. The present study evaluated the impact of the low-grade albuminuria on LV diastolic function in patients with coronary artery disease (CAD). Methods: A cross-sectional study was conducted in 202 chronic CAD patients with normal urinary albumin levels. Subjects were divided into 3 tertiles according to sex-specific urinary albumin-to-creatinine concentration ratio (UACR) cut-off points. Subjects in the upper tertile were classified as having low-grade albuminuria. To evaluate the LV function, all subjects underwent echocardiography. LV diastolic dysfunction was defined as E/e'>15 or 8<E/e'<15, with an E/A<0.5, a deceleration time>280ms, and a LV mass index>122g/m2 for women or >149g/m2 for men. Results: Among the 202 patients, 76 patients (37.6%) had LV diastolic dysfunction. The prevalence of LV diastolic dysfunction in the upper tertile was significantly greater than that in the middle and lower tertiles (49.3%, 32.3% and 29.2%, respectively; p for trend. =. 0.029). Adjusting for confounding factors, the presence of low-grade albuminuria independently associated with LV diastolic dysfunction (odds ratio 2.22, 95% confidence interval: 1.05-4.71, p. =. 0.037). Conclusions: A high UACR level that is still below the current microalbuminuria threshold is significantly associated with an increased prevalence of LV diastolic dysfunction in CAD patients. Our data suggest that low-grade albuminuria in high-risk populations may provide greater cardiovascular risk stratification.

DOI： 10.1016/j.ijcme.2015.01.006

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 35 巻頁： 902 - 902 2014年9月

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 35 巻頁： 130 - 130 2014年9月

Impact of Albuminuria on the Incidence of Periprocedural Myocardial Injury in Patients Undergoing Elective Coronary Stent Implantation 査読有り

Osugi Naohiro, Suzuki Susumu, Ishii Hideki, Yasuda Yoshinari, Shibata Yohei, Tatami Yosuke, Ota Tomoyuki, Kawamura Yoshihiro, Okumura Satoshi, Tanaka Akihito, Inoue Yosuke, Matsuo Seiichi, Murohara Toyoaki

AMERICAN JOURNAL OF CARDIOLOGY 114 巻 ( 1 ) 頁： 42 - 46 2014年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Journal of Cardiology

Albuminuria has traditionally been associated with an elevated risk of cardiovascular events. However, few studies have examined the potential relation between albuminuria and periprocedural risk in percutaneous coronary intervention (PCI). The aim of this study was to evaluate the impact of albuminuria on the incidence of periprocedural myocardial injury (PMI) in patients who underwent PCI. The study included 252 consecutive patients who underwent PCI. The incidence of PMI was significantly higher in patients with albuminuria than in those with normoalbuminuria (31.9% vs 43.3%, respectively, p = 0.014). Even after adjustment for confounders, the presence of albuminuria predicted PMI (odds ratio 2.07, 95% confidence interval 1.08 to 3.97, p = 0.029). Furthermore, patients with albuminuria and preserved estimated glomerular filtration rate had a 4.2-fold higher risk for PMI than did patients with normoalbuminuria and preserved estimated glomerular filtration rate. In conclusion, albuminuria was a strong predictor of PMI in patients who underwent PCI. © 2014 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.amjcard.2014.03.058

Impact of chronic obstructive pulmonary disease on composition of left main coronary artery plaque with intermediate stenosis 査読有り

Kumagai Soichiro, Ishii Hideki, Takashima Hiroaki, Waseda Katsuhisa, Kurita Akiyoshi, Ando Hirohiko, Gosho Masahiko, Yoshikawa Daiji, Suzuki Susumu, Tanaka Akihito, Matsubara Tatsuaki, Murohara Toyoaki, Amano Tetsuya

INTERNATIONAL JOURNAL OF CARDIOLOGY 174 巻 ( 3 ) 頁： 865 - 866 2014年

Influence of the false lumen status on clinical outcomes in patients with acute type B aortic dissection 査読有り国際誌

Tanaka Akihito, Sakakibara Masaki, Ishii Hideki, Hayashida Ryo, Jinno Yasushi, Okumura Satoshi, Okada Koji, Murohara Toyoaki

JOURNAL OF VASCULAR SURGERY 59 巻 ( 2 ) 頁： 321 - 326 2014年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Vascular Surgery

Objective Clinical outcomes in acute type B aortic dissection patients with partial thrombosis of the false lumen have not been clearly elucidated. The purpose of this study was to investigate long-term mortality and incidence of surgical treatment by focusing on the status of the false lumen including partial thrombosis. Methods One hundred three patients (69 males, mean age 67 ± 13 years) with acute type B aortic dissection were enrolled. Patients were divided into three groups according to the status of the false lumen on enhanced computed tomography image (complete thrombosis, n = 55; partial thrombosis, n = 25; patent, n = 23). Results Requirement of surgical (open or endovascular) treatment during initial hospitalization was significantly less frequent in patients with complete thrombosis (0% in complete thrombosis, 16% in partial thrombosis, and 26% in patent). The long-term mortality (mean follow-up term, 1143 ± 933 days) did not differ among the three groups. Long-term surgical treatment-free rate was significantly lower in patients with patent false lumen. Cox regression analysis revealed that age (P <.01) and male sex (P =.013) were significant predictive factors of long-term mortality. Conclusions In acute type B aortic dissection, the incidence of surgical treatment was higher in patients with patent false lumen during long-term follow-up, whereas status of the false lumen did not influence long-term mortality. © 2014 by the Society for Vascular Surgery.

DOI： 10.1016/j.jvs.2013.08.031

Accelerated decline in renal function after acute myocardial infarction in patients with high low-density lipoprotein-cholesterol to high-density lipoprotein-cholesterol ratio 査読有り国際誌

Okumura Satoshi, Sakakibara Masaki, Hayashida Ryo, Jinno Yasushi, Tanaka Akihito, Okada Koji, Hayashi Mutsuharu, Ishii Hideki, Murohara Toyoaki

HEART AND VESSELS 29 巻 ( 1 ) 頁： 7 - 14 2014年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

High low-density lipoprotein-cholesterol to high-density lipoprotein-cholesterol (L/H) ratio is associated with progressions of coronary arteriosclerosis and chronic kidney disease. On the other hand, renal function markedly declined after acute myocardial infarction (AMI). The aims of the present study were (1) to identify what type of patients with AMI would have high L/H ratio at follow-up and (2) to evaluate whether decline in renal function after AMI had accelerated or not in patients with high L/H ratio. The 190 eligible AMI patients who underwent primary percutaneous coronary intervention (PCI) and received atorvastatin (10 mg) were divided into one of two groups according to the L/H ratio at 6-month follow-up: L/H >2 group (n = 81) or L/H ≤2 group (n = 109). The characteristics on admission in the two groups were examined. Furthermore, changes in serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) during 1- and 6-month follow-up were compared between the two groups. L/H >2 group were significantly younger and had greater body mass index (BMI) and worse lipid profile on admission compared with L/H ≤2 group. Percentage increase in sCr and percentage decrease in eGFR during 1-month follow-up in L/H >2 group tended to be greater than in L/H ≤2 group, and those during 6-month follow-up were significantly greater (16.5 ± 2.77 vs. 9.79 ± 2.23%, p = 0.03 and 11.8 ± 1.93 vs. 2.75 ± 3.85%, p = 0.04, respectively). In AMI patients undergoing primary PCI, those who were young and had large BMI and poor lipid profile on admission were likely to have a high L/H ratio at follow-up despite statin therapy. In addition, the decline in renal function after AMI had significantly accelerated in patients with high L/H ratio. © Springer 2013.

DOI： 10.1007/s00380-012-0321-y

Impact of serum bilirubin levels on carotid atherosclerosis in patients with coronary artery disease 査読有り

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

IJC Metabolic and Endocrine 5 巻頁： 24 - 27 2014年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：IJC Metabolic and Endocrine

Background/objectives: Bilirubin protects against oxidative stress-mediated diseases, especially atherosclerotic diseases. On the other hand, subjects with carotid atherosclerosis have a high incidence of adverse cardiovascular events. The aim of this study was to evaluate the possible relationship between serum bilirubin levels and carotid atherosclerosis in patients with coronary artery disease (CAD). Methods: We evaluated a total of 394 patients with chronic CAD, defined as stable angina pectoris or a previous myocardial infarction. They were divided into four groups according to serum bilirubin level. Carotid intima-media thickness and plaque score (PS) in the common carotid artery were measured using an ultrasound system. Severe carotid atherosclerosis was defined as PS >. 10. Results: With increasing quartiles of serum bilirubin levels, the prevalence of severe carotid atherosclerosis significantly decreased (48.2%, 39.6%, 30.3%, and 27.0%, respectively, p for trend = 0.007). After adjusting for other risk factors, low serum bilirubin levels were independently correlated with severe carotid atherosclerosis in CAD patients (odds ratio 0.89, 95% confidence interval, 0.81-0.99, p = 0.027). Conclusion: We demonstrated that low serum bilirubin levels were associated with severe carotid atherosclerosis in CAD patients. Our data suggest that serum bilirubin levels might be an independent, useful, and cost-effective tool for evaluating atherosclerotic status in CAD patients.

DOI： 10.1016/j.ijcme.2014.08.006

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 126 巻 ( 21 ) 2012年11月

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 33 巻頁： 243 - 243 2012年8月

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 査読有り

TANAKA Akihito, SAKAKIBARA Masaki, OKUMURA Satoshi, OKADA Koji, ISHIII Hideki, MUROHARA Toyoaki

Journal of cardiology 60 巻 ( 1 ) 頁： 7 - 11 2012年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: Recent studies have reported that concomitant use of clopidogrel with proton-pump inhibitors (PPIs) might decrease antiplatelet effects and increase the risk of adverse outcomes after coronary stenting. However, little is known about the difference between clopidogrel and ticlopidine in concomitant use with PPIs, especially within the Asian population. Methods: We retrospectively analyzed 302 consecutive patients (248 males, mean age 66. ± 12 years) undergoing primary stenting for acute myocardial infarction from July 2006 to June 2010. PPIs were administered to 92% (278/302) of the patients. The patients were divided into two groups on the basis of clopidogrel (clopidogrel group, n= 187) or ticlopidine (ticlopidine group, n= 91) with PPI. Their characteristics, medications, and 30-day clinical outcomes were examined. Results: There were no significant differences in 30-day major adverse cardiac events (cardiac death, non-fatal myocardial infarction, and definite stent thrombosis), bleeding events, and stroke between the two groups. The discontinuation of clopidogrel due to side effects was significantly less frequent than that of ticlopidine (1.1% vs 7.7%, p= 0.003, respectively). Conclusion: Our findings suggest that concomitant use of clopidogrel with PPIs might be safer than ticlopidine with PPIs in patients undergoing primary stenting for acute myocardial infarction. © 2012 Japanese College of Cardiology.

DOI： 10.1016/j.jjcc.2012.02.003

Does N-Acetylcysteine Reduce the Incidence of Contrast-Induced Nephropathy and Clinical Events in Patients Undergoing Primary Angioplasty for Acute Myocardial Infarction? 査読有り

Tanaka Akihito, Suzuki Yoriyasu, Suzuki Noriyuki, Hirai Toshihisa, Yasuda Nobuyuki, Miki Ken, Fujita Masaya, Tanaka Toshikazu

Internal Medicine 50 巻 ( 7 ) 頁： 673 - 677 2011年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：The Japanese Society of Internal Medicine

<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>

DOI： 10.2169/internalmedicine.50.4226

Percutaneous coronary intervention with a virtual 2-Fr system. 査読有り

Tanaka A, Saito S

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 76 巻 ( 5 ) 頁： 684 - 6 2010年

Ability of dynamic chest radiography to identify left ventricular systolic dysfunction in heart failure 国際誌

Hiraiwa H., Nagai S., Ito R., Kondo K., Kazama S., Kondo T., Adachi S., Furusawa K., Tanaka A., Morimoto R., Okumura T., Murohara T.

International Journal of Cardiovascular Imaging 2025年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Journal of Cardiovascular Imaging

Dynamic chest radiography (DCR) can estimate haemodynamic parameters in heart failure (HF). However, no studies have evaluated its ability to determine cardiac systolic function in HF. This experimental study investigates the correlation between left ventricular (LV) ejection fraction (LVEF) and DCR image parameters in HF. Ninety-one patients with acute HF (median age, 58 years; males, 75%) (cardiologist diagnosis using the Framingham criteria) underwent DCR and transthoracic echocardiography after treatment for the uncompensated phase of HF. The LV apex pixel value (PV) change was measured by DCR. Correlations between the PV change and LVEF, as well as sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of DCR, were evaluated. LVEF and LV apex PV change were correlated in all patients (R = 0.428, P < 0.001) and in patients with LVEF < 50% (n = 38; R = 0.355, P = 0.029), < 40% (n = 31; R = 0.343, P = 0.059), and < 30% (n = 23; R = 0.321, P = 0.135). There was no significant correlation for patients with LVEF ≥ 50% (n = 53; R = − 0.004, P = 0.980). The LV apex PV change rate cutoff values for identifying LVEF < 50%, < 40%, and < 30% were 9.3% (AUC: 0.761, sensitivity: 0.698, specificity: 0.789, P < 0.001), 5.5% (AUC: 0.765, sensitivity: 0.883, specificity: 0.645, P < 0.001), and 5.5% (AUC: 0.767, sensitivity: 0.838, specificity: 0.696, P < 0.001), respectively. DCR may be useful to identify LV systolic dysfunction based on LVEF in acute HF.

DOI： 10.1007/s10554-025-03332-x

The Influence of Eicosapentaenoic Acid to Arachidonic Acid Ratio on Long-term Cardiovascular Events Following Percutaneous Coronary Intervention 査読有り

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

Japanese Journal of Medicine 60 巻 ( 24 ) 頁： 3865 - 3871 2021年12月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本内科学会

Objective 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. Methods 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. Results 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. Conclusion A low EPA/AA ratio was associated with long-term adverse cardiovascular events in Japanese patients with coronary artery disease.

DOI： 10.2169/internalmedicine.7336-21

Incidental findings on computed tomography for preoperative assessment before transcatheter aortic valve implantation in Japanese patients 査読有り

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

HEART AND VESSELS 36 巻 ( 12 ) 頁： 1911 - 1922 2021年12月

担当区分：責任著者記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

Extra-cardiovascular incidental findings (IFs) on preoperative computed tomography (CT) are frequently observed in transcatheter aortic valve implantation (TAVI) candidates. However, the backgrounds of TAVI candidates and comorbidities differ based on the race and/or country, and data on IFs in a specific population are not always applicable to another. The aim of this study was to assess the prevalence, type, and clinical impact of IFs in Japanese TAVI candidates. This was a retrospective, single-center, observational study. CT reports of 257 TAVI candidates were reviewed, and IFs were classified as (a) insignificant: findings that did not require further investigation, treatment, or follow-up; (b) intermediate: findings that needed to be followed up or were considered for further investigation but did not affect the planning of TAVI; and (c) significant: findings that required further investigation immediately or affected the planning of TAVI. At least one IF was found in 254 patients (98.8%). Insignificant, intermediate, and significant IFs were found in 253 (98.4%), 153 (59.5%), and 34 (13.2%) patients, respectively. Newly indicated significant IFs were found in 19 patients (7.4%). In 2 patients (0.8%), TAVI was canceled because of significant IFs. In patients who consequently underwent TAVI, the presence of significant IFs was not associated with the duration from CT performance to TAVI [28 (19–40) days vs. 27 (19–43) days, p = 0.74] and all-cause mortality during the median follow-up period of 413 (223–805) days (p = 0.44). Almost all Japanese TAVI candidates had at least one IF, and the prevalence of significant IFs was not negligible. Although the presence of significant IFs was not associated with mid-term mortality, appropriate management of IFs was considered important.

DOI： 10.1007/s00380-021-01875-2

High-output Heart Failure Caused by a Tumor-related Arteriovenous Fistula: A Case Report and Literature Review 査読有り

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

Japanese Journal of Medicine 60 巻 ( 18 ) 頁： 2979 - 2984 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本内科学会

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.

DOI： 10.2169/internalmedicine.6962-20

Improvement in the nutritional status after transcatheter aortic valve implantation 査読有り

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

JOURNAL OF CARDIOLOGY 78 巻 ( 3 ) 頁： 250 - 254 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: A poor nutritional status of patients before transcatheter aortic valve implantation (TAVI) has been reported to be associated with poor clinical outcomes. However, changes in the nutritional status following TAVI have not been fully elucidated. Methods: In this single-center retrospective observational study, 129 patients whose nutritional status at baseline and 6 months after TAVI were available were investigated. The prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) were used to assess the nutritional status of the patients at baseline and at 6 months. We further assessed changes in the nutritional status of patients in the subgroups stratified according to the baseline levels as low and high. Results: The PNI and GNRI values at 6 months were significantly better than at baseline [PNI, baseline: 44.5 (41.0–48.0), 6 months: 46.0 (41.9–48.3), p = 0.02; GNRI, baseline: 95.3 (89.0–100.3), 6 months: 97.8 (91.5–101.4), p = 0.006]. Both PNI and GNRI values at 6 months were significantly better in the patients with a low baseline nutritional status, while no significant change was observed in those with high baseline levels [PNI, low; baseline: 36.8 (36.1–39.4), 6 months: 40.8 (39.0–43.4), p = 0.002, high; baseline: 47.0 (43.0–49.5), 6 months: 46.5 (43.5–50.5), p = 0.44 and GNRI, low; baseline: 86.4 (81.7–88.7), 6 months: 88.6 (83.4–95.3), p = 0.001, high; baseline: 99.8 (95.3–102.8), 6 months: 100.7 (96.8–103.4), p = 0.34]. Conclusion: Nutritional status of patients might improve during the chronic phase after TAVI, especially in those with poor baseline levels.

DOI： 10.1016/j.jjcc.2021.04.006

Worsening renal function after transcatheter aortic valve replacement and surgical aortic valve replacement 査読有り

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

HEART AND VESSELS 36 巻 ( 7 ) 頁： 1080 - 1087 2021年7月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

Several prior reports have investigated worsening renal function around transcatheter aortic valve replacement (TAVR) procedures. However, in clinical practice, it seems more important to evaluate changes associated with TAVR-related procedures, including preoperative enhanced computed tomography (CT), as well as the TAVR procedure itself, as CT assessment is considered essential for safe TAVR. This study evaluated worsening renal function during the TAVR perioperative period, from the preoperative enhanced CT to 1 month after TAVR, and then compared the incidence with that in patients undergoing surgical aortic valve replacement (SAVR). This retrospective single-center study investigated 123 TAVR patients and 130 SAVR patients. We evaluated baseline renal function before enhanced CT in TAVR patients and before operation in SAVR patients, and again at 1 month post-operatively. We defined worsening renal function at 1 month according to three definitions: (1) an increase in serum creatinine ≥ 0.3 mg/dL or ≥ 1.5-fold from baseline or initiation of dialysis, (2) a decline in eGFR at 1 month ≥ 20% from baseline or initiation of dialysis, (3) a decline in eGFR at 1 month ≥ 30% from baseline or initiation of dialysis. TAVR patients were significantly older and had higher surgical risk scores than SAVR patients. In TAVR patients, serum creatinine levels were 1.00 ± 0.32 mg/dL at baseline and 1.01 ± 0.40 mg/dL at 1 month post-operatively (p = 0.58), while in SAVR patients, these levels were 0.99 ± 0.51 mg/dL and 0.98 ± 0.49 mg/dL, respectively (p = 0.59). In TAVR patients, 7 (5.7%), 14 (11.4%), and 3 (2.4%) patients experienced worsening renal function according to the three definitions, respectively, but there were no significant differences from those in SAVR patients, for any definition. Worsening renal function after TAVR was uncommon, and the incidence rate was comparable to that in SAVR patients, even though TAVR patients had worse baseline characteristics.

DOI： 10.1007/s00380-021-01778-2

その他リンク： https://link.springer.com/article/10.1007/s00380-021-01778-2/fulltext.html

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

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

日本循環器學誌 85 巻 ( 7 ) 頁： 1093 - 1098 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本循環器学会

Background: The changes in electrocardiographic left ventricular hypertrophy (ECG-LVH) after transcatheter aortic valve implantation (TAVI) are not fully elucidated. Methods and Results: 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. Conclusions: Regression of ECG-LVH was observed between 1 and 6 months after TAVI.

DOI： 10.1253/circj.cj-21-0354

The Mid-term Mortality and Mode of Death in Survivors with ST-elevation Myocardial Infarction 査読有り

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

Japanese Journal of Medicine 60 巻 ( 11 ) 頁： 1665 - 1674 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本内科学会

Objective 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. Methods 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. Results 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). Conclusion 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.

DOI： 10.2169/internalmedicine.6549-20

Ten-Year Mortality in Patients With ST-Elevation Myocardial Infarction 査読有り

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

AMERICAN JOURNAL OF CARDIOLOGY 149 巻頁： 9 - 15 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Journal of Cardiology

Knowledge of the long-term prognosis (>10 years) and mortality predictors of ST-elevation myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (p-PCI) is scarce. Therefore, this study evaluated the long-term prognosis and determined the predictors of long-term outcomes for STEMI patients after p-PCI. Between January, 2006 and December, 2010, we collected data and analyzed 459 consecutive patients with acute STEMI who underwent p-PCI and were discharged from the hospital (mean age, 66.8 years; male, 75.2%; peak creatine phosphokinase level, 2,292.5 IU/L). The primary endpoint was 10-year all-cause mortality. The cumulative 10-year incidence of all-cause death was 23.8%. The Cox multivariate regression analysis identified age ≥ 65 years (adjusted hazard ratio [aHR], p <0.001), body mass index (aHR, 0.93, p = 0.033), presence of atrial fibrillation (aHR, 1.69, p = 0.038), mineralocorticoid receptor antagonist use (aHR, 1.95, p = 0.008), ejection fraction <40% (aHR, 2.14, p = 0.005), and albumin <3.5 g/dL (aHR, 2.01, p = 0.005) as independent predictors of all-cause mortality. In conclusion, a post-discharge 10-year survival rate of 76.2% was identified for STEMI patients who underwent p-PCI.

DOI： 10.1016/j.amjcard.2021.03.008

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;術前握力の有用性査読有り

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 27 巻 ( 2 ) 頁： 129 - 135 2021年6月

記述言語：日本語出版者・発行元：(NPO)日本心臓リハビリテーション学会

【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)

Perioperative D-dimer levels after transcatheter aortic valve replacement: Comparison of patients with and without anticoagulant therapy 査読有り

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

CARDIOLOGY JOURNAL 28 巻 ( 1 ) 頁： 170 - 172 2021年2月

Relationship between epicardial adipose tissue volume and coronary artery spasm 査読有り

Kataoka Takashi, Harada Ken, Tanaka Akihito, Onishi Tomohiro, Matsunaga Shun, Funakubo Hiroshi, Harada Kazuhiro, Nagao Tomoyuki, Shinoda Norihiro, Marui Nobuyuki, Niwa Kiyoshi, Tashiro Hiroshi, Hitora Yusuke, Furusawa Kenji, Ishii Hideki, Amano Tetsuya, Murohara Toyoaki

INTERNATIONAL JOURNAL OF CARDIOLOGY 324 巻頁： 8 - 12 2021年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Journal of Cardiology

Background: Epicardial adipose tissue (EAT) is considered to play a critical role in vascular endothelial function. Coronary artery spasm has been postulated to be a causal factor in vascular endothelial abnormalities and atherosclerosis. This study aimed to investigate the relationship between coronary artery spasm and EAT volume, total abdominal adipose tissue (AAT) area, and abdominal visceral adipose tissue (AVAT) area. Method: Among patients undergoing coronary computed tomography (CT) to evaluate coronary artery disease, we identified 110 patients who did not have significant coronary artery stenosis and underwent a coronary spasm provocation test with cardiac catheterization. They were divided into two groups according to the results of the spasm provocation test: spasm-positive and spasm-negative. EAT volume, total AAT area, and AVAT area were evaluated using CT images. Results: Seventy-seven patients were included in the spasm-positive group and 33 patients in the spasm-negative group. There were no significant differences in baseline clinical characteristics between the two groups, except for the prevalence of current smoking (48% vs. 27%, p = 0.04). EAT volume was significantly higher in the spasm-positive group (108 ± 38 mL vs. 87 ± 34 mL, p = 0.007), while no significant difference was seen in total AAT area (280 ± 113 cm2 vs. 254 ± 128 cm2, p = 0.32) or AVAT area (112 ± 54 cm2 vs. 98 ± 55 cm2, p = 0.27). Multivariate logistic analysis indicated that EAT volume (per 10 cm3) (odds ratio, 1.198; 95% confidence interval, 1.035–1.388; p = 0.016) was a significant predictor of coronary artery spasm. Conclusion: Our results suggest that EAT has a strong association with coronary artery spasm, while AAT may not.

DOI： 10.1016/j.ijcard.2020.09.074

Serial Images of Aortic Plaque Rupture During Transfemoral Transcatheter Aortic Valve Replacement 査読有り

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

JACC-CARDIOVASCULAR INTERVENTIONS 13 巻 ( 22 ) 頁： E203 - E204 2020年11月

Multimodality imaging evaluation of saphenous vein graft peri-stent contrast staining enlargement 査読有り

Shibata Naoki, Sugiura Tsuyoshi, Tanaka Akihito, Shimizu Kiyokazu

INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 36 巻 ( 11 ) 頁： 2105 - 2106 2020年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Journal of Cardiovascular Imaging

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.

DOI： 10.1007/s10554-020-01937-y

Impact of skeletal muscle mass on clinical outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement 査読有り

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 36 巻 ( 4 ) 頁： 514 - 522 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular Intervention and Therapeutics

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.

DOI： 10.1007/s12928-020-00725-8

Rotational Atherectomy for Severely Calci fi ed Lesions in Patients With Left Ventricular Systolic Dysfunction: One-Year Outcomes From a Single-Center Registry Analysis 査読有り

Yoshida Ruka, Ishii Hideki, Morishima Itsuro, Tanaka Akihito, Takagi Kensuke, Yoshioka Naoki, Morita Yasuhiro, Unno Kazumasa, Yoshida Yukihiko, Tsuboi Hideyuki, Murohara Toyoaki

CARDIOVASCULAR REVASCULARIZATION MEDICINE 21 巻 ( 10 ) 頁： 1220 - 1227 2020年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular Revascularization Medicine

Background: High-risk percutaneous coronary intervention (PCI) in patients with left ventricular (LV) systolic dysfunction has been proven to induce reverse LV remodeling. However, the impact of high-risk PCI focusing on rotational atherectomy (RA) in patients with severe LV systolic dysfunction has not been completely addressed. Methods: Among 4339 consecutive patients who underwent PCI, 178 patients with 192 lesions were treated with RA. The reduced ejection fraction (EF) group (LVEF ≤35%) included 25 patients, the mid-range EF group (LVEF 36–50%) included 44 patients, and the preserved EF group (LVEF >50%) included 109 patients. The primary outcome was a composite of cardiac death, non-fatal myocardial infarction, target-vessel revascularization, and ischemic stroke. Results: The cumulative 1-year incidence of the primary outcome was similar among the three groups (reduced EF, 29%; mid-range EF, 25%; preserved EF, 26%; p = 0.95). After adjusting for confounding factors, the incidence of the primary outcome in the reduced EF group (hazard ratio [HR], 1.07; 95% confidence interval [CI], 0.43–2.37; p = 0.87) and the mid-range EF group (HR, 0.99; 95% CI, 0.47–1.94; p = 0.97) was similar to that in the preserved EF group. LVEF was significantly improved in the reduced EF and mid-range EF groups compared with the preserved EF group (absolute change in LVEF: 13.6 ± 11.3%, 9.0 ± 10.1%, and −0.7 ± 7.8%, respectively; p < 0.0001). Conclusions: Reduced EF was not associated with increase in the primary outcome in patients undergoing RA. This seemed to result from the improved LV function after PCI. Summary for annotated table of contents: This single center analysis study investigated 1-year composite outcome of cardiac death, non-fatal myocardial infarction, target-vessel revascularization, and ischemic stroke in patients with severe LV systolic dysfunction undergoing RA compared with that in patients with preserved LV function. The cumulative 1-year incidence of the composite outcome was similar among the three groups (reduced EF, 29%; mid-range EF, 25%; preserved EF, 26%; p = 0.95). LVEF was significantly improved in the reduced EF and mid-range EF groups compared with the preserved EF group (absolute change in LVEF: 13.6 ± 11.3%, 9.0 ± 10.1%, and −0.7 ± 7.8%, respectively; p < 0.0001).

DOI： 10.1016/j.carrev.2020.03.033

Reduced exercise capacity and clinical outcomes following acute myocardial infarction 査読有り

Tashiro Hiroshi, Tanaka Akihito, Ishii Hideki, Motomura Nariko, Arai Kenji, Adachi Takeshi, Okajima Takashi, Iwakawa Naoki, Kojima Hiroki, Mitsuda Takayuki, Hirayama Kenshi, Hitora Yusuke, Hayashi Motoharu, Furusawa Kenji, Yoshida Ruka, Imai Hajime, Ogawa Yasuhiro, Kawaguchi Katsuhiro, Murohara Toyoaki

HEART AND VESSELS 35 巻 ( 8 ) 頁： 1044 - 1050 2020年8月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

Reduced exercise capacity is known to be an important predictor of poor prognosis and disability in patients with cardiovascular diseases and chronic heart failure, and even members of the general population. However, data about exercise capacity assessed by cardiopulmonary exercise testing (CPX) in acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention (PCI) is scarce. Among 594 consecutive AMI patients who underwent primary PCI, we examined 136 patients (85.3% men, 64.9 ± 11.9 years) who underwent CPX during hospitalization for AMI. CPX was usually performed 5 days after the onset of AMI. Reduced exercise capacity was defined as peak VO2 ≤ 12. Clinical outcomes including all-cause death, myocardial infarction, and hospitalization due to heart failure were followed. Among 136 patients, reduced exercise capacity (peak VO2 ≤ 12) was seen in 38 patients (28%). Patients with reduced exercise capacity were older, more likely to have hypertension, and had lower renal function. In echocardiography, patients with reduced exercise capacity had higher E/e’ and larger left atrial dimension. Multivariate logistic analysis showed that E/e’ (OR 1.19, 95% CI 1.09–1.31, p < 0.001) was an independent predictor of reduced exercise capacity (peak VO2 ≤ 12). Median follow-up term was 12 months (IQR 9–22). The occurrence of composite endpoints of all-cause death, myocardial infarction, and hospitalization due to heart failure was significantly higher in patients with peak VO2 ≤ 12 than those with peak VO2 > 12 (p < 0.001). Reduced exercise capacity following primary PCI in AMI patients is associated with diastolic dysfunction and may lead to poorer clinical outcomes.

DOI： 10.1007/s00380-020-01576-2

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 査読有り

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

CARDIOVASCULAR INTERVENTION AND THERAPEUTICS 35 巻 ( 3 ) 頁： 259 - 268 2020年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular Intervention and Therapeutics

Although chronic total occlusion (CTO) in non-infarct-related arteries (non-IRAs) negatively affects long-term mortality in patients with acute myocardial infarction (AMI) who are undergoing primary percutaneous coronary intervention (PCI), the prognostic impact of successful CTO-PCI has not been completely addressed. Among 1855 consecutive patients with AMI who underwent primary PCI, those who were treated for CTO with either PCI or medical therapy were included. We evaluated the association between recanalization of CTO and long-term cardiac mortality. Of the 172 included patients, 88 underwent CTO-PCI, and the procedures were successful in 65 patients. Thus, the successfully recanalized CTO (SR-CTO) group included 65 patients; and the no recanalized CTO (NR-CTO) group, 107 patients. During the follow-up, 72 patients died, and of whom 56 (77.8%) died because of cardiac causes. The cumulative 10-year, 30-day, and 30-day to 10-year incidences of cardiac mortality were lower in the SR-CTO group than in the NR-CTO group (19.0% vs. 51.9% p = 0.004; 4.6% vs. 14.0%, p = 0.05; 15.0% vs. 44.1%, p = 0.003, respectively). After adjusting for confounding factors, the benefits of SR-CTO for the 10-year cardiac mortality remained significant compared with those of NR-CTO (hazard ratio 0.37; 95% confidence interval 0.17–0.75; p = 0.004). In conclusion, patients with SR-CTO in non-IRAs after AMI was associated with reduced long-term cardiac mortality compared with those with NR-CTO.

DOI： 10.1007/s12928-019-00615-8

Optical Coherence Tomography-Guided Stent Implantation for Woven Coronary Artery Anomaly 査読有り

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

CIRCULATION JOURNAL 84 巻 ( 6 ) 頁： 1044 - 1044 2020年6月

Clinical comparison study between a newly developed optical-based fractional flow reserve device and the conventional fractional flow reserve device 査読有り

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

CORONARY ARTERY DISEASE 31 巻 ( 4 ) 頁： 342 - 347 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Coronary Artery Disease

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.

DOI： 10.1097/MCA.0000000000000842

Lipid-rich large plaques in a non-culprit left main coronary artery and long-term clinical outcomes 査読有り

Tashiro Hiroshi, Tanaka Akihito, Ishii Hideki, Sakakibara Keisuke, Tobe Akihiro, Kataoka Takashi, Miki Yusuke, Hitora Yusuke, Niwa Kiyoshi, Furusawa Kenji, Murohara Toyoaki

INTERNATIONAL JOURNAL OF CARDIOLOGY 305 巻頁： 5 - 10 2020年4月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Journal of Cardiology

Background: An integrated backscatter (IB) intravascular ultrasound (IVUS) provides an information about tissue components and vulnerability of coronary plaques. The presence of vulnerable plaque in non-culprit lesion is associated with future clinical events. The purpose of this study was to assess the association between the characteristics of non-culprit left main coronary artery (LMCA) plaques evaluated by IB-IVUS and long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). Methods: Among the patients who underwent non-LMCA PCI, we studied 366 patients with adequate LMCA IVUS images. Conventional and IB-IVUS analyses of the LMCA segment were performed. Lipid-rich large plaque was defined as the presence of both a lager plaque volume and a higher percentage of the lipid component than the obtained median values. Major adverse cardiovascular events (MACE) included cardiac death, myocardial infarction, and unplanned revascularization. Results: The mean age of the patients was 68.5 ± 10.2 years, 79.8% were men. Median follow-up period was 6.0 years (IQR: 4.2–8.1 years). The incidence of MACE was significantly higher in patients with lipid-rich large plaques (P = .006). The incidence rates of cardiac death, myocardial infarction, and unplanned revascularization were significantly higher in patients with lipid-rich large plaques (P = .02, 0.004, and 0.02, respectively). Multivariate Cox regression analysis showed that the presence of a lipid-rich large plaque was significantly associated with MACE (HR: 1.74; 95%CI: 1.17–2.58; P = .006). Conclusion: The presence of lipid-rich large plaques in a non-culprit LMCA can be associated with the long-term MACE in patients who have undergone PCI.

DOI： 10.1016/j.ijcard.2020.01.072

Clinical outcomes after percutaneous coronary intervention in non-dialysis patients with acute coronary syndrome and advanced renal dysfunction 査読有り

Uemura Yusuke, Ishikawa Shinji, Takemoto Kenji, Negishi Yosuke, Tanaka Akihito, Takagi Kensuke, Yoshioka Naoyuki, Umemoto Norio, Inoue Yosuke, Morishima Itsuro, Shibata Naoki, Asano Hiroshi, Ishii Hideki, Watarai Masato, Murohara Toyoaki

CLINICAL AND EXPERIMENTAL NEPHROLOGY 24 巻 ( 4 ) 頁： 339 - 348 2020年4月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Clinical and Experimental Nephrology

Background: Data about the clinical outcomes of ACS patients with advanced renal dysfunction (estimated glomerular filtration rate < 30 mL/min/1.73 m2) following percutaneous coronary intervention (PCI) are limited. Methods: We examined the data obtained from 194 ACS patients with non-dialysis advanced renal dysfunction who underwent PCI at five hospitals. The primary composite endpoint was the incidence of major adverse cardiac and cerebrovascular events (MACCE: all-cause death, myocardial infarction, and ischemic stroke). Results: Eighty patients (41.2%) were diagnosed with ST-elevation myocardial infarction (STEMI), and 117 patients (58.8%) with non-ST-elevation ACS (NSTE-ACS). Overall patients were followed for a median of 657.5 days. Cumulative incidence of MACCE at median follow-up was 32.3% (45.4% for STEMI and 23.4% for NSTE-ACS). Kaplan–Meier analysis demonstrated that patients in the STEMI group had significantly higher incidence of MACCE than those in the non-STEMI and unstable angina group (Log-rank p < 0.001). In-hospital MACCE rate was higher in the STEMI group than in the NSTE-ACS group, whereas post-discharge MACCE rate was comparable between the two groups. In the multivariate analysis, STEMI and Killip classification ≥ 2 were associated with in-hospital MACCE. On the other hand, body mass index and serum albumin at admission were independent predictors of post-discharge MACCE. Conclusions: Short- and long-term prognoses following PCI in non-dialysis patients with ACS and advanced renal dysfunction is still unfavorable. STEMI and Killip classification ≥ 2 were independent predictors for in-hospital MACCE, and body mass index and serum albumin were for post-discharge MACCE.

DOI： 10.1007/s10157-019-01839-x

Influence of Preadmission Frailty on Short- and Mid-Term Prognoses in Octogenarians With ST-Elevation Myocardial Infarction 査読有り

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 84 巻 ( 4 ) 頁： 683 - 683 2020年4月

Influence of Preadmission Frailty on Short- and Mid-Term Prognoses in Octogenarians With ST-Elevation Myocardial Infarction 査読有り

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 84 巻 ( 1 ) 頁： 109 - 118 2020年1月

Differences in primary indication for guide-extension catheter usage among the three target vessels 査読有り

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

POSTEPY W KARDIOLOGII INTERWENCYJNEJ 16 巻 ( 2 ) 頁： 192 - + 2020年

Long-term renal outcomes after elective percutaneous coronary intervention in patients with advanced renal dysfunction 査読有り

Tashiro Hiroshi, Tanaka Akihito, Ishii Hideki, Takagi Kensuke, Uemura Yusuke, Inoue Yosuke, Umemoto Norio, Negishi Yosuke, Shibata Naoki, Yoshioka Naoki, Shimizu Kiyokazu, Morishima Itsuro, Watarai Masato, Asano Hiroshi, Murohara Toyoaki

HEART AND VESSELS 36 巻 ( 4 ) 頁： 452 - 460 2020年

担当区分：責任著者記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

The aim of the present study was to evaluate the renal outcomes, including the time course of renal function, after elective PCI in patients with advanced renal dysfunction and to assess the predictors of renal dysfunction progression. This is a subanalysis of a previous observational multicenter study that investigated long-term clinical outcomes in patients with advanced renal dysfunction (eGFR < 30 mL/min/1.73 m2), focusing on 151 patients who underwent elective PCI and their long-term renal outcomes. Renal dysfunction progression was defined as a 20% relative decrease in eGFR at 1 year from baseline or the initiation of permanent dialysis within 1 year. Progression of renal dysfunction at 1 year occurred in 42 patients (34.1%). Among patients with renal dysfunction progression, the decrease of renal function from baseline was not observed at 1 month but after 6 months of the index PCI. Baseline eGFR and serum albumin level were significant predictors of renal dysfunction progression at 1 year. Among 111 patients who had not been initiated on dialysis within 1 year, those with renal dysfunction progression had a significantly higher incidence of dialysis initiation more than 1 year after the index PCI than those with preserved renal function (p < 0.001). Among patients with advanced renal dysfunction who underwent elective PCI, 34.1% showed renal dysfunction progression at 1 year. The decrease in renal function was not observed at 1 month but after 6 months of the index PCI in patients with renal dysfunction progression. Furthermore, patients with renal dysfunction progression had poorer long-term renal outcomes.

DOI： 10.1007/s00380-020-01720-y

Improved Renal Function After Percutaneous Coronary Intervention in Non-Dialysis Patients With Acute Coronary Syndrome and Advanced Renal Dysfunction 査読有り

Uemura Yusuke, Ishikawa Shinji, Takemoto Kenji, Negishi Yosuke, Tanaka Akihito, Takagi Kensuke, Yoshioka Naoki, Tashiro Hiroshi, Umemoto Norio, Inoue Yosuke, Morishima Itsuro, Shimizu Kiyokazu, Shibata Naoki, Asano Hiroshi, Ishii Hideki, Watarai Masato, Murohara Toyoaki

CARDIOVASCULAR REVASCULARIZATION MEDICINE 24 巻頁： 26 - 30 2020年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular Revascularization Medicine

Background: The deterioration of renal function is a strong prognostic predictor in patients with coronary artery disease. Although percutaneous coronary intervention (PCI) has sometimes resulted in improved renal function (IRF) in acute coronary syndrome (ACS) patients, its clinical implications have not been fully elucidated. This study aimed to investigate the prevalence and predictors of IRF after PCI and its relationship with long-term renal outcomes. Methods: In this retrospective observational cohort study, we examined data from 177 ACS patients with non-dialysis advanced renal dysfunction (estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73 m2) who underwent PCI. Patients with and without IRF were compared in terms of baseline demographic, clinical, and procedural characteristics and renal outcomes. IRF was defined as a 20% increase in eGFR from baseline at 7 or 30 days after the index PCI. Results: IRF was observed in 66 (37.3%) patients. ST-elevation myocardial infarction and shock during PCI were independent predictors of IRF. Patients were followed up for a median of 695 days. Kaplan-Meier analyses demonstrated that patients with IRF had the lower incidence of initiation of permanent dialysis than those without IRF (Log-rank P = 0.015). Conclusions: IRF was relatively common in non-dialysis patients with ACS and advanced renal dysfunction who underwent PCI. ST-elevation myocardial infarction and shock, which may be indicative of hemodynamic instability during PCI, were independent predictors of IRF. Further, IRF was associated with favorable renal outcomes. Hemodynamic stabilization may be important for improving the short-term and long-term renal outcomes of high-risk patients.

DOI： 10.1016/j.carrev.2020.09.011

Prognostic impact of lipoprotein(a) levels during lipid management with statins after ST-elevation acute myocardial infarction 査読有り

Mitsuda Takayuki, Uemura Yusuke, Ishii Hideki, Tanaka Akihito, Takemoto Kenji, Koyasu Masayoshi, Ishikawa Shinji, Shibata Rei, Watarai Masato, Murohara Toyoaki

CORONARY ARTERY DISEASE 30 巻 ( 8 ) 頁： 600 - 607 2019年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Coronary Artery Disease

The causal relationship of lipoprotein(a) with cardiovascular disease has been established. However, clinical impacts of lipoprotein(a) levels on adverse vascular events in patients with established coronary artery disease who are undergoing statin treatment have not been fully elucidated. We measured lipoprotein(a) levels of 668 consecutive patients with ST-elevated myocardial infarction upon admission and reevaluated lipoprotein(a) of 189 of these patients during statin treatment at least 6 months later than the date of index ST-elevated myocardial infarction. Changes in lipoprotein(a) and associations between lipoprotein(a) levels and the incidence of major adverse cardiac and cerebrovascular event for 3 years were examined. Lipoprotein(a) at baseline was an independent predictor of 3-year major adverse cardiac and cerebrovascular event after ST-elevated myocardial infarction. Levels of lipoprotein(a) at follow-up were slightly but significantly elevated despite improvements in other lipid parameters due to statin treatment. Furthermore, higher levels of lipoprotein(a) achieved with statin treatment were also associated with the subsequent incidence of major adverse cardiac and cerebrovascular event over 3 years, regardless of whether or not the LDL-cholesterol levels were below 100 mg/dl. In conclusion, lipoprotein(a) levels during lipid management by statin are also predictive of adverse vascular events in Japanese patients with ST-elevated myocardial infarction.

DOI： 10.1097/MCA.0000000000000798

Late Stent Thrombosis Concurrent With Stent Fracture at Calcified Nodule Lesion in Saphenous Vein Graft 査読有り

Uemura Yusuke, Tanaka Akihito, Takemoto Kenji, Koyasu Masayoshi, Mitsuda Takayuki, Ishii Hideki, Murohara Toyoaki, Watarai Masato

JACC-CARDIOVASCULAR INTERVENTIONS 12 巻 ( 22 ) 頁： E199 - E200 2019年11月

What are the remaining lessons to be learnt from 1st-generation bioresorbable scaffolds? 招待有り査読有り国際共著

Tanaka Akihito, Jabbour Richard J, Colombo Antonio

INTERNATIONAL JOURNAL OF CARDIOLOGY 293 巻頁： 103 - 104 2019年10月

Impact of adjunctive use of guide extension catheter on midterm outcome of drug-coated balloon angioplasty 査読有り

Yoshida Ruka, Ishii Hideki, Morishima Itsuro, Tanaka Akihito, Takagi Kensuke, Iwakawa Naoki, Tashiro Hiroshi, Kojima Hiroki, Mitsuda Takayuki, Hirayama Kenshi, Hitora Yusuke, Furusawa Kenji, Murohara Toyoaki

EUROINTERVENTION 15 巻 ( 8 ) 頁： 688 - 691 2019年10月

Impact of Postdischarge Bleeding on Long-Term Mortality in Percutaneous Coronary Intervention Patients Taking Oral Anticoagulants 査読有り

Yoshida Ruka, Ishii Hideki, Morishima Itsuro, Tanaka Akihito, Morita Yasuhiro, Takagi Kensuke, Yoshioka Naoki, Hirayama Kenshi, Iwakawa Naoki, Tashiro Hiroshi, Kojima Hiroki, Mitsuda Takayuki, Hitora Yusuke, Furusawa Kenji, Tsuboi Hideyuki, Murohara Toyoaki

JOURNAL OF CARDIOVASCULAR PHARMACOLOGY 74 巻 ( 3 ) 頁： 210 - 217 2019年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiovascular Pharmacology

Although postdischarge bleeding (PDB) is known to negatively affect long-term outcome in patients undergoing percutaneous coronary intervention (PCI) with antiplatelet therapy (APT), the prognostic importance of PDB in patients who require both oral anticoagulants (OACs) and APT has not been fully elucidated. Among 3718 consecutive patients who underwent PCI, 302 patients were treated with both OACs and APT. We evaluated the association between PDB and 3-year all-cause mortality, as estimated by a time-updated Cox proportional hazard regression model. We performed nearest-neighbor matching on the propensity score to adjust the differences in baseline characteristics. Among 302 patients treated with OACs and APT, PDB was observed in 98 patients at a median time of 239 days. Patients experienced PDB had significantly higher incidence of 3-year all-cause mortality in the overall cohort and 94 propensity-score-matched pairs (hazard ratio 6.21, 95% confidence interval 3.29-11.72, P < 0.0001; and hazard ratio 6.13, 95% confidence interval 2.68-14.02, P < 0.0001, respectively). The risk of subsequent mortality was the highest within 180 days after PDB (58.3% within 180 days and 75.0% within 1 year). In conclusion, PDB was significantly associated with long-term mortality in patients taking both OACs and APT after PCI.

DOI： 10.1097/FJC.0000000000000702

Temporary immobile leaflet following transcatheter aortic valve replacement of a SAPIEN-XT valve 査読有り

Aoki Toshijiro, Tanaka Akihito, Tokuda Yoshiyuki, Oshima Hideki, Suzuki Susumu, Ishii Hideki

CARDIOVASCULAR INTERVENTION AND THERAPEUTICS 34 巻 ( 3 ) 頁： 277 - 278 2019年7月

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 査読有り

Yoshida Ruka, Ishii Hideki, Morishima Itsuro, Tanaka Akihito, Morita Yasuhiro, Takagi Kensuke, Yoshioka Naoki, Hirayama Kenshi, Iwakawa Naoki, Tashiro Hiroshi, Kojima Hiroki, Mitsuda Takayuki, Hitora Yusuke, Furusawa Kenji, Tsuboi Hideyuki, Murohara Toyoaki

JOURNAL OF CARDIOLOGY 73 巻 ( 6 ) 頁： 479 - 487 2019年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: No standardized tool exists for weighting bleeding risk before selecting an antithrombotic regimen in patients undergoing percutaneous coronary intervention (PCI) who require both oral anticoagulant (OAC) and antiplatelet agents. Methods: We performed PCI in 3718 consecutive patients between April 2011 and March 2017, 302 of whom were treated with both OAC and antiplatelet agents. We retrospectively evaluated the predictive performance of four major bleeding risk scores (HAS-BLED, ORBIT, PRECISE-DAPT, and PARIS score). Patients were followed for up to 3 years for bleeding events, defined as a composite of major and minor bleeding according to the Thrombolysis in Myocardial Infarction (TIMI) criteria and the Bleeding Academic Research Consortium (BARC) criteria. Results: TIMI significant bleedings (major, minor, and requiring medical attention) were seen in 90 patients (29.8%); whereas the BARC class ≥3 bleedings were seen in 53 patients (17.5%). Regarding TIMI significant bleedings, HAS-BLED, ORBIT, and PRECISE-DAPT scores equally categorized high-risk patients, but the PARIS score could not [high-risk versus non-high-risk: hazard ratio (HR), 1.74; 95% confidence interval (CI), 1.15–2.64; p = 0.01; HR, 1.63; 95% CI, 1.08–2.48; p = 0.02; HR, 1.62; 95% CI, 1.06–2.51; p = 0.03; HR, 1.05; 95% CI, 0.70–1.63; p = 0.79, respectively); regarding BARC class ≥3 bleeding, all four scores could stratify high-risk patients (high-risk versus non-high-risk: HR, 2.23; 95% CI, 1.30–3.88; p = 0.004; HR, 2.25; 95% CI, 1.31–3.96; p = 0.003; HR, 3.87; 95% CI, 2.06–7.91; p < 0.0001; HR, 1.85; 95% CI, 1.04–3.47; p = 0.04, respectively). Conclusions: In patients taking an OAC undergoing PCI, HAS-BLED, ORBIT, and PRECISE-DAPT scores predicted TIMI significant bleeding events better than the PARIS score; whereas all four scores could predict BARC class ≥3 bleeding events.

DOI： 10.1016/j.jjcc.2018.10.013

Contrast-Induced Nephropathy and Long-Term Clinical Outcomes Following Percutaneous Coronary Intervention in Patients With Advanced Renal Dysfunction (Estimated Glomerular Filtration Rate <30 ml/min/1.73 m(2)) 査読有り

Negishi Yosuke, Tanaka Akihito, Ishii Hideki, Takagi Kensuke, Inoue Yosuke, Uemura Yusuke, Umemoto Norio, Yoshioka Naoyuki, Morishima Itsuro, Asano Hiroshi, Watarai Masato, Shibata Naoki, Suzuki Susumu, Murohara Toyoaki

AMERICAN JOURNAL OF CARDIOLOGY 123 巻 ( 3 ) 頁： 361 - 367 2019年2月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Journal of Cardiology

The incidence of contrast-induced nephropathy (CIN) increases with the progression of renal dysfunction. Recent reports have shown that percutaneous coronary intervention (PCI) can be safely performed even in patients with advanced renal dysfunction by appropriate CIN-prevention strategies. However, data are limited regarding the occurrence and prognostic influence of CIN in patients with advanced renal dysfunction. We examined the data obtained from 323 consecutive patients with advanced renal dysfunction (eGFR <30 ml/min/1.73 m 2 ) who underwent PCI at 5 hospitals. CIN was defined as a ≥25% increase in baseline serum creatinine levels and/or a ≥0.5 mg/dl increase in absolute serum creatinine levels within 72 hours after PCI. Incidence of all-cause death and the initiation of permanent dialysis were examined during follow-up. The prevalence of emergency/urgent PCI was 53.3%. Intravascular ultrasound was used in 266 patients (82.4%), and the volume of contrast used was 71.7 ± 57.2 ml. CIN was observed in 31 patients (9.7%). The median follow-up duration was 656 days (interquartile range 257–1143 days). The cumulative rates of all-cause death or the initiation of permanent dialysis, all-cause death, and the initiation of permanent dialysis were 38.1%, 25.9%, and 18.2%, respectively, at 2 years. A comparison between patients with and without CIN showed no significant intergroup differences in the occurrence of the aforementioned events. In conclusion, the incidence of CIN was not high in Japanese patients with advanced renal dysfunction in routine clinical practice. Whereas, the long-term prognosis following PCI is observed to be poor in this studied population, and CIN did not show a significant prognostic influence.

DOI： 10.1016/j.amjcard.2018.10.038

Influence of chronic kidney disease and worsening renal function on clinical outcomes in patients undergoing primary percutaneous coronary intervention 査読有り

Aoki Toshijiro, Ishii Hideki, Tanaka Akihito, Suzuki Susumu, Ichimiya Satoshi, Kanashiro Masaaki, Murohara Toyoaki

CLINICAL AND EXPERIMENTAL NEPHROLOGY 23 巻 ( 2 ) 頁： 182 - 188 2019年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Clinical and Experimental Nephrology

Background: The combined influence of CKD and worsening renal function (WRF) on clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has not been fully understood. Methods: We analyzed 443 patients diagnosed with AMI who underwent primary PCI. Based on their estimated glomerular filtration rate (eGFR), they were classified into two groups: a high eGFR group (eGFR ≥ 45 mL/min/1.73 m 2 , n = 381) and a low eGFR group (eGFR < 45 mL/min/1.73 m 2 , n = 63). WRF was defined as an increase in serum creatinine levels ≥ 0.3 mg/dL above the admission value during the course of hospitalization. The primary end-point was set as all-cause mortality. Results: WRF was observed in 88 patients (19.8%). The median follow-up duration was 769 (interquartile range 397–1314) days. The all-cause mortality rate was significantly lower in the high eGFR than in the low eGFR group (5.5 vs. 28.6%, respectively, at 1500 days, P < 0.001). In patients with WRF, the all-cause and cardiac mortality rates were significantly higher than in patients without WRF, and these results were consistent between the high and low eGFR sub-groups. Multivariate Cox proportional hazards model analysis showed that low eGFR and WRF remained independent predictors of all-cause mortality [(hazard ratio 2.61, 95% confidence interval 1.27–5.36, P = 0.009) and (hazard ratio 2.59, 95% confidence interval 1.34–5.01, P = 0.005), respectively]. Conclusions: Both eGFR at baseline and WRF were observed to be important predictors of mortality in patients with AMI undergoing primary PCI. WRF showed a significant effect on mortality even in patients with high eGFR.

DOI： 10.1007/s10157-018-1622-y

Coronary air embolism following transbronchial lung biopsy 査読有り

Sumi Takuya, Tanaka Akihito, Ishii Hideki, Suzuki Susumu, Kada Kenji, Murohara Toyoaki

CARDIOVASCULAR INTERVENTION AND THERAPEUTICS 34 巻 ( 1 ) 頁： 64 - 66 2019年1月

Impact of Nutritional and Inflammation Status on Long-Term Bleeding in Patients Undergoing Percutaneous Coronary Intervention with an Oral Anticoagulant 査読有り

Yoshida Ruka, Ishii Hideki, Morishima Itsuro, Tanaka Akihito, Morita Yasuhiro, Takagi Kensuke, Yoshioka Naoki, Hirayama Kenshi, Iwakawa Naoki, Tashiro Hiroshi, Kojima Hiroki, Mitsuda Takayuki, Hitora Yusuke, Furusawa Kenji, Tsuboi Hideyuki, Murohara Toyoaki

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 26 巻 ( 8 ) 頁： 728 - 737 2019年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本動脈硬化学会

Aim: 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. Methods: 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. Results: 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; p＜0.0001) and hs-CRP level ≥ 2.5 mg/L (HR, 2.75; 95% CI, 1.61 – 4.78; p=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; p＜ 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, p＜0.0001; IDI, 0.066, p＜0.0001). Conclusions: The GNRI and hs-CRP were novel predictors of the long-term bleeding risk in patients requiring both OACs and APT after PCI.

DOI： 10.5551/jat.47654

Early versus delayed invasive strategy in patients with non-ST-elevation acute coronary syndrome and concomitant congestive heart failure 査読有り

Yoshida Ruka, Ishii Hideki, Morishima Itsuro, Tanaka Akihito, Morita Yasuhiro, Takagi Kensuke, Yoshioka Naoki, Hirayama Kenshi, Iwakawa Naoki, Tashiro Hiroshi, Kojima Hiroki, Mitsuda Takayuki, Hitora Yusuke, Furusawa Kenji, Tsuboi Hideyuki, Murohara Toyoaki

JOURNAL OF CARDIOLOGY 74 巻 ( 3-4 ) 頁： 320 - 327 2019年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: Although there are guidelines that recommend an early invasive strategy in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and concomitant congestive heart failure (CHF), optimal timing of the invasive strategy remains controversial. Methods: Among 2045 patients who were admitted owing to NSTE-ACS or CHF, 300 presented with NSTE-ACS and concomitant CHF. Of the 300 patients, we enrolled 160 patients for whom coronary angiography (CAG) during their hospital stay was planned at the time of admission; 64 of these patients were classified into the early invasive group (<24 h) and 96 were classified to the delayed invasive group (≥24 h). We evaluated the primary outcome which was defined as a composite of cardiac mortality, life-threatening arrhythmia, and non-fatal myocardial infarction (MI). Results: The median time between presentation and CAG was 2 h in the early invasive group and 240 h in the delayed group. During follow-up, the primary outcome was significantly lower in the early invasive group [hazard ratio (HR), 0.52; 95% confidence interval (CI), 0.30–0.87; p = 0.01]. After the adjustment of confounding factors, the primary outcome was significantly less frequent (HR, 0.44; 95% CI, 0.23–0.78; p = 0.004) in the early invasive group compared to the delayed invasive group. Conclusions: The early invasive strategy was associated with a lower risk of the composite primary outcome in the long-term follow-up of patients with NSTE-ACS and concomitant CHF.

DOI： 10.1016/j.jjcc.2019.03.006

Incidence, Technical Safety, and Feasibility of Coronary Angiography and Intervention Following Self-expanding Transcatheter Aortic Valve Replacement. 査読有り

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

Cardiovascular revascularization medicine : including molecular interventions 20 巻 ( 5 ) 頁： 371 - 375 2019年

JCS GUIDELINES : JCS 2018 Guideline on Diagnosis and Treatment of Acute Coronary Syndrome

Kimura Kazuo, Kimura Takeshi, Ishihara Masaharu, Nakagawa Yoshihisa, Nakao Koichi, Miyauchi Katsumi, Sakamoto Tomohiro, Tsujita Kenichi, Hagiwara Nobuhisa, Miyazaki Shunichi, Ako Junya, Arai Hirokuni, Ishii Hideki, Origuchi Hideki, Shimizu Wataru, Takemura Hirofumi, Tahara Yoshio, Morino Yoshihiro, Iino Kenji, Itoh Tomonori, Iwanaga Yoshitaka, Uchida Keiji, Endo Hirohisa, Kongoji Ken, Sakamoto Kenji, Shiomi Hiroki, Shimohama Takao, Suzuki Atsushi, Takahashi Jun, Takeuchi Ichiro, Tanaka Akihito, Tamura Toshihiro, Nakashima Takahiro, Noguchi Teruo, Fukamachi Daisuke, Mizuno Tomohiro, Yamaguchi Junichi, Yodogawa Kenji, Kosuge Masami, Kohsaka Shun, Yoshino Hideaki, Yasuda Satoshi, Shimokawa Hiroaki, Hirayama Atsushi, Akasaka Takashi, Haze Kazuo, Ogawa Hisao, Tsutsui Hiroyuki, Yamazaki Tsutomu

日本循環器學誌 83 巻 ( 5 ) 頁： 1085 - 1196 2019年

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

Yoshida Ruka, Takagi Kensuke, Ishii Hideki, Morishima Itsuro, Tanaka Akihito, Morita Yasuhiro, Kanzaki Yasunori, Nagai Hiroaki, Watanabe Naoki, Furui Koichi, Shibata Naoki, Yoshioka Naoki, Yamauchi Ryota, Komeyama Shotaro, Sugiyama Hiroki, Tsuboi Hideyuki, Murohara Toyoaki

JOURNAL OF NUCLEAR CARDIOLOGY 28 巻 ( 4 ) 頁： 1422 - 1434 2019年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Nuclear Cardiology

Background: The effect of prasugrel over clopidogrel on myocardial salvage in ST-segment-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (p-PCI) is not fully elucidated. Methods: Among 854 consecutive STEMI patients who underwent p-PCI, 446 patients were evaluated by two-phase (7 days and 3 months) single-photo emission computed tomography (SPECT). Patients were divided into two groups based on the loading P2Y12 inhibitor. The clopidogrel group was further divided based on the result of platelet function testing. Thus, the prasugrel group included 227 patients; the clopidogrel without high-residual platelet reactivity (HRPR) group, 109 patients; and the clopidogrel with HRPR group, 107 patients. The primary endpoint was the Myocardial Salvage Index (MSI), determined by SPECT. Results: The incidence of final TIMI 0/1 and TIMI myocardial perfusion grade 0/1 was higher in the clopidogrel with HRPR group (0.9%, 1.8%, and 7.5%, P = .002; 19.8%, 29.4%, and 41.1%, P = .0002, in the prasugrel, clopidogrel without HRPR, and clopidogrel with HRPR groups, respectively). The MSI was significantly lower in the clopidogrel with HRPR group (48% [27-66], 44% [30-72], and 36% [15-55], P = .006, respectively). Conclusions: Prasugrel in STEMI patients was associated with an increased MSI compared with clopidogrel in the presence of HRPR.

DOI： 10.1007/s12350-019-01852-3

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 19 巻 ( 6 ) 頁： 207 - 210 2019年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology Cases

A 23-year-old Japanese man presented to a nearby hospital with a complaint of chest pain. In terms of the risk factors for cardiovascular events, there were no abnormal findings in past medical examinations and no smoking history. The 12-lead electrocardiogram revealed ST-elevation in V1-V6, I, and aVL, and he was diagnosed with acute myocardial infarction. Emergency coronary angiography findings revealed total occlusion of the left main trunk and collateral vessels from the right coronary artery to the left anterior descending artery. He underwent emergency percutaneous coronary intervention and placement of drug-eluting stent under the support of venoarterial-extracorporeal membrane oxygenator (VA-ECMO). On day 8 after the onset, transthoracic echocardiography revealed that cardiac function improved with left ventricular ejection fraction from 10% to 20% and VA-ECMO was successfully removed. Alternatively, laboratory findings revealed abnormally high levels of serum lipoprotein(a) [Lp(a), 74 mg/dL] despite the normal levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride. In addition, computed tomography angiography revealed atherosclerosis and stenosis of internal and external carotid arteries, subclavian artery, and renal artery. The abnormally high levels of serum Lp(a) could influence systemic atherosclerosis as well as the onset of myocardial infarction in our young adult patient. <Learning objective: This was a rare survival case of a young adult patient with acute extensive myocardial infarction owing to plaque rupture of the left main trunk. Additionally, he had atherosclerosis of the whole body, including the carotid artery, subclavian artery, and renal artery. Blood test results revealed abnormally high levels of serum lipoprotein(a) [Lp(a)] despite the normal levels of low-density lipoprotein cholesterol. Lp(a) could strongly influence coronary atherosclerosis and myocardial infarction.>

DOI： 10.1016/j.jccase.2019.02.004

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. 査読有り国際共著

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 2 Investigators.

International journal of cardiology 280 巻頁： 30 - 37 2018年12月

New-Generation Drug-Eluting Stents for Left Main In-Stent Restenosis: The DELTA-2 Registry. 査読有り国際共著

Giustino G, Tanaka A, Erglis A, Morice MC, Van Mieghem NM, Meliga E, D'Ascenzo F, Stefanini GG, Capodanno D, Chieffo A, DELTA-2 Investigators.

JACC. Cardiovascular interventions 11 巻 ( 23 ) 頁： 2438-2440 - 2440 2018年12月

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

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 270 巻頁： 113-117 - 117 2018年11月

Vasospastic angina in a 16-year-old female 査読有り

Sumi Takuya, Tanaka Akihito, Ishii Hideki, Suzuki Susumu, Oguri Mitsutoshi, Murohara Toyoaki

CARDIOVASCULAR INTERVENTION AND THERAPEUTICS 33 巻 ( 4 ) 頁： 393 - 394 2018年10月

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 3 巻 ( 1 ) 頁： 79 - 88 2018年7月

記述言語：日本語出版者・発行元：The journal of applied laboratory medicine

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.

DOI： 10.1373/jalm.2017.025296

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 19 巻頁： 3 - 7 2018年6月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：IJC Heart and Vasculature

Background: Vascular endothelial growth factor-A (VEGF-A) promotes neovascularization and is attracting considerable attention as a remarkable risk factor in patients after acute myocardial infarction (AMI). In contrast, the association between VEGF-A165b, which is the main anti-angiogenic isoform of VEGF-A, and adverse clinical outcomes after AMI remains unclear. The present study aimed to investigate the association between serum VEGF-A165b and major adverse cardiac and cerebrovascular events (MACCEs) after percutaneous coronary intervention (PCI) for AMI. Methods: We evaluated 23 patients with AMI who underwent primary percutaneous coronary intervention. VEGF-A and VEGF-A165b levels were measured on admission (day 1) and at days 3, 7, and 30 after PCI. Results: The levels of total VEGF-A tended to be lower, while the ratio of VEGF-A165b to total VEGF-A tended to be higher in patients with MACCEs than in those without. The patients with a high ratio of VEGF-A165b to total VEGF-A had a significantly higher risk of MACCEs using the cut-off values for MACCEs at day 30 after PCI (0.87 vs. 0.25, log-rank test, p = 0.0058). Conclusion: The assessment of VEGF-A165b combined with VEGF-A may be a valuable screening tool for predicting MACCEs in clinical practice.

DOI： 10.1016/j.ijcha.2018.03.004

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 17 巻 ( 1 ) 頁： 21 2018年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Lipids in Health and Disease

Background: Periprocedural myocardial injury (PMI) is a major complication of percutaneous coronary intervention (PCI) and is associated with atherosclerotic coronary plaque and worse clinical outcomes. High-density lipoprotein cholesterol (HDL-C) is a protective factor for cardiovascular disease. However, the role of HDL-C subfractions, such as HDL2 cholesterol (HDL2-C) or HDL3 cholesterol (HDL3-C), in cardiovascular disease remains unclear. The purpose of the study was to investigate the relationship between HDL2-C and HDL3-C subfractions and the incidence of PMI in patients who underwent elective PCI. Methods: We enrolled 129 patients who underwent elective PCI for stable angina pectoris. PMI was defined as an increase in high-sensitivity troponin T levels > 5 times the upper normal limit (> 0.070 ng/mL) at 24 h after PCI. Serum HDL-C subfractions (HDL2-C and HDL3-C) were assessed using ultracentrifugation in patients with and those without PMI. Results: HDL3-C levels were significantly lower in patients with PMI than in those without (15.1 ± 3.0 mg/dL vs. 16.4 ± 2.9 mg/dL, p = 0.016) and had an independent and inverse association with PMI (odds ratio, 0.86; 95% confidence interval, 0.74-0.99; p = 0.038). When divided by the cut-off value of HDL3-C for PMI (14.3 mg/dL), the incidence of PMI was significantly higher in low HDL3-C patients than in high HDL3-C patients (51.2% vs. 30.2%, p = 0.020). Conclusions: HDL3-C was an independent inverse predictor of PMI in patients who underwent elective PCI.

DOI： 10.1186/s12944-018-0670-3

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. 査読有り

Mitomo S, Jabbour RJ, 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 254 巻頁： 53 - 58 2018年

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

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

JOURNAL OF CARDIOLOGY 71 巻 ( 5-6 ) 頁： 464 - 470 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Objectives: To evaluate whether balloon inflation for post-dilatation causes longitudinal stent deformation (LSD). Methods and results: Two stents, sized 2.5 mm × 28 mm and 3.5 mm × 28 mm (Nobori ® , biodegradable polymer biolimus-eluting stent; Ultimaster ® , biodegradable polymer sirolimus-eluting stent; Terumo Co., Tokyo, Japan), were deployed at nominal pressure in straight and tapered silicon vessel models. Then, post-dilatation was performed in two ways: dilatation from the distal (D-P group) or proximal (P-D group) side of the stent. Microscopic findings showed that the stents were elongated during every step of the procedure regardless of the post-dilatation method and type of vessel model. The D-P group showed linear elongation during each step of post-dilatation (straight model: 28.7 ± 0.3 mm vs. 29.9 ± 0.3 mm, p = 0.002; tapered model: 28.0 ± 0.1 mm vs. 29.9 ± 0.1 mm, p < 0.001). In contrast, in the P-D group, the most significant change was observed in the first step of post-dilatation and only slight changes were observed thereafter (straight model: 28.6 ± 0.1 mm vs. 29.5 ± 0.1 mm, p < 0.001; tapered model: 28.2 ± 0.1 mm vs. 29.5 ± 0.1 mm, p < 0.001). Optical frequency domain imaging analysis showed that the frequency of stent strut malapposition was positively correlated with the percentage change in stent length (r = 0.74, p < 0.0001). Conclusion: LSD was observed during every step of post-dilatation in both the straight and tapered vessel models. However, some differences were observed between the D-P and P-D groups. Minimizing stent strut malapposition may reduce the risk of LSD.

DOI： 10.1016/j.jjcc.2017.11.003

Different Behavior of Bioresorbable Vascular Scaffold and Metallic Stent With Positive Vessel Remodeling. 査読有り

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

Circulation journal : official journal of the Japanese Circulation Society 82 巻 ( 6 ) 頁： 1716 - 1717 2018年

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. 査読有り

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 : official journal of the Society for Cardiac Angiography & Interventions 91 巻 ( 5 ) 頁： 966 - 974 2018年

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). 査読有り

Moscarella E, Tanaka A, Ielasi A, Cortese B, Coscarelli S, De Angelis MC, 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 : official journal of the Society for Cardiac Angiography & Interventions 92 巻 ( 4 ) 頁： 668 - 677 2018年

Delayed Coronary Obstruction After Transcatheter Aortic Valve Replacement.

Jabbour RJ, 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 JM, 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 71 巻 ( 14 ) 頁： 1513 - 1524 2018年

"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 25 巻 ( 4 ) 頁： 532 - 533 2018年

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

Mangieri A, Lanzillo G, Bertoldi L, Jabbour RJ, Regazzoli D, Ancona MB, 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 11 巻 ( 15 ) 頁： 1519 - 1526 2018年

Delayed Coronary Occlusion After Transcatheter Aortic Valve Implantation: Implications for New Transcatheter Heart Valve Design and Patient Management.

Jabbour RJ, Tanaka A, Colombo A, Latib A

Interventional cardiology (London, England) 13 巻 ( 3 ) 頁： 137 - 139 2018年

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

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

International journal of cardiology 263 巻頁： 17 - 23 2018年

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 17 巻 ( 4 ) 頁： 126 - 129 2018年

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 96 巻 ( 50 ) 頁： e9297 2017年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Medicine (United States)

The usefulness of distal protection devices is still controversial. Moreover, there is no report on thrombus evaluation by using optical coherence tomography (OCT) for determining whether to use a distal protection device. The aim of the present study was to investigate the predictor of filter no-reflow (FNR) by using OCT in primary percutaneous coronary intervention (PCI) for ST-elevated acute myocardial infarction (STEMI). We performed preinterventional OCT in 25 patients with STEMI who were undergoing primary PCI with Filtrap. FNR was defined as coronary flow decreasing to TIMI flow grade 0 after mechanical dilatation. FNR was observed in 13 cases (52%). In the comparisons between cases with or without the FNR, the stent length, lipid pool length, lipid pool + thrombus length, and lipid pool + thrombus index showed significant differences. In multivariate analysis, lipid pool + thrombus length was the only independent predictor of FNR (OR 1.438, 95% CI 1.001 - 2.064, P < .05). The optimal cut-off value of lipid pool + thrombus length for predicting FNR was 13.1 mm (AUC = 0.840, sensitivity 76.9%, specificity 75.0%). Moreover, when adding the evaluation of thrombus length to that of lipid pool length, the prediction accuracy of FNR further increased (IDI 0.14: 0.019-0.25, P = .023). The longitudinal length of the lipid pool plus thrombus was an independent predictor of FNR and the prediction accuracy improved by adding the thrombus to the lipid pool. These results might be useful for making intraoperative judgment about whether filter devices should be applied in primary PCI for STEMI.

DOI： 10.1097/MD.0000000000009297

Expansion in calcific lesions and overall clinical outcomes following bioresorbable scaffold implantation optimized with intravascular ultrasound. 査読有り

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 : official journal of the Society for Cardiac Angiography & Interventions 89 巻 ( 5 ) 頁： 789 - 797 2017年

Long-term outcome of full plastic jacket treatment for bare metal in-stent restenosis. 査読有り

Jabbour RJ, Tanaka A, Mangieri A, Regazzoli D, Ancona M, Pagnesi M, Giannini F, Latib A, Colombo A

Cardiovascular revascularization medicine : including molecular interventions 18 巻 ( 2 ) 頁： 139 - 140 2017年

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. 査読有り

Chieffo A, 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, DELTA 2 Investigators.

JACC. Cardiovascular interventions 10 巻 ( 23 ) 頁： 2401 - 2410 2017年

Predictive Value of Aortic Valve Calcification for Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention 査読有り

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 24 巻 ( 5 ) 頁： 487 - 494 2017年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本動脈硬化学会

<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>

DOI： 10.5551/jat.36582

Influence of False Lumen Status on the Prognosis of Acute Type A Aortic Dissection without Urgent Surgical Treatment 査読有り

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

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 24 巻 ( 2 ) 頁： 169 - 175 2017年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本動脈硬化学会

Aim: 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. Methods: 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, n =28; partial thrombosis, n =27; patent, n=7). Patients with partial thrombosis were further divided into two groups (thrombus-dominant, n=15; flow-dominant, n =12). Results: 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, p=0.001 and 30-day, p＜0.001). Conclusions: 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.

DOI： 10.5551/jat.35675

How should I treat recurrent restenosis with underexpanded multilayered struts after repeated complex bifurcation stenting? 査読有り

Tanaka A, Ruparelia N, Kawamoto H, Latib A, Colombo A, Stankovic G, Louvard Y

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 12 巻 ( 14 ) 頁： 1795 - 1798 2017年

Single-Antiplatelet Therapy in Patients with Contraindication to Dual-Antiplatelet Therapy After Transcatheter Aortic Valve Implantation. 査読有り

Mangieri A, Jabbour RJ, Montalto C, Pagnesi M, Regazzoli D, Ancona MB, 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

The American journal of cardiology 119 巻 ( 7 ) 頁： 1088 - 1093 2017年

A hybrid strategy with bioresorbable vascular scaffolds and drug eluting stents for treating complex coronary lesions. 査読有り

Jabbour RJ, 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 : including molecular interventions 18 巻 ( 5 ) 頁： S4 - S9 2017年

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

Tanaka A, Jabbour RJ, Mitomo S, Latib A, Colombo A

JACC. Cardiovascular interventions 10 巻 ( 6 ) 頁： 539 - 547 2017年

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

Regazzoli D, Ancona MB, Mangieri A, Tanaka A, Romano V, Leone PP, Tresoldi M, Lanzillo G, Agricola E, Latib A, Colombo A, Montorfano M

Journal of cardiovascular medicine (Hagerstown, Md.) 18 巻 ( 10 ) 頁： 828 - 830 2017年

Bioresorbable Vascular Scaffolds as a Treatment Option for Left Main Lesions. 査読有り

Jabbour RJ, 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 NM, Tamburino C, Colombo A, Latib A

JACC. Cardiovascular interventions 10 巻 ( 7 ) 頁： 743 - 745 2017年

Bioresorbable Vascular Scaffolds and Very Late Scaffold Thrombosis: Searching an Explanation and a Solution. 査読有り

Tanaka A, Latib A, Jabbour RJ, Mitomo S, Regazzoli D, Leone PP, Chieffo A, Carlino M, Montorfano M, Colombo A

JACC. Cardiovascular interventions 10 巻 ( 7 ) 頁： 745 - 746 2017年

Advances in percutaneous interventional therapies: the tricuspid valve. 査読有り

Jabbour RJ, Giannini F, Tanaka A, Mangieri A, Mikhail GW, Latib A, Colombo A

Future cardiology 13 巻 ( 3 ) 頁： 239 - 245 2017年

Dual Antiplatelet Therapy After Bioresorbable Vascular Scaffold Implantation: Insights From the Milan Cohort. 査読有り

Mitomo S, Latib A, Tanaka A, Jabbour RJ, Regazzoli D, Leone PP, Giannini F, Chieffo A, Carlino M, Montorfano M, Colombo A

JACC. Cardiovascular interventions 10 巻 ( 14 ) 頁： 1471 - 1472 2017年

Mid-term clinical outcomes of ABSORB bioresorbable vascular scaffold versus everolimus-eluting stent for coronary bifurcation lesions. 査読有り

Naganuma T, Kawamoto H, Panoulas VF, Latib A, Tanaka A, Mitomo S, Ruparelia N, Jabbour RJ, Chieffo A, Carlino M, Montorfano M, Colombo A

International journal of cardiology 246 巻頁： 26 - 31 2017年

Impact of Mitral Annular Calcium on Outcomes after Transcatheter Aortic Valve Implantation. 査読有り

Ancona MB, Giannini F, Mangieri A, Regazzoli D, Jabbour RJ, 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

The American journal of cardiology 120 巻 ( 12 ) 頁： 2233 - 2240 2017年

Tips and tricks for implanting BRSs: Sizing, pre- and postdilatation 査読有り

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

Bioresorbable Scaffolds: From Basic Concept to Clinical Applications 2017年

Clinical outcomes of a real-world cohort following bioresorbable vascular scaffold implantation utilising an optimised implantation strategy. 査読有り

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 : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 12 巻 ( 14 ) 頁： 1730 - 1737 2016年10月

Bioresorbable Scaffolds: What Does "Less Forgiving" Mean? 査読有り

Tanaka A, Jabbour RJ, Latib A, Colombo A

JACC. Cardiovascular interventions 9 巻 ( 17 ) 頁： 1856 - 7 2016年9月

T-Stenting With Small Protrusion: The Default Strategy for Bailout Provisional Stenting? 査読有り

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 9 巻 ( 17 ) 頁： 1853 - 4 2016年9月

Minimal Acute Recoil Following Bioresorbable Scaffold Implantation in Fibrocalcific Lesion Detected by Optical Frequency-Domain Imaging. 査読有り

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

The Journal of invasive cardiology 28 巻 ( 3 ) 頁： E34 - 6 2016年3月

Case illustration of the difference between bench test and in-vivo scaffold fracture thresholds. 査読有り

Tanaka A, Jabbour RJ, Latib A, Colombo A

International journal of cardiology 225 巻頁： 20 - 22 2016年

Treatment with cilostazol improves clinical outcome after endovascular therapy in hemodialysis patients with peripheral artery disease 査読有り

Ishii Hideki, Aoyama Toru, Takahashi Hiroshi, Kumada Yoshitaka, Kamoi Daisuke, Sakakibara Takashi, Umemoto Norio, Suzuki Susumu, Tanaka Akihito, Ito Yasuhiko, Murohara Toyoaki

JOURNAL OF CARDIOLOGY 67 巻 ( 2 ) 頁： 199 - 204 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: Cilostazol has been reported to prevent atherosclerotic events in the general population. However, data have been limited whether there are beneficial effects of cilostazol use on long-term clinical outcomes after endovascular therapy in hemodialysis (HD) patients with peripheral artery disease (PAD). Methods and results: This study consisted of 595 HD patients undergoing endovascular therapy for a clinical diagnosis of PAD. They were divided into two groups: patients receiving 100. mg cilostazol twice daily in conjunction with standard therapy (n= 249 patients, cilostazol group) and those not administered cilostazol ( n= 346 patients, control group). A propensity score analysis was performed to adjust for baseline differences between the two groups. The propensity score-adjusted 10-year event-free survival rate from major adverse cardiovascular events (MACE) was significantly higher in the cilostazol group than in the control group [58.6% vs. 43.7%, hazard ratio (HR) 0.57; 95% confidence interval (CI) 0.41-0.79; p= 0.0010]. Notably, the adjusted stroke-free rate was significantly higher in the cilostazol group than in the control group (81.6% vs. 74.7%; HR = 0.48; 95% CI, 0.25-0.92, p= 0.028). Even after adjusting for other confounders, treatment with cilostazol was an independent predictor for prevention of MACE and stroke (p = 0.0028 and p= 0.039, respectively). Conclusions: Cilostazol administration improves long-term clinical outcomes including prevention of MACE and stroke after endovascular therapy in HD patients with PAD.

DOI： 10.1016/j.jjcc.2015.05.003

Progression from stenosis to occlusion in the proximal native coronary artery after coronary artery bypass grafting 査読有り

Tanaka Akihito, Ishii Hideki, Oshima Hideki, Shibata Yohei, Tatami Yosuke, Osugi Naohiro, Ota Tomoyuki, Kawamura Yoshihiro, Suzuki Susumu, Usui Akihiko, Murohara Toyoaki

HEART AND VESSELS 31 巻 ( 7 ) 頁： 1056 - 1060 2016年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

Coronary artery bypass grafting (CABG) is an established treatment for multivessel coronary artery disease. However, problematic situations are occasionally encountered after CABG, such as disease progression in the native coronary artery with graft occlusion, which causes difficulty in revascularization. The purpose of this study was to evaluate changes in the native coronary artery after CABG. Between 2009 and 2012 in our institution, 351 patients underwent CABG, and 768 bypass grafts were anastomosed to non-occluded coronary arteries. Of these, 489 bypass grafts had available early postoperative angiographic results (≤6 months) suitable for assessment in this study. We defined malignant graft failure after CABG to be bypass graft occlusion and de novo complete occlusion of the target native coronary artery proximal to the graft anastomosis site. In the early angiographic results, 17 grafts were occluded (17/489; 3.5 %). Two of the grafts displayed malignant graft failure (a saphenous vein graft to the right coronary artery and a saphenous vein graft to the diagonal branch) (2 of 17 occluded grafts, and 2 of 489 studied grafts). Of the patent bypass grafts, 24 involved progression to occlusion in the proximal native coronary artery (19 saphenous vein grafts, 4 left internal thoracic artery grafts, and 1 right internal thoracic artery graft). Malignant graft failure was uncommon during short-term follow-up after CABG. At the same time, disease progression in the proximal native coronary artery from stenosis to occlusion following patent bypass grafting was relatively common, especially for vein grafts.

DOI： 10.1007/s00380-015-0715-8

Unfractionated Heparin during the Interruption of Antiplatelet Therapy for Non-cardiac Surgery after Drug-eluting Stent Implantation 査読有り

Tanaka Akihito, Ishii Hideki, Tatami Yosuke, Shibata Yohei, Osugi Naohiro, Ota Tomoyuki, Kawamura Yoshihiro, Suzuki Susumu, Nagao Yoshimasa, Matsushita Tadashi, Murohara Toyoaki

Internal Medicine 55 巻 ( 4 ) 頁： 333 - 337 2016年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本内科学会

<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

Reverse association of omega-3/omega-6 polyunsaturated fatty acids ratios with carotid atherosclerosis in patients on hemodialysis 査読有り

Umemoto Norio, Ishii Hideki, Kamoi Daisuke, Aoyama Toru, Sakakibara Takashi, Takahashi Hiroshi, Tanaka Akihito, Yasuda Yoshinari, Suzuki Susumu, Matsubara Tatsuaki, Murohara Toyoaki

ATHEROSCLEROSIS 249 巻頁： 65 - 69 2016年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Atherosclerosis

Background and aims: Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) are widely recognized to have beneficial effects against cardiovascular disease. We investigated the association of n-3 PUFAs levels with carotid atherosclerosis in patients on hemodialysis (HD), who are at high risk for cardiovascular events. Methods: Carotid ultra-sound was performed in a total of 461 patients on HD (male 67%, age 67 ± 12years, diabetes rate 46%). Intima-media thickness (IMT) and the plaque score (PS) in carotid arteries were measured. Carotid atherosclerosis was defined as IMT >1.2 mm and/or PS > 5.0. The levels of n-6 PUFAs [dihomo-gamma-linolenic acid (DHLA) and arachidonic acid (AA)] and n-3 PUFAs [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] were also measured prior to carotid ultra-sound. Results: Carotid atherosclerosis was observed in 94 patients (20.4%). Individual PUFAs levels were comparable between patients with and without carotid atherosclerosis. However, the ratio of EPA/AA and that of n-3/n-6 PUFAs were significantly lower in patients with carotid atherosclerosis compared to those without (median 0.36 vs. 0.41, p = 0.031 and 0.85 vs. 0.93, p = 0.041, respectively]. After adjustment for other confounders, the ratio of EPA/AA (OR 0.30, 95% CI 0.12-0.70, p = 0.0055) and the ratio of n-3/n-6 PUFAs (OR 0.45, 95% CI 0.25-0.80, p = 0.0066) showed an independent reverse association with carotid atherosclerosis. In addition, the area under receiver-operating characteristic curves for carotid atherosclerosis was significantly greater in an established risk model with EPA/AA and n-3/n-6 ratios than in the established risk model alone. Conclusions: These data suggest that low ratios of both EPA/AA ratio and n-3/n-6 PUFAs were closely associated with carotid atherosclerosis in patients on HD.

DOI： 10.1016/j.atherosclerosis.2016.03.037

Restored Physiological Vasomotion Imitating Intrascaffold Restenosis 3 Years After Bioresorbable Scaffold Implantation. 査読有り

Ancona MB, Tanaka A, Latib A, Jabbour RJ, Kawamoto H, Regazzoli D, Mangieri A, Colombo A

The Canadian journal of cardiology 32 巻 ( 12 ) 頁： 1574.e9 - 1574.e10 2016年

Preliminary Report of Clinical Outcomes After Single Crossover Bioresorbable Scaffold Implantation Without Routine Side Branch Strut Dilation. 査読有り

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

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 88 巻 ( 6 ) 頁： 865 - 870 2016年

Left main "Culotte in Culotte" to manage a trapped broken balloon. 査読有り

Ancona MB, Giannini F, Jabbour RJ, Tanaka A, Regazzoli D, Mangieri A, Carlino M, Colombo A

International journal of cardiology 221 巻頁： 347 - 9 2016年

Impact of post-procedural hyperglycemia on acute kidney injury after transcatheter aortic valve implantation. 査読有り

Giannini F, Latib A, Jabbour RJ, Ruparelia N, Aurelio A, Ancona MB, 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 221 巻頁： 892 - 7 2016年

Incidence and significance of side branch occlusions following bioresorbable scaffold implantation for long left anterior descending artery lesions. 査読有り

Tanaka A, Jabbour RJ, Kawamoto H, Chieffo A, Carlino M, Montorfano M, Latib A, Colombo A

International journal of cardiology 222 巻頁： 674 - 675 2016年

Impact of Angiographic Result After Predilatation on Outcome After Drug-Coated Balloon Treatment of In-Stent Coronary Restenosis. 査読有り

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

The American journal of cardiology 118 巻 ( 10 ) 頁： 1460 - 1465 2016年

Bioresorbable Scaffolds for the Management of Coronary Bifurcation Lesions. 査読有り

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

JACC. Cardiovascular interventions 9 巻 ( 10 ) 頁： 989 - 1000 2016年

Multimodality evaluation of percutaneous closure of coronary fistula using AMPLATZER Vascular Plug IV. 査読有り

Regazzoli D, Giglio M, Besana F, Leone PP, Tanaka A, Ancona MB, Mangieri A, Montorfano M, Giannini F, De Angelis G, Colombo A, Latib A

International journal of cardiology 225 巻頁： 381 - 383 2016年

Bioresorbable vascular scaffolds: From patient selection to optimal scaffold implantation; tips and tricks to minimize device failure. 査読有り

Tanaka A, Jabbour RJ, Latib A, Colombo A

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 88 巻 ( S1 ) 頁： 10 - 20 2016年

Is Multislice Computed Tomography a Feasible Option for Follow-Up of Complex Coronary Lesions Treated With Bioresorbable Scaffolds? 査読有り

Regazzoli D, Latib A, Tanaka A, Di Marco D, Giglio M, Jabbour R, Ancona MB, Leone PP, Mangieri A, Montorfano M, Giannini F, Colombo A

JACC. Cardiovascular interventions 9 巻 ( 24 ) 頁： 2578 - 2581 2016年

Excimer laser facilitated coronary angioplasty of a heavy calcified lesion treated with bioresorbable scaffolds. 査読有り

Mangieri A, Jabbour RJ, Tanaka A, Aurelio A, Colombo A, Latib A

Journal of cardiovascular medicine (Hagerstown, Md.) 17 巻頁： e149 - e150 2016年

Clinical outcomes following target lesion revascularization for bioresorbable scaffold failure. 査読有り

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

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 87 巻 ( 5 ) 頁： 832 - 6 2016年

A super high-pressure balloon solution for a non-dilatable in-stent restenosis. 査読有り

Tanaka A, Jabbour RJ, Kawamoto H, Latib A, Colombo A

International journal of cardiology 203 巻頁： 357 - 9 2016年

Very Late Restenosis After Bioresorbable Scaffold Implantation Due to Simultaneous External Compression of the Scaffold and Intrascaffold Tissue Growth. 査読有り

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

JACC. Cardiovascular interventions 9 巻 ( 2 ) 頁： e15 - 7 2016年

Long-Term Outcomes After Transcatheter Aortic Valve Implantation from a Single High-Volume Center (The Milan Experience). 査読有り

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

The American journal of cardiology 117 巻 ( 5 ) 頁： 813 - 9 2016年

Clinical outcomes following bioresorbable scaffold implantation in small vessels. 査読有り

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 207 巻頁： 59 - 61 2016年

Vascular Healing of a False Lumen After Bioresorbable Scaffold Implantation. 査読有り

Kawamoto H, Jabbour RJ, Tanaka A, Latib A, Colombo A

Circulation. Cardiovascular interventions 9 巻 ( 2 ) 頁： e003498 2016年

The Bioresorbable Scaffold: Will Oversizing Affect Outcomes? 査読有り

Kawamoto H, Jabbour RJ, Tanaka A, Latib A, Colombo A

JACC. Cardiovascular interventions 9 巻 ( 3 ) 頁： 299 - 300 2016年

Contained coronary rupture following bioresorbable scaffold implantation in a small vessel. 査読有り

Kawamoto H, Jabbour RJ, Tanaka A, Latib A, Colombo A

International journal of cardiology 209 巻頁： 24 - 5 2016年

Transcatheter aortic valve implantation in intermediate- and low-risk populations: An inevitable progression? 査読有り

Jabbour RJ, 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 210 巻頁： 35 - 7 2016年

Long-Term Clinical Outcomes After Bioresorbable Vascular Scaffold Implantation for the Treatment of Coronary In-Stent Restenosis: A Multicenter Italian Experience. 査読有り

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 9 巻 ( 4 ) 頁： e003148 2016年

Illustration of the Resorption Process Between 2 Different Overlapping Bioresorbable Scaffolds. 査読有り

Tanaka A, Jabbour RJ, Kawamoto H, Latib A, Colombo A

JACC. Cardiovascular imaging 9 巻 ( 12 ) 頁： 1469 - 1470 2016年

Bioresorbable scaffold failure for recurrent restenosis at multi-layered stent fracture. 査読有り

Tanaka A, Jabbour RJ, Kawamoto H, Latib A, Colombo A

International journal of cardiology 214 巻頁： 360 - 1 2016年

Usefulness of Predilation Before Transcatheter Aortic Valve Implantation. 査読有り

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

The American journal of cardiology 118 巻 ( 1 ) 頁： 107 - 12 2016年

Clinical outcomes following bifurcation double-stenting with bioresorbable scaffolds. 査読有り

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

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 88 巻 ( 6 ) 頁： 854 - 862 2016年

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) 査読有り

Ota Tomoyuki, Ishii Hideki, Suzuki Susumu, Shibata Yohei, Tatami Yosuke, Harata Shingo, Shimbo Yusaku, Takayama Yohei, Tanaka Akihito, Kawamura Yoshihiro, Osugi Naohiro, Maeda Kengo, Kondo Takahisa, Murohara Toyoaki

ATHEROSCLEROSIS 242 巻 ( 1 ) 頁： 155 - 160 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Atherosclerosis

Background: Statins are reportedly effective in the primary and secondary prevention of cardiovascular disease, mainly due to their ability to aggressively reduce low-density lipoprotein cholesterol (LDL-C) levels. However, patients sometimes exhibit the so-called "statin escape" phenomenon. The purpose of our study was to investigate the impact of the statin escape phenomenon on long-term clinical outcomes in patients with acute myocardial infarction (AMI). Method: This was a subgroup analysis of 1144 patients from the Nagoya Acute Myocardial Infarction Study (NAMIS) treated between January 2004 and December 2012. We analyzed 660 patients who initiated statin treatment after AMI. Statin escape phenomenon was defined as an increase in the LDL-C levels during the 9-month treatment period by >10% of the initial values after 4 weeks of initiating statin treatment. Patients were divided into two groups depending on whether they exhibited the statin escape phenomenon, with 474 patients in the non-escape group and 186 patients in the escape group. Result: Compared to the non-escape group, the escape group showed significantly lower LDL-C levels at 4 weeks after treatment initiation (81.3 ± 20.1 mg/dL vs. 101.1 ± 25.4 mg/dL, P < 0.01). By contrast, the escape group showed significantly higher LDL-C levels at 9 months after treatment initiation (105.8 ± 28.3 mg/dL vs. 90.3 ± 22.6 mg/dL, P < 0.01). Major adverse cardiac and cerebrovascular events (MACCE; a composite of all-cause death, MI, and stroke) were more frequent in the escape group than in the non-escape group (10.8% vs. 6.1%, P = 0.03). Multivariate analysis showed that statin escape phenomenon was an independent predictor of MACCE (hazard ratio: 2.02, 95% confidence interval: 1.11-3.66, P = 0.02). Conclusion: Statin escape phenomenon may be an independent predictor of long-term clinical outcomes in AMI patients.

DOI： 10.1016/j.atherosclerosis.2015.07.012

Impact of cigarette smoking on coronary plaque composition 査読有り国際誌

Kumagai Soichiro, Amano Tetsuya, Takashima Hiroaki, Waseda Katsuhisa, Kurita Akiyoshi, Ando Hirohiko, Maeda Kazuyuki, Ito Yoshitaka, Ishii Hideki, Hayashi Mutsuharu, Yoshikawa Daiji, Suzuki Susumu, Tanaka Akihito, Matsubara Tatsuaki, Murohara Toyoaki

CORONARY ARTERY DISEASE 26 巻 ( 1 ) 頁： 60 - 65 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Coronary Artery Disease

Objectives Cigarette smoking is associated with atherosclerosis and is an important risk factor for cardiovascular disease. We evaluated the impact of cigarette smoking on coronary plaque composition using integrated backscatter intravascular ultrasound (IB-IVUS).

DOI： 10.1097/MCA.0000000000000168

Relation Between Paradoxical Decrease in High-Density Lipoprotein Cholesterol Levels After Statin Therapy and Adverse Cardiovascular Events in Patients With Acute Myocardial Infarction 査読有り

Ota Tomoyuki, Ishii Hideki, Suzuki Susumu, Tanaka Akihito, Shibata Yohei, Tatami Yosuke, Harata Shingo, Shimbo Yusaku, Takayama Yohei, Kawamura Yoshihiro, Osugi Naohiro, Maeda Kengo, Kondo Takahisa, Murohara Toyoaki

AMERICAN JOURNAL OF CARDIOLOGY 115 巻 ( 4 ) 頁： 411 - 416 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Journal of Cardiology

Statin therapy moderately increases high-density lipoprotein cholesterol (HDL-C) levels. Contrary to this expectation, a paradoxical decrease in HDL-C levels after statin therapy is seen in some patients. We evaluated 724 patients who newly started treatment with statins after acute myocardial infarction (AMI). These patients were divided into 2 groups according to change in HDL-C levels between baseline and 6 to 9 months after initial AMI (ΔHDL). In total, 620 patients had increased HDL-C levels and 104 patients had decreased HDL-C levels. Both groups achieved follow-up low-density lipoprotein cholesterol levels <100 mg/dl. Adverse cardiovascular events (a composite of all-cause death, myocardial infarction, and stroke) have more frequently occurred in the decreased HDL group compared with the increased HDL group (15.4% vs 7.1%, p = 0.01). Multivariate analysis showed that decreased HDL, onset to balloon time, and multivessel disease were the independent predictors of adverse cardiovascular events (hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.08 to 3.52; HR 1.05, 95% CI 1.01 to 1.09; and HR 2.08, 95% CI 1.22 to 3.56, respectively). In conclusion, a paradoxical decrease in serum HDL-C levels after statin therapy might be an independent predictor of long-term adverse cardiovascular events in patients with AMI.

DOI： 10.1016/j.amjcard.2014.11.043

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

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

JACC. Cardiovascular interventions 8 巻 ( 12 ) 頁： 1635 - 7 2015年

Practical Approach to Evaluate Asymptomatic Coronary Artery Disease in End-Stage Renal Disease Patients at the Initiation of Dialysis 査読有り

Tanaka Akihito, Sakakibara Masaki, Asada Hiroaki, Tanaka Toshikazu, Ishii Hideki, Murohara Toyoaki

THERAPEUTIC APHERESIS AND DIALYSIS 18 巻 ( 2 ) 頁： 167 - 173 2014年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Therapeutic Apheresis and Dialysis

The high prevalence of significant asymptomatic coronary artery disease (CAD) has been reported in patients with end-stage renal disease (ESRD) at the initiation of dialysis. However, the approach to evaluate asymptomatic CAD for these patients has not been established. The aim of this study is to assess the applicability of our practical approach at the initiation of dialysis. We prospectively enrolled 182 consecutive ESRD patients who initiated dialysis. After echocardiography as primary screening, pharmacologic stress thallium-201 scintigraphy and/or coronary angiography (CAG) were performed to diagnose CAD. The patients were classified into two groups: those with coronary artery stenosis by CAG (CAD+ group), those without coronary artery stenosis by CAG or with negative scintigraphy examination (CAD- group). Of the eligible 93 patients without the history of CAD, 22 patients were allocated to the CAD+ group (18 of 26 patients with abnormal echocardiography and 4 of 13 patients with positive scintigraphy examination) and 71 patients to the CAD- group. Patients were followed up for an average of 520±304 days. The event-free survival rate of major adverse cardiac events was significantly lower in the CAD+ group than in the CAD- group (P<0.001). There was no cardiovascular event including major adverse cardiac events, unstable angina, coronary revascularization or stroke in the CAD- group during the first year of dialysis. Patients without CAD diagnosed by our approach had favorable clinical outcomes. Our approach may be useful for screening of occult CAD in ESRD patients at the initiation of dialysis. © 2014 International Society for Apheresis.

DOI： 10.1111/1744-9987.12098

Temporary Adjunctive Cilostazol vs Clopidogrel Loading for ST-segment Elevation Acute Myocardial Infarction 査読有り

Tanaka Akihito, Ishii Hideki, Sakakibara Masaki, Okumura Satoshi, Jinno Yasushi, Okada Koji, Suzuki Susumu, Inoue Yosuke, Murohara Toyoaki

AMERICAN JOURNAL OF CARDIOVASCULAR DRUGS 14 巻 ( 2 ) 頁： 131 - 136 2014年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Journal of Cardiovascular Drugs

Background: Clopidogrel loading is a standard method to achieve rapid platelet inhibition and prevent thrombotic events. At the current time, little information is available to determine the effect of adjunctive cilostazol compared with clopidogrel loading. Methods: We retrospectively analyzed 212 patients undergoing primary percutaneous coronary intervention with drug-eluting stents for ST-segment elevation acute myocardial infarction. All patients were administered aspirin (100 mg once a day) and clopidogrel (75 mg once a day). The patients were divided into two groups according to the presence (loading group, n = 100) or absence (cilostazol group, n = 112) of clopidogrel loading (300 mg). Patients in the cilostazol group were administered adjunctive cilostazol (100 mg twice a day) in place of clopidogrel loading. Patient characteristics, medications, and 30-day clinical outcomes were examined. Results: The mean duration of cilostazol administration in the cilostazol group was 6.2 ± 4.9 days from the time of primary coronary intervention. No significant difference was observed in major adverse cardiac events (cardiac death, definite stent thrombosis, and non-fatal myocardial infarction) between the loading group and the cilostazol group (9/100; 9.0 vs. 8/112; 7.1 %, p = 0.62). Definite stent thrombosis was observed for two patients in the loading group and one patient in the cilostazol group. The occurrence ratio of bleeding events did not differ significantly between the two groups (9.0 vs. 5.4 %, p = 0.30). Conclusion: There was no significant difference in the incidence of major adverse cardiac events between temporary adjunctive cilostazol treatment and clopidogrel loading in ST-segment elevation acute myocardial infarction patients. Our findings suggest one potential of cilostazol. © 2014 Springer International Publishing.

DOI： 10.1007/s40256-013-0059-7

Impact of diabetic retinopathy on late cardiac events after percutaneous coronary intervention 査読有り

Tanaka Akihito, Ishii Hideki, Tatami Yosuke, Shibata Yohei, Osugi Naohiro, Ota Tomoyuki, Okumura Satoshi, Suzuki Susumu, Inoue Yosuke, Murohara Toyoaki

JOURNAL OF CARDIOLOGY 64 巻 ( 3 ) 頁： 175 - 178 2014年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: Diabetic retinopathy has been identified as a predictor of cardiovascular events and heart failure in patients with diabetes mellitus (DM). This study aimed to assess the impact of diabetic retinopathy on the incidence of late cardiac events following percutaneous coronary intervention. Methods: We enrolled 88 consecutive DM patients who underwent elective percutaneous coronary intervention and whose ophthalmologic records were available. Patients were divided into 2 groups: those with diabetic retinopathy (DR+ group; n = 47), and those without diabetic retinopathy (DR- group; n = 41). We examined the incidence of major adverse cardiac events (MACE) including cardiac death, myocardial infarction, and acute heart failure requiring emergency admission over a period of up to 5 years. Results: Patients in the DR+ group were likely to have a lower estimated glomerular filtration rate. Kaplan-Meier analysis showed that the event-free survival rates for all MACE, myocardial infarction, and heart failure were significantly lower in the DR+ group than in the DR- group (p = 0.002, p = 0.025, and p = 0.022, respectively). Multivariate Cox proportional hazards analysis indicated that the presence of DR was a significant predictor of MACE (hazard ratio: 8.7; 95% CI: 1.1-69.8, p = 0.042). Conclusion: The presence of DR might be a useful predictor of late cardiac events following percutaneous coronary intervention.

DOI： 10.1016/j.jjcc.2013.12.006

The risk of adverse cardiac events following minor surgery under discontinuation of all antiplatelet therapy in patients with prior drug-eluting stent implantation 査読有り

Tanaka Akihito, Sakakibara Masaki, Ishii Hideki, Okumura Satoshi, Suzuki Susumu, Inoue Yosuke, Jinno Yasushi, Okada Koji, Murohara Toyoaki

INTERNATIONAL JOURNAL OF CARDIOLOGY 172 巻 ( 1 ) 頁： E125 - E126 2014年

Evaluation for hypoperfusion distal to arteriovenous vascular access using skin perfusion pressure in fingers 査読有り

Tanaka Akihito, Sakakibara Masaki, Nishimura Hayato, Asano Marina, Kariya Tetsuyoshi, Masamoto Daijiro, Mizutani Makoto, Ishii Hideki, Murohara Toyoaki

JOURNAL OF VASCULAR ACCESS 15 巻 ( 1 ) 頁： 29 - 32 2014年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Vascular Access

Purpose: The usefulness of skin perfusion pressure (SPP) measurement in the assessment of critical ischemia of the lower limb has previously been established. This study investigated whether finger SPP measurement is useful to evaluate hypoperfusion distal to arteriovenous vascular access in dialysis patients. Methods: Seventeen asymptomatic hemodialysis patients with upper extremity arteriovenous access and 17 non-dialysis control patients were prospectively examined. SPP in the thumb, the middle finger and the little finger of both hands was measured. The bilateral difference of the mean SPP of the three fingers was evaluated. Results: The mean difference of SPP between the contralateral and the arteriovenous access sides among hemodialysis patients (33±2 5 mmHg) was significantly larger than the mean difference of SPP between the left and the right hands among control patients (1.0±6.0 mmHg, p<0.01). Conclusions: This report shows the potential usefulness of SPP measurement to evaluate hypoperfusion distal to arteriovenous vascular access. © 2013 Wichtig Editore.

DOI： 10.5301/jva.5000170

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 Akihito, Sakakibara Masaki, Okada Koji, Jinno Yasushi, Ishii Hideki, Murohara Toyoaki

Internal Medicine 52 巻 ( 11 ) 頁： 1195 - 1198 2013年

担当区分：筆頭著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：The Japanese Society of Internal Medicine

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

Treatment of sirolimus-eluting stent restenosis: additional stent, balloon angioplasty, and coronary artery bypass graft. 査読有り国際誌

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

Journal of cardiac surgery 28 巻 ( 2 ) 頁： 97 - 101 2013年

Migration of fractured renal artery stent. 査読有り

Tanaka A, Takahashi S, Saito S

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 77 巻 ( 2 ) 頁： 305 - 7 2011年

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 27 巻 ( 4 ) 2011年

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 24 巻 ( 3 ) 2009年

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