1,107 results on '"Takeshi Morimoto"'
Search Results
2. P-wave terminal force in lead V1 and outcomes in patients with persistent atrial fibrillation undergoing catheter ablation
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Yuya Sudo, Takeshi Morimoto, Ryu Tsushima, Masahiro Sogo, Masatomo Ozaki, Masahiko Takahashi, and Keisuke Okawa
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Cardiology and Cardiovascular Medicine - Published
- 2023
3. Rationale and study design of the GOREISAN for heart failure (GOREISAN-HF) trial: A randomized clinical trial
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Hidenori Yaku, Takao Kato, Takeshi Morimoto, Kazuhisa Kaneda, Ryusuke Nishikawa, Takeshi Kitai, Yasutaka Inuzuka, Yodo Tamaki, Taketoshi Yamazaki, Jun Kitamura, Hirotaka Ezaki, Kazuya Nagao, Hiromi Yamamoto, Akihiro Isotani, Arita Takeshi, Chisato Izumi, Yukihito Sato, Yoshihisa Nakagawa, Satoaki Matoba, Yasushi Sakata, Koichiro Kuwahara, and Takeshi Kimura
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Cardiology and Cardiovascular Medicine - Published
- 2023
4. Mechanical ventilation for acute exacerbation of fibrosing interstitial lung diseases
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Atsushi Matsunashi, Kazuma Nagata, Takeshi Morimoto, and Keisuke Tomii
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Pulmonary and Respiratory Medicine - Published
- 2023
5. Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention inPatients With Multivessel Disease
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Ko Yamamoto, Hiroki Shiomi, Takeshi Morimoto, Hiroki Watanabe, Akiyoshi Miyazawa, Kyohei Yamaji, Masanobu Ohya, Sunao Nakamura, Satoru Mitomo, Satoru Suwa, Takenori Domei, Shojiro Tatsushima, Koh Ono, Hiroki Sakamoto, Kiyotaka Shimamura, Masataka Shigetoshi, Ryoji Taniguchi, Yuji Nishimoto, Hideki Okayama, Kensho Matsuda, Takafumi Yokomatsu, Masahiro Muto, Ren Kawaguchi, Koichi Kishi, Mitsuyoshi Hadase, Tsutomu Fujita, Yasunori Nishida, Masami Nishino, Hiromasa Otake, Kengo Tanabe, Mitsuru Abe, Kiyoshi Hibi, Kazushige Kadota, Kenji Ando, and Takeshi Kimura
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coronary stent ,percutaneous coronary intervention ,Cardiology and Cardiovascular Medicine ,intravascular ultrasound - Abstract
BACKGROUND: Intravascular ultrasound (IVUS) was only rarely used in landmark trials comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with multivessel disease. OBJECTIVES: The authors aimed to evaluate clinical outcomes after optimal IVUS-guided PCI in patients undergoing multivessel PCI. METHODS: The OPTIVUS (OPTimal IntraVascular UltraSound)-Complex PCI study multivessel cohort was a prospective multicenter single-arm study enrolling 1, 021 patients undergoing multivessel PCI, including left anterior descending coronary artery using IVUS, aiming to meet the prespecified criteria (OPTIVUS criteria: minimum stent area > distal reference lumen area [stent length≥28mm], and minimum stent area >0.8× average reference lumen area [stent length
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- 2023
6. 臨床研究トレーニングに組み入れて実施する能動的研究倫理学習プログラムの開発と教育の試み
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Rie NISHIMURA, Jiro TAKEUCHI, Mio SAKUMA, Mari NEZU, Kazutaka UCHIDA, Miki HIGAONNA, Norito KINJO, Fumihiro SAKAKIBARA, Tsukasa NAKAMURA, Shinji KOSAKA, Shinichi YOSHIMURA, Shinichiro UEDA, and Takeshi MORIMOTO
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Pharmacology ,Pharmacology (medical) - Published
- 2023
7. Clopidogrel Monotherapy After 1-Month DAPT in Patients With High Bleeding Risk or Complex PCI
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Ko Yamamoto, Hirotoshi Watanabe, Takeshi Morimoto, Yuki Obayashi, Masahiro Natsuaki, Takenori Domei, Kyohei Yamaji, Satoru Suwa, Tsuyoshi Isawa, Hiroki Watanabe, Ruka Yoshida, Hiroki Sakamoto, Masaharu Akao, Yoshiki Hata, Itsuro Morishima, Hideo Tokuyama, Masahiro Yagi, Hiroshi Suzuki, Kohei Wakabayashi, Nobuhiro Suematsu, Tsukasa Inada, Toshihiro Tamura, Hideki Okayama, Mitsuru Abe, Kazuya Kawai, Koichi Nakao, Kenji Ando, Kengo Tanabe, Yuji Ikari, Yoshihiro Morino, Kazushige Kadota, Yutaka Furukawa, Yoshihisa Nakagawa, and Takeshi Kimura
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coronary stent ,percutaneous coronary intervention ,high bleeding risk ,Cardiology and Cardiovascular Medicine ,complexity ,antiplatelet therapy - Abstract
BACKGROUND: High bleeding risk (HBR) and complex percutaneous coronary intervention (PCI) are major determinants for dual antiplatelet therapy (DAPT) duration. OBJECTIVES: The aim of this study was to evaluate the effects of HBR and complex PCI on short vs standard DAPT. METHODS: Subgroup analyses were conducted on the basis of Academic Research Consortium-defined HBR and complex PCI in the STOPDAPT-2 (Short and Optimal Duration of Dual Antiplatelet Therapy After Verulam's-Eluting Cobalt-Chromium Stent-2) Total Cohort, which randomly compared clopidogrel monotherapy after 1-month DAPT with 12-month DAPT with aspirin and clopidogrel after PCI. The primary endpoint was the composite of cardiovascular (cardiovascular death, myocardial infarction, definite stent thrombosis, or stroke) or bleeding (Thrombolysis In Myocardial Infarction [TIMI] major or minor) endpoints at 1 year. RESULTS: Regardless of HBR (n=1, 893 [31.6%]) and complex PCI (n=999 [16.7%]), the risk of 1-month DAPT relative to 12-month DAPT was not significant for the primary endpoint (HBR, 5.01% vs 5.14%; non-HBR, 1.90% vs 2.02%; P interaction=0.95) (complex PCI, 3.15% vs 4.07%; noncomplex PCI, 2.78% vs 2.82%; P interaction=0.48) and for the cardiovascular endpoint (HBR, 4.35% vs 3.52%; and non-HBR, 1.56% vs 1.22%; P interaction=0.90) (complex PCI, 2.53% vs 2.52%; noncomplex PCI, 2.38% vs 1.86%; P interaction=0.53), while it was lower for the bleeding endpoint (HBR, 0.66% vs 2.27%; non-HBR, 0.43% vs 0.85%; P interaction=0.36) (complex PCI, 0.63% vs 1.75%; noncomplex PCI, 0.48% vs 1.22%; P interaction=0.90). The absolute difference in the bleeding between 1- and 12-month DAPT was numerically greater in patients with HBR than in those without HBR (-1.61% vs-0.42%). CONCLUSIONS: The effects of 1-month DAPT relative to 12-month DAPT were consistent regardless of HBR and complex PCI. The absolute benefit of 1-month DAPT over 12-month DAPT in reducing major bleeding was numerically greater in patients with HBR than in those without HBR. Complex PCI might not be an appropriate determinant for DAPT durations after PCI. (Short and Optimal Duration of Dual Antiplatelet Therapy After Everolimus-Eluting Cobalt-Chromium Stent-2 [STOPDAPT-2], NCT02619760; Short and Optimal Duration of Dual Antiplatelet Therapy After Everolimus-Eluting Cobalt-Chromium Stent-2 for the Patients With ACS [STOPDAPT-2 ACS], NCT03462498).
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- 2023
8. Effect of Direct Slow Pathway Capture Mapping–Guided Ablation on Typical Atrioventricular Nodal Re-Entrant Tachycardia
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Ryu Tsushima, Keisuke Okawa, Takeshi Morimoto, Yuya Sudo, Masahiro Sogo, Masatomo Ozaki, Masahiko Takahashi, and Takeshi Tobiume
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- 2023
9. Atrial Fibrillation Ablation Outcomes and Heart Failure (from the Kansai Plus Atrial Fibrillation Registry)
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Nobuaki Tanaka, Koichi Inoue, Atsushi Kobori, Kazuaki Kaitani, Takeshi Morimoto, Toshiya Kurotobi, Itsuro Morishima, Hirosuke Yamaji, Yumie Matsui, Yuko Nakazawa, Kengo Kusano, Koji Tanaka, Yuko Hirao, Masato Okada, Yasushi Koyama, Atsunori Okamura, Katsuomi Iwakura, Kenshi Fujii, Takeshi Kimura, and Satoshi Shizuta
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Cardiology and Cardiovascular Medicine - Abstract
The impact of rhythm outcomes on heart failure (HF) hospitalizations remains unknown after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). We sought to elucidate whether AF recurrence was associated with HF hospitalizations after AF RFCA. We conducted a large-scale, prospective, multicenter, observational study (Kansai Plus Atrial Fibrillation Registry), enrolling 5,010 consecutive patients (age 64 ± 10 years, 27.3% female, and 35.7% nonparoxysmal AF) who underwent an initial AF RFCA at 26 centers. The median follow-up duration was 2.9 years. The cumulative 3-year incidence of HF hospitalizations after the initial RFCA was 1.84% (0.69%/year). Hospitalized patients with HF were older with a higher prevalence of nonparoxysmal AF, renal dysfunction, diabetes, and underlying heart disease pre-RFCA. HF hospitalizations occurred more often in patients with than without recurrences (3.27 vs 0.84%, log-rank p0.0001). After adjusting for confounders using a Cox model, AF recurrence remained an independent predictor of HF hospitalizations (hazard ratio [HR] 2.84, 95% confidence interval [CI] 1.80 to 4.47, p0.0001). AF recurrence was a distinct HF hospitalization risk in patients with a left ventricular ejection fraction ≥50% (HR 4.54, 95% CI 2.38 to 8.65, p0.0001) but not50% (HR 1.31, 95% CI 0.65 to 2.62, p = 0.45), with significant interactions. Furthermore, patients with AF recurrences within 1 year had a greater HF hospitalization risk after 1 year (1.61% vs 0.79%, log-rank p = 0.019). In conclusion, AF recurrence after RFCA was independently associated with HF hospitalizations.
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- 2023
10. Catheter Ablation for Paroxysmal Atrial Fibrillation With Sick Sinus Syndrome: Insights From the Kansai Plus Atrial Fibrillation Registry
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Itsuro Morishima, Yasunori Kanzaki, Yasuhiro Morita, Koichi Inoue, Atsushi Kobori, Kazuaki Kaitani, Toshiya Kurotobi, Hirosuke Yamaji, Yumie Matsui, Yuko Nakazawa, Kengo Kusano, Toshiro Tomomatsu, Yoshihiro Ikai, Koichi Furui, Ryota Yamauchi, Hiroyuki Miyazawa, Nobuaki Tanaka, Takeshi Morimoto, Takeshi Kimura, and Satoshi Shizuta
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Pulmonary and Respiratory Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Coexisting sick sinus syndrome (SSS) is associated with both electrical and structural atrial remodelling in patients with atrial fibrillation (AF). Limited data are available concerning catheter ablation (CA) for AF in this condition. This study investigated the efficacy of CA as a curative therapy for AF and SSS in a large-scale prospective multicentre registry.The Kansai Plus Atrial Fibrillation registry enrolled 5,010 consecutive patients who underwent CA for AF; this included 3,133 patients with paroxysmal AF (mean age, 66 years; male, 69.3%; mean CHA2DS2-VASc score, 2.05±1.50; SSS, n=315 [tachy-brady syndrome, n=285]). The endpoints included the recurrence of AF with a blanking period of 90 days after CA, and de novo pacemaker implantation during the follow-up period (median duration, 2.93 years).The AF-free survival did not significantly differ between patients with and those without SSS (n=2,818) after the initial (log-rank p=0.864) and final sessions (log-rank p=0.268). Pacemakers were implanted in 48 patients with SSS, and implantation in this group was significantly associated with AF recurrence, including early recurrence (adjusted odds ratio, 3.57; 95% confidence interval, 1.67-7.64; p=0.002). The remaining 85.3% of patients with SSS did not require pacemaker implantation at 3 years after CA.Coexisting SSS did not adversely affect recurrence-free survival after CA for paroxysmal AF. Pacemaker implantation was not required in most patients with SSS, with AF recurrence serving as a strong predictor for this.
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- 2023
11. Atrial fibrillation in patients with severe aortic stenosis
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Shintaro, Matsuda, Takao, Kato, Takeshi, Morimoto, Tomohiko, Taniguchi, Eri, Minamino-Muta, Mitsuo, Matsuda, Hiroki, Shiomi, Kenji, Ando, Shinichi, Shirai, Norio, Kanamori, Koichiro, Murata, Takeshi, Kitai, Yuichi, Kawase, Chisato, Izumi, Makoto, Miyake, Hirokazu, Mitsuoka, Masashi, Kato, Yutaka, Hirano, Kazuya, Nagao, Tsukasa, Inada, Hiroshi, Mabuchi, Yasuyo, Takeuchi, Keiichiro, Yamane, Mamoru, Toyofuku, Mitsuru, Ishii, Moriaki, Inoko, Tomoyuki, Ikeda, Akihiro, Komasa, Katsuhisa, Ishii, Kozo, Hotta, Nobuya, Higashitani, Toshikazu, Jinnai, Yoshihiro, Kato, Yasutaka, Inuzuka, Yuko, Morikami, Naritatsu, Saito, Kenji, Minatoya, and Takeshi, Kimura
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Cardiology and Cardiovascular Medicine - Abstract
There has been no previous report evaluating the long impact of atrial fibrillation (AF) on the clinical outcomes stratified by the initial management [conservative or aortic valve replacement (AVR)] strategies of severe aortic stenosis (AS).We analyzed 3815 patients with severe AS enrolled in the CURRENT AS registry. Patients with AF were defined as those having a history of AF when severe AS was found on the index echocardiography. The primary outcome measure was a composite of aortic valve-related death or hospitalization for heart failure.The cumulative 5-year incidence of the primary outcome measure was significantly higher in patients with AF than in those without AF (44.2 % versus 33.2 %, HR 1.54, 95 % CI 1.35-1.76). After adjusting for confounders, the risk of AF relative to no AF remained significant (HR 1.34, 95 % CI 1.16-1.56). The magnitude of excess adjusted risk of AF for the primary outcome measure was greater in the initial AVR stratum (N = 1197, HR 1.95, 95 % CI 1.36-2.78) than in the conservative stratum (N = 2618, HR 1.26, 95 % CI 1.08-1.47) with a significant interaction (p = 0.04). In patients with AF, there was a significant excess adjusted risk of paroxysmal AF (N = 254) relative to chronic AF (N = 528) for the primary outcome measure (HR 1.34, 95 % CI 1.01-1.78).In patients with severe AS, concomitant AF was independently associated with worse clinical outcomes regardless of the initial management strategies. In those patients with conservative strategy, paroxysmal AF is stronger risk factor than chronic AF.
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- 2023
12. Errors Identified by Early, Risk-adapted, Triggered On-site Monitoring in Physician-initiated Clinical Trials not for Regulatory Approval in Cardiovascular Diseases
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Yumi IKEHARA, Takeshi MORIMOTO, Masayuki IKEDA, Koichi NODE, and Shinichiro UEDA
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Pharmacology ,Pharmacology (medical) - Published
- 2023
13. The influence of stimulating electrode conditions on electrically evoked potentials and resistance in suprachoroidal transretinal stimulation
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Kentaro Nishida, Takeshi Morimoto, Yasuo Terasawa, Hirokazu Sakaguchi, Motohiro Kamei, Tomomitsu Miyoshi, Takashi Fujikado, and Kohji Nishida
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Ophthalmology ,General Medicine - Published
- 2023
14. Effects of Low-Dose Colchicine on Serum High-Sensitivity C-Reactive Protein Level in Coronary Artery Disease Patients with Type 2 Diabetes Mellitus and Enhanced Inflammatory Response Protocol for a Randomized, Double-Blind, Placebo-Controlled, Phase 2, Dose-Finding Study
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Yoshikazu Miwa, Akiko Mutoh, Takeshi Morimoto, Yumi Ikehara, Takanori Yasu, Shinji Koba, Junya Ako, Yukihito Higashi, Masato Kajikawa, Hiroki Uehara, Kazuo Ishikawa, Ichiro Sakuma, Hirofumi Tomiyama, Koichi Node, Yuji Kumagai, and Shinichiro Ueda
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General Earth and Planetary Sciences ,General Environmental Science - Abstract
Although cardiovascular mortality in Japan is lower than in other industrialized countries, clinical outcomes in coronary artery disease (CAD) patients with type 2 diabetes mellitus (T2DM) remain poor despite multiple evidence-based drug therapies and interventions. We assumed that part of residual risk in these patients may be attributable to enhanced inflammation, which can be inhibited presumably by colchicine. However, dose-responsiveness of anti-inflammatory effect of colchicine has not been elucidated. Therefore, we designed a multicenter, randomized, double-blinded, parallel-group study to explore the dose-dependent effects of low-dose colchicine on serum high-sensitivity C-reactive protein (hs-CRP) concentration and safety in CAD patients with T2DM and enhanced inflammatory response as a phase 2 study. Enhanced inflammatory response was defined as peripheral white-blood cell count ≥7,000/μL. Patients (N = 63) will be randomly assigned to two doses of colchicine 0.25 mg/day, 0.5 mg/day, or placebo in a 1:1:1 ratio once daily for 12 weeks. Changes in serum hs-CRP levels will be evaluated as the primary endpoint, and changes in flow-mediated vasodilation and plasma myeloperoxidase levels will be evaluated as secondary endpoints. The results of this study will contribute to the development of a protocol for a planned future phase 3 trial to estimate the reduction in CAD. The present study describes the rationale, design, and methods of the trial.
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- 2022
15. Statins Reduce Bleeding Risk in Patients Taking Oral Anticoagulants for Nonvalvular Atrial Fibrillation: A Retrospective Registry Study
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Kazutaka Uchida, Shinichiro Ueda, Fumihiro Sakakibara, Norito Kinjo, Mari Nezu, Hideki Arai, and Takeshi Morimoto
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Pharmacology (medical) ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
The effects of statins in patients with non-valvular atrial fibrillation (NVAF) taking oral anticoagulants (OACs) are not well-studied. This study was a historical multicenter registry of patients with NVAF taking OACs in Japan.We excluded those patients with mechanical heart valves or a history of pulmonary or deep vein thrombosis. Overall, 7826 patients were registered on 26 February 2013 and followed until 25 February 2017. We compared those with versus without statin treatment (statin vs. no-statin groups) for the primary outcome of major bleeding and secondary outcomes of all-cause mortality, ischemic events, hemorrhagic stroke, and ischemic stroke.Statins were administered in 2599 (33%) patients. The statin group was more likely to have paroxysmal AF (37% vs. 33%; p = 0.0003), hypertension (84% vs. 76%; p 0.0001), diabetes mellitus (41% vs. 27%; p 0.0001), and dyslipidemia (91% vs. 30%; p 0.0001) than the no-statin group. The cumulative incidence of major bleeding was 6.9% and 8.1% (p = 0.06). The adjusted hazard ratio [HR] (95% confidence interval [CI]) of the statin group for major bleeding was 0.77 (0.63-0.94) compared with the no-statin group. The adjusted HR (95% CI) for all-cause mortality, ischemic events, hemorrhagic stroke, and ischemic stroke were 0.58 (0.47-0.71), 0.77 (0.59-0.999), 0.85 (0.48-1.50), and 0.79 (0.60-1.05), respectively.Statins significantly reduced the risk of major bleeding, all-cause mortality, and ischemic events in patients with NVAF taking OACs. Their additive benefits should be considered in routine practice and thus be further researched.
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- 2022
16. Extensive Macular Atrophy with Pseudodrusen in a Japanese Patient Evaluated by Wide-Field OCTA
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Shigeru Sato, Takeshi Morimoto, Takashi Fujikado, Sayaka Tanaka, Motokazu Tsujikawa, and Kohji Nishida
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Ophthalmology - Abstract
Extensive macular atrophy with pseudodrusen (EMAP) is a relatively newly proposed clinical entity that was first reported in 2009. Although no definitive diagnostic criteria have been defined, characteristic findings can distinguish it from other diseases, especially dry age-related macular dystrophy (AMD). Herein, we present the case of a patient with EMAP who underwent a comprehensive ophthalmic examination and whole-exome sequencing (WES). A 72-year-old Japanese man complained of progressive visual impairment in his right eye and nyctalopia. Ophthalmic examination revealed that the best-corrected visual acuity (BCVA) in decimal units was 0.08 on the right and 0.8 on the left. Fundoscopy and fundus autofluorescence (FAF) revealed well-demarcated symmetrical macular atrophy, with a vertical axis larger than the horizontal axis, which reached the vascular arcade inferiorly and exceeded it superiorly. Pseudodrusen were widespread throughout the retina in both eyes. Paving-stone degeneration was not observed in the extreme periphery of either eye. Seven months later, his left BCVA decreased to 0.3 without major changes on multimodal imaging. Based on the above findings, we diagnosed EMAP. Wide-field optical coherence tomography angiography (OCTA) showed no significant changes in the retinal vessels, but the density of choroidal vessels was reduced in the degenerated areas. We thought that this finding suggests that EMAP originates between the deep retina and choroid. WES did not reveal any candidate mutations in known pathogenic genes. To the best of our knowledge, this is the first report of a Japanese patient with EMAP, and no data for analysis of wide-field OCTA or equatorial OCT images of EMAP cases have been found in previous reports. EMAP is not well recognized in Asia and may be incorrectly diagnosed as dry-type AMD. EMAP should be included in the differential diagnosis of dry AMD, and this may lead to more Asians being diagnosed with EMAP in the future.
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- 2022
17. Association between body mass index and long-term clinical outcomes in patients with non-valvular atrial fibrillation taking oral anticoagulants
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Mari Nezu, Shinichiro Ueda, Kazutaka Uchida, Fumihiro Sakakibara, Norito Kinjo, Hideki Arai, and Takeshi Morimoto
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Cardiology and Cardiovascular Medicine - Abstract
The association between body mass index (BMI) and clinical outcomes of patients with non-valvular atrial fibrillation (NVAF) taking oral anticoagulants (OACs) are controversial, and we thus analyzed the large registry data to elucidate them.We conducted a historical cohort study at 71 centers in Japan and included outpatients with NVAF taking vitamin K antagonists (VKAs). Physicians in charge could change VKAs to direct OACs based on their judgement during follow-up period. We categorized patients into four BMI groups (kg/mAmong NVAF patients taking OACs, underweight patients had higher risks of all-cause death and ischemic events than other patients. Overweight patients had lower risk of all-cause death.
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- 2022
18. Causes of long-term mortality in patients with venous thromboembolism in the real world: From the COMMAND VTE registry
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Yugo, Yamashita, Takeshi, Morimoto, Kazushige, Kadota, Toru, Takase, Seiichi, Hiramori, Kitae, Kim, Maki, Oi, Masaharu, Akao, Yohei, Kobayashi, Mamoru, Toyofuku, Moriaki, Inoko, Tomohisa, Tada, Po-Min, Chen, Koichiro, Murata, Yoshiaki, Tsuyuki, Yuji, Nishimoto, Jiro, Sakamoto, Kiyonori, Togi, Hiroshi, Mabuchi, Kensuke, Takabayashi, Takao, Kato, Koh, Ono, and Takeshi, Kimura
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Cohort Studies ,Recurrence ,Risk Factors ,Neoplasms ,Anticoagulants ,Humans ,Registries ,Venous Thromboembolism ,Hematology ,Pulmonary Embolism ,Retrospective Studies - Abstract
There is still a scarcity of data on causes of long-term mortality in patients with venous thromboembolism (VTE).The COMMAND VTE Registry is a physician-initiated, retrospective, multicenter cohort study in which consecutive 3027 patients with acute symptomatic VTE among 29 centers in Japan were included between January 2010 and August 2014. We investigated detailed causes and risk factors for long-term mortality.During a median observation period of 1218 days, a total of 764 patients died, and the prevalence of active cancer was higher in patients who died than in patients alive (61 % versus 10 %, P 0.001). The cumulative incidences of cardiac death, pulmonary embolism (PE)-related death, bleeding death, cancer death, and non-cardiovascular non-cancer death were 2.2 %, 2.9 %, 2.0 %, 16.1 %, and 6.7 % at 5 years, respectively. The incidence of cancer death increased gradually, which was the most common cause of long-term death. Among patients without active cancer, the incidence of PE-related death increased rapidly and became a plateau beyond the acute phase, whereas the incidence of non-cardiovascular non-cancer death kept increasing, which became most common in the long term. The separate multivariable analysis among patient with and without active cancer identified independent risk factors of all-cause death including a few patient characteristics among patients with active cancer and several patient characteristics among patients without active cancer.Cancer was the most common cause of long-term mortality, while non-cardiovascular non-cancer death became most common among patients without active cancer.
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- 2022
19. Drug-Related Pneumonitis Induced by Osimertinib as First-Line Treatment for Epidermal Growth Factor Receptor Mutation-Positive Non-Small Cell Lung Cancer
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Yuki Sato, Hiromitsu Sumikawa, Ryota Shibaki, Takeshi Morimoto, Yoshihiko Sakata, Yuko Oya, Motohiro Tamiya, Hidekazu Suzuki, Hirotaka Matsumoto, Takashi Yokoi, Kazuki Hashimoto, Hiroshi Kobe, Aoi Hino, Megumi Inaba, Yoko Tsukita, Hideki Ikeda, Daisuke Arai, Hirotaka Maruyama, Satoshi Hara, Shinsuke Tsumura, Shinya Sakata, and Daichi Fujimoto
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Pulmonary and Respiratory Medicine ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine - Published
- 2022
20. Safety of Apixaban Monotherapy for Non-Valvular Atrial Fibrillation-Related Acute Stroke with Intra-/Extracranial Artery Stenosis
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Masaomi, Koyanagi, Taketo, Hatano, Kazutaka, Uchida, Takenori, Ogura, Hiroshi, Yamagami, Masunari, Shibata, Yukiko, Enomoto, Norihito, Fukawa, Yasushi, Matsumoto, Nobuyuki, Sakai, Masataka, Takeuchi, Tadashi, Nonaka, Fuminori, Shimizu, Masayuki, Ezura, Takahiro, Ota, Hajime, Ohta, Masafumi, Morimoto, Takeshi, Morimoto, and Shinichi, Yoshimura
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Neurology ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Introduction: We investigated whether apixaban is safe for the prevention of further adverse events in non-valvular atrial fibrillation (NVAF) patients with intra-/extracranial artery stenosis (Stenosis group) compared with acute large vessel occlusion without intra-/extracranial artery stenosis (No stenosis group). We also examined whether combination therapy using apixaban and antiplatelet is safe. Methods: ALVO (Apixaban on clinical outcome of patients with Large Vessel Occlusion [LVO] or stenosis) was a historical and prospective multicenter registry at 38 centers in Japan. Patients with NVAF and acute LVO or stenosis who received apixaban within 14 days after onset were included. We conducted the post hoc analysis using the ALVO dataset. We compared patients with stenosis versus those without stenosis in terms of the primary outcome, which was defined as a composite of all-cause death, major bleeding events, and ischemic events 365 days after onset. Results: Of the 662 patients, 54 (8.2%) patients were classified into the Stenosis group, and 104 patients of the total (16%) reached the primary outcome. The cumulative incidence of primary outcome was not significantly different between the No stenosis and the Stenosis groups (hazard ratio [HR] 1.2, 95% confidence interval [CI]: 0.64–2.4; p = 0.52). Even after adjustment for predictive clinical variates, no significant difference in the primary endpoint between the No stenosis and the Stenosis groups was shown (adjusted HR 1.2, 95% CI: 0.59–2.5; p = 0.60). Fifty patients (7.6%) used an antiplatelet with apixaban. Among the Stenosis group patients, the cumulative incidence of the primary outcome was significantly higher among patients treated with an antiplatelet and apixaban (HR 3.5, 95% CI: 1.0–12; p = 0.048). Conclusion: Apixaban monotherapy appears safe for the prevention of further adverse events in the Stenosis group patients similar to the No stenosis group patients. Concomitant use of an antiplatelet might not be favorable in patients with stenosis.
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- 2022
21. Low Serum Total Protein at Admission Predicts in-Hospital Mortality Among General Inpatients: Historical Cohort Study
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Miharu Inoue, Jiro Takeuchi, Mio Sakuma, Tsukasa Nakamura, and Takeshi Morimoto
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International Journal of General Medicine ,General Medicine - Abstract
Miharu Inoue,1 Jiro Takeuchi,2 Mio Sakuma,2 Tsukasa Nakamura,3 Takeshi Morimoto2 1Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan; 2Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan; 3Department of Infectious Diseases, Shimane Prefectural Central Hospital, Izumo, JapanCorrespondence: Takeshi Morimoto, Department of Clinical Epidemiology, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan, Tel +81-798-45-6879, Fax +81-798-45-6920, Email morimoto@kuhp.kyoto-u.ac.jpPurpose: Low total protein (TP) is associated with mortality among patients with specific diseases, but its association was uncertain among general patients. We evaluated the effects of low TP on in-hospital mortality among general inpatients.Patients and Methods: We used data from the Japan Adverse Drug Events study series. We enrolled adult inpatients (⥠16 years) admitted to a tertiary care hospital between September 1 and November 30, 2013. We excluded patients with multiple myeloma, pregnant women, and bone marrow graft donors. Patient data were extracted from electronic medical records. All patients were stratified into those with and without malignancy and divided into the low and normal TP groups. Low TP was defined as < 6.5 g/dL. We compared the in-hospital mortality of the low and normal TP groups stratified by the presence of malignancy.Results: Among the 2235 enrolled patients (mean age, 67.8 years), the TP value was lower in 516 patients with malignancy than in 1719 patients without malignancy (6.6 g/dL vs 6.8 g/dL, P = 0.0002). Among patients without or with malignancy, 27% (462/1719) and 35% (183/516) were in the low TP group, respectively. Mortality was higher in the low TP group among patients without malignancy (23.2% vs 10.2%, P < 0.0001). Likewise, among patients with malignancy, mortality was higher in the low TP group (34.7% vs 11.3%, P = 0.0029). The adjusted hazard ratio of the low TP group was 1.75 (95% confidence interval, 1.04â 2.96) in patients without malignancy and 2.45 (95% confidence interval, 1.12â 5.37) in patients with malignancy, but the interaction was not significant (P = 0.23).Conclusion: Low TP values were associated with higher in-hospital mortality among general inpatients, and this association was observed among patients with and those without malignancy. Routinely measured TP should be utilized to risk stratification on admission.Keywords: admission, general patients, historical cohort study, mortality, total protein
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- 2022
22. Relationship Between Endothelial Dysfunction and the Outcomes After Atrial Fibrillation Ablation
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Keisuke Okawa, Masahiro Sogo, Takeshi Morimoto, Ryu Tsushima, Yuya Sudo, Eisuke Saito, Masatomo Ozaki, and Masahiko Takahashi
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Cardiology and Cardiovascular Medicine - Abstract
Background Endothelial dysfunction (ED) is associated with cardiovascular events in patients with atrial fibrillation (AF). However, the utility of ED as a prognostic marker after AF ablation supplementary to the CHA 2 DS 2 ‐VASc score is unclear. This study aimed to investigate the relationship between ED and 5‐year cardiovascular events in patients undergoing AF ablation. Methods and Results We conducted a prospective cohort study of patients who underwent a first‐time AF ablation and for whom the endothelial function was assessed by the peripheral vascular reactive hyperemia index (RHI) before ablation. We defined ED as an RHI of 2 DS 2 ‐VASc score ( P =0.004). The 5‐year incidence of cardiovascular events was higher among patients with ED than those without ED (98 [11.8%] versus 13 [6.2%]; log‐rank P =0.014). We found ED to be an independent predictor of cardiovascular events after AF ablation (hazard ratio [HR], 1.91 [95% CI, 1.04–3.50]; P =0.036) along with a CHA 2 DS 2 ‐VASc score of ≥2 (≥3 for women) (HR, 3.68 [95% CI, 1.89–7.15]; P Conclusions The prevalence of ED among patients with AF was high. Assessing the endothelial function could enable the risk stratification of cardiovascular events after AF ablation.
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- 2023
23. Age and long-term outcomes of patients with venous thromboembolism: From the COMMAND VTE Registry
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Kotaro Takahashi, Yugo Yamashita, Takeshi Morimoto, Tomohisa Tada, Hiroki Sakamoto, Toru Takase, Seiichi Hiramori, Kitae Kim, Maki Oi, Masaharu Akao, Yohei Kobayashi, Po-Min Chen, Koichiro Murata, Yoshiaki Tsuyuki, Yuji Nishimoto, Jiro Sakamoto, Kiyonori Togi, Hiroshi Mabuchi, Kensuke Takabayashi, Takao Kato, Koh Ono, and Takeshi Kimura
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Cardiology and Cardiovascular Medicine - Published
- 2023
24. Cytomegalovirus-Induced Optic Neuritis Through Cerebrospinal Fluid Viral Transmission in an Immunocompetent Patient: A Case Report
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Shizuka Takahashi, Noriyasu Hashida, Kazuichi Maruyama, Rina Omura, Rei Sakurai, Takeshi Morimoto, and Kohji Nishida
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Ophthalmology ,Neurology (clinical) - Published
- 2023
25. Patient-reported outcomes for quality of care among pediatric patients
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Mio Sakuma and Takeshi Morimoto
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Health Policy ,Public Health, Environmental and Occupational Health ,General Medicine - Published
- 2023
26. Heterogeneity in Characteristics and Outcomes of Patients who met the Indications for Vericiguat Approved by the Japanese Agency: From the KCHF Registry
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MASAYUKI SHIBA, TAKAO KATO, TAKESHI MORIMOTO, HIDENORI YAKU, YASUTAKA INUZUKA, YODO TAMAKI, NEIKO OZASA, YUTA SEKO, ERIKA YAMAMOTO, YUSUKE YOSHIKAWA, TAKESHI KITAI, YUGO YAMASHITA, MORITAKE IGUCHI, KAZUYA NAGAO, YUICHI KAWASE, TAKASHI MORINAGA, MAMORU TOYOFUKU, YUTAKA FURUKAWA, KENJI ANDO, KAZUSHIGE KADOTA, YUKIHITO SATO, KOICHIRO KUWAHARA, and TAKESHI KIMURA
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Cardiology and Cardiovascular Medicine - Published
- 2023
27. Insomnia in patients with acute heart failure: from the KCHF registry
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Yuta, Seko, Erika, Yamamoto, Takao, Kato, Takeshi, Morimoto, Hidenori, Yaku, Yasutaka, Inuzuka, Yodo, Tamaki, Neiko, Ozasa, Masayuki, Shiba, Yusuke, Yoshikawa, Yugo, Yamashita, Takeshi, Kitai, Ryoji, Taniguchi, Moritake, Iguchi, Kazuya, Nagao, Takafumi, Kawai, Akihiro, Komasa, Ryusuke, Nishikawa, Yuichi, Kawase, Takashi, Morinaga, Mamoru, Toyofuku, Yutaka, Furukawa, Kenji, Ando, Kazushige, Kadota, Yukihito, Sato, Koichiro, Kuwahara, and Takeshi, Kimura
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Heart Failure ,Hospitalization ,Insomnia ,Acute heart failure ,Humans ,Registries ,Diuretics ,Cardiology and Cardiovascular Medicine ,Patient Discharge ,Outcome - Abstract
[Aims] Insomnia is a known risk factor for heart failure (HF) and a predictor of cardiac events in HF patients, but the clinical significance of insomnia in patients with acute HF (AHF) is not adequately evaluated. This study aimed to investigate the association between insomnia and subsequent clinical outcomes in patients with AHF. [Methods] From the Kyoto Congestive Heart Failure registry, consecutive 3414 patients hospitalized for HF who were discharged alive were divided into the 2 groups at discharge: insomnia group and non-insomnia group. We compared baseline characteristics and 1 year clinical outcomes according to the presence of insomnia. The primary outcome measure was all-cause death. [Results] There were 330 patients (9.7%) and 3084 patients (90.3%) with and without insomnia, respectively. In the multivariable logistic regression analysis, brain-type natriuretic peptide above median value at discharge (OR = 1.50, 95% CI = 1.08–2.10, P = 0.02) and the presence of oedema at discharge (OR = 4.23, 95% CI = 2.95–6.07, P < 0.001) were positively associated with insomnia at discharge, whereas diuretics at discharge (OR = 0.60, 95% CI = 0.39–0.90, P = 0.01) were negatively associated with insomnia at discharge. The cumulative 1 year incidence of all-cause death was significantly higher in the insomnia group than in the non-insomnia group (25.1% vs. 16.2%, P < 0.001). Even after adjusting the confounders, the higher mortality risk of patients with insomnia relative to those without insomnia remained significant (HR = 1.55, 95% CI = 1.24–1.94; P < 0.001). [Conclusions] Patients with insomnia at discharge were associated with a higher risk of mortality than those without insomnia at discharge.
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- 2022
28. Comprehensive Genome Profiles Obtained by Next-generation Sequencing Using the Cytological Samples in Our Hospital
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Yukihiro Hasegawa, Takeshi Morimoto, Dai Miura, and Koichi Hagiwara
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Pulmonary and Respiratory Medicine ,Oncology - Published
- 2022
29. Prediction of ESBL-producing E coli for suspected urinary tract infection
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Hiroshi Higuchi, Tsukasa Nakamura, Junji Mashino, Toshihiro Imada, and Takeshi Morimoto
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General Medicine - Abstract
Aim: The widespread existence of extended-spectrum β-lactamase (ESBL) producing Escherichia coli ( E. coli) has become a critical threat in developed countries. Prediction rule for ESBL producing E. coli is relevant to see patients with suspected urinary tract infection. Materials and methods: We collected clinical and laboratory data and constructed multivariate logistic regression models to develop a clinical prediction rule in the derivation cohort with 1185 patients with urine cultures and validated the rule in the validation cohort with 516 patients. Results: ESBL-producing E. coli was found in 185 patients (16%) in the derivation cohort. When assigning 14 points for being female (odds ratio (OR): 4.2), six points for CRP >5 mg/dl (OR: 1.87), and four points for a history of urinary tract infection (OR: 1.52), the area under the curve (AUC) had 0.67 (95% confidence interval (CI): 0.63–0.70) in the derivation cohort and 0.64 (95% CI: 0.59–0.69] in the validation cohort. Conclusions: The developed prediction rule had moderate accuracy to predict ESBL-producing E. coli in patients with suspected urinary tract infection.
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- 2022
30. Modifiers of the Risk of Diabetes for Long-Term Outcomes After Coronary Revascularization
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Kyohei Yamaji, Hiroki Shiomi, Takeshi Morimoto, Yukiko Matsumura-Nakano, Natsuhiko Ehara, Hiroki Sakamoto, Yasuaki Takeji, Yusuke Yoshikawa, Ko Yamamoto, Eri T. Kato, Kazuaki Imada, Takeshi Tada, Ryoji Taniguchi, Ryusuke Nishikawa, Tomohisa Tada, Takashi Uegaito, Tatsuya Ogawa, Miho Yamada, Teruki Takeda, Hiroshi Eizawa, Nobushige Tamura, Keiichi Tambara, Satoru Suwa, Manabu Shirotani, Toshihiro Tamura, Moriaki Inoko, Junichiro Nishizawa, Masahiro Natsuaki, Hiroshi Sakai, Takashi Yamamoto, Naoki Kanemitsu, Nobuhisa Ohno, Katsuhisa Ishii, Akira Marui, Hiroshi Tsuneyoshi, Yasuhiko Terai, Shogo Nakayama, Kazuhiro Yamazaki, Mamoru Takahashi, Takashi Tamura, Jiro Esaki, Shinji Miki, Tomoya Onodera, Hiroshi Mabuchi, Yutaka Furukawa, Masaru Tanaka, Tatsuhiko Komiya, Yoshiharu Soga, Michiya Hanyu, Takenori Domei, Kenji Ando, Kazushige Kadota, Kenji Minatoya, Yoshihisa Nakagawa, Takeshi Kimura, Mitsuo Matsuda, Yuzo Takeuchi, Hirokazu Mitsuoka, Takashi Konishi, Seiji Ootani, Hisayoshi Fujiwara, Yoshiki Takatsu, Yukihito Sato, Kazuaki Kataoka, Ryuji Nohara, Kimisato Nakano, Syoichi Miyamoto, Nagai Kunihiko, Tomoyuki Murakami, Katsuya Ishida, Masakiyo Nobuyoshi, Hitoshi Yasumoto, Masashi Iwabuchi, Masayuki Kato, Ryozo Tatami, Ryuichi Hattori, Toru Kita, Yasuki Kihara, Hiroshi Kato, Takeshi Aoyama, Takahiro Sakurai, Masaki Kawanami, Tamaki Suyama, Eiji Tada, Tsukasa Inada, Hiroyasu Uzui, Akira Nakano, Jong-Dae Lee, Akinori Takizawa, Nawada Ryuzo, Eiji Shinoda, Masaaki Takahashi, Minoru Horie, Hiroyuki Takashima, Mamoru Toyofuku, Hajime Kotoura, Akira Miura, Yoshiki Matoba, Takuro Takumi, Chuwa Tei, Shuichi Hamasaki, Osamu Doi, Hirofumi Kambara, Satoshi Kaburagi, Kazuaki Mitsudo, Tetsu Mizoguchi, Yoshida Akira, Kazuhisa Kaneda, Hisao Ogawa, Koichi Sugamura, Seigo Sugiyama, Kiyoshi Doyama, Makoto Araki, Ryuzo Sakata, Tadashi Ikeda, Masahiko Onoe, Kazuo Yamanaka, Atsushi Iwakura, Keiichi Fujiwara, Kinji Soga, Tsutomu Matsushita, Noboru Nishiwaki, Yuichi Yoshida, Yukikatsu Okada, Michihiro Nasu, Tadaaki Koyama, Kuniyoshi Tanaka, Takaaki Koshiji, Koichi Morioka, Mitsuomi Shimamoto, Fumio Yamazaki, Masaki Aota, Hiroyuki Hara, Takafumi Tabata, Yutaka Imoto, Hiroyuki Yamamoto, Katsuhiko Matsuda, Masafumi Nara, Hiroyuki Nakajima, Michio Kawasuji, Syuji Moriyama, Sakiko Arimura, Yumika Fujino, Miya Hanazawa, Chikako Hibi, Risa Kato, Yui Kinoshita, Kumiko Kitagawa, Masayo Kitamura, Takahiro Kuwahara, Maeda Sachiko, Izumi Miki, Saeko Minematsu, Satoko Nishida, Naoko Okamoto, Asuka Saeki, Hitomi Sasae, Yuki Sato, Asuka Takahashi, Emi Takinami, Saori Tezuka, Marina Tsuda, Miyuki Tsumori, Yuriko Uchida, Yuko Yamamoto, Misato Yamauchi, Itsuki Yamazaki, Mai Yoshimoto, Mitsuru Abe, Masayuki Fuki, Mamoru Hayano, Eri Kato, Yoshihiro Kato, Tetsu Nakajima, Kenji Nakatsuma, Junichi Tazaki, Akihiro Tokushige, Hiroki Watanabe, Hidenori Yaku, Erika Yamamoto, and Yugo Yamashita
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- 2022
31. Endovascular Therapy for Acute Stroke with a Large Ischemic Region
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Shinichi Yoshimura, Nobuyuki Sakai, Hiroshi Yamagami, Kazutaka Uchida, Mikiya Beppu, Kazunori Toyoda, Yuji Matsumaru, Yasushi Matsumoto, Kazumi Kimura, Masataka Takeuchi, Yukako Yazawa, Naoto Kimura, Keigo Shigeta, Hirotoshi Imamura, Ichiro Suzuki, Yukiko Enomoto, So Tokunaga, Kenichi Morita, Fumihiro Sakakibara, Norito Kinjo, Takuya Saito, Reiichi Ishikura, Manabu Inoue, and Takeshi Morimoto
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Stroke ,Treatment Outcome ,Fibrinolytic Agents ,Infarction ,Tissue Plasminogen Activator ,Endovascular Procedures ,Humans ,Recovery of Function ,General Medicine ,Intracranial Hemorrhages ,Brain Ischemia ,Ischemic Stroke ,Thrombectomy - Abstract
Endovascular therapy for acute ischemic stroke is generally avoided when the infarction is large, but the effect of endovascular therapy with medical care as compared with medical care alone for large strokes has not been well studied.We conducted a multicenter, open-label, randomized clinical trial in Japan involving patients with occlusion of large cerebral vessels and sizable strokes on imaging, as indicated by an Alberta Stroke Program Early Computed Tomographic Score (ASPECTS) value of 3 to 5 (on a scale from 0 to 10, with lower values indicating larger infarction). Patients were randomly assigned in a 1:1 ratio to receive endovascular therapy with medical care or medical care alone within 6 hours after they were last known to be well or within 24 hours if there was no early change on fluid-attenuated inversion recovery images. Alteplase (0.6 mg per kilogram of body weight) was used when appropriate in both groups. The primary outcome was a modified Rankin scale score of 0 to 3 (on a scale from 0 to 6, with higher scores indicating greater disability) at 90 days. Secondary outcomes included a shift across the range of modified Rankin scale scores toward a better outcome at 90 days and an improvement of at least 8 points in the National Institutes of Health Stroke Scale (NIHSS) score (range, 0 to 42, with higher scores indicating greater deficit) at 48 hours.A total of 203 patients underwent randomization; 101 patients were assigned to the endovascular-therapy group and 102 to the medical-care group. Approximately 27% of patients in each group received alteplase. The percentage of patients with a modified Rankin scale score of 0 to 3 at 90 days was 31.0% in the endovascular-therapy group and 12.7% in the medical-care group (relative risk, 2.43; 95% confidence interval [CI], 1.35 to 4.37; P = 0.002). The ordinal shift across the range of modified Rankin scale scores generally favored endovascular therapy. An improvement of at least 8 points on the NIHSS score at 48 hours was observed in 31.0% of the patients in the endovascular-therapy group and 8.8% of those in the medical-care group (relative risk, 3.51; 95% CI, 1.76 to 7.00), and any intracranial hemorrhage occurred in 58.0% and 31.4%, respectively (P0.001).In a trial conducted in Japan, patients with large cerebral infarctions had better functional outcomes with endovascular therapy than with medical care alone but had more intracranial hemorrhages. (Funded by Mihara Cerebrovascular Disorder Research Promotion Fund and the Japanese Society for Neuroendovascular Therapy; RESCUE-Japan LIMIT ClinicalTrials.gov number, NCT03702413.).
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- 2022
32. Citizen science observation of a gamma-ray glow associated with the initiation of a lightning flash
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Miwa Tsurumi, Teruaki Enoto, Yuko Ikkatai, Ting Wu, Daohong Wang, Taro Shinoda, Kazuhiro Nakazawa, Naoki Tsuji, Gabriel Sousa Diniz, Jun Kataoka, Nanase Koshikawa, Ryoji Iwashita, Masashi Kamogawa, Toru Takagaki, Shoko Miyake, Dai Tomioka, Takeshi Morimoto, Yoshitaka Nakamura, and Harufumi Tsuchiya
- Abstract
Gamma-ray glows are observational evidence of relativistic electron acceleration due to the electric field in thunderclouds. However, it is yet to be understood whether such relativistic electrons contribute to the initiation of lightning discharges. To tackle this question, we started the citizen science “Thundercloud Project’, where we map radiation measurements of glows from winter thunderclouds along Japan sea coast area. We developed and deployed 58 compact gamma-ray monitors at the end of 2021. On 30 December 2021, five monitors simultaneously detected a glow with its radiation distribution horizontally extending for 2 km.The glow terminated coinciding with a lightning flash at 04:08:34 JST, which was recorded by the two radio-band lightning mapping systems, FALMA and DALMA. The initial discharges during the preliminary breakdown started above the glow, i.e., in vicinity of the electron acceleration site. This result provides one example of possible connections between electron acceleration and lightning initiation.
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- 2023
33. Life Expectancy of Patients With Severe Aortic Stenosis in Relation to Age and Surgical Risk Score
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Tomohiko Taniguchi, Takeshi Morimoto, Kyohei Yamaji, Shinichi Shirai, Kenji Ando, Hiroki Shiomi, Yasuaki Takeji, Nobuhisa Ohno, Norio Kanamori, Fumio Yamazaki, Tadaaki Koyama, Kitae Kim, Natsuhiko Ehara, Yutaka Furukawa, Tatsuhiko Komiya, Atsushi Iwakura, Manabu Shirotani, Jiro Esaki, Genichi Sakaguchi, Kosuke Fujii, Shogo Nakayama, Hiroshi Mabuchi, Hiroshi Tsuneyoshi, Hiroshi Eizawa, Kotaro Shiraga, Michiya Hanyu, Akira Nakano, Katsuhisa Ishii, Nobushige Tamura, Nobuya Higashitani, Ichiro Kouchi, Tomoyuki Yamada, Junichiro Nishizawa, Toshikazu Jinnai, Yuko Morikami, Kenji Minatoya, and Takeshi Kimura
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Pulmonary and Respiratory Medicine ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 2023
34. Abstract 1: The Very Core Limit Of Endovascular Therapy For Acute Stroke With A Large Ischemic Region
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Manabu Inoue, Takeshi Yoshimoto, Kazunori Toyoda, Nobuyuki Sakai, Hiroshi Yamagami, Yuji Matsumaru, Yasushi Matsumoto, Kazumi Kimura, Reiichi Ishikura, Kazutaka Uchida, Mikiya Beppu, Fumihiro Sakakibara, Takeshi Morimoto, and Shinichi Yoshimura
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Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background and Purpose: To assess the actual malignant core volume in endovascular therapy (EVT) eligible patients with large ischemic regions from the RESCUE-Japan LIMIT database. Methods: RESCUE-Japan LIMIT was a multicenter, open-label, randomized clinical trial in large vessel occlusion patients with large ischemic region indicated by an ASPECTS valued from 3 to 5. We assessed the volumetrically measured core volume which identifies an unfavorable outcome (modified Rankin Scale; mRS 4-6 at 90 days) by receiver operating characteristic (ROC) analysis in the endovascular therapy (EVT) group. Predictive marginal probabilities were also assessed to identify the unfavorable outcome. Symptomatic intracranial hemorrhages and death within 90 days in the EVT group and the medical management (MM) group were compared. Clinical characteristics and radiological values were also compared. Results: Of the 203 cases enrolled, 182 patients (92 in EVT group vs. 90 in MM group) had adequate core volume. The mean age was 75.6±10 years old and 46% of females in the EVT group and 77.0±10 years old and 42% of females in the MM group. Median core volume was 94 (IQR; 65.3-147.5) mL in EVT patients and 110 (IQR; 74.0-140.0) mL in those with MM group (P=0.84). ROC analysis identified a core volume of 120 mL as the unfavorable outcome (61/92) in the EVT group (51% sensitivity and 77% specificity, area under curve=0.65) and 99 mL in the MM group (77/91, 62% sensitivity and 54% specificity, area under curve=0.56). Predictive marginal probabilities indicated 132 mL as an overlay of the two groups for achieving the unfavorable functional outcome. Symptomatic intracranial hemorrhage was seen in 9.8% in the EVT group and 5.6% in the MM group (p=0.28), and death within 90 days was 17.4% in the EVT group and 23.3% in the MM group (p=0.32). Conclusions: The current analysis demonstrates that a core threshold of approximately 130 mL is the upper limit for identifying large ischemic region stroke patients treated with EVT who are unlikely to suffer from unfavorable outcomes. EVT-eligible patients under this threshold may benefit from EVT. Registration: URL: http://www.clinicaltrials.gov; Unique identifier: NCT03702413.
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- 2023
35. Prognostic Value of the Severity of Clinical Congestion in Patients Hospitalized for Decompensated Heart Failure: Findings From the Japanese KCHF Registry
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KENJI AIDA, KAZUYA NAGAO, TAKAO KATO, HIDENORI YAKU, TAKESHI MORIMOTO, YASUTAKA INUZUKA, YODO TAMAKI, ERIKA YAMAMOTO, YUSUKE YOSHIKAWA, TAKESHI KITAI, RYOJI TANIGUCHI, MORITAKE IGUCHI, MASASHI KATO, MAMORU TAKAHASHI, TOSHIKAZU JINNAI, TAKAFUMI KAWAI, AKIHIRO KOMASA, RYUSUKE NISHIKAWA, YUICHI KAWASE, TAKASHI MORINAGA, KANAE SU, MITSUNORI KAWATO, YUTA SEKO, TSUKASA INADA, MORIAKI INOKO, MAMORU TOYOFUKU, YUTAKA FURUKAWA, YOSHIHISA NAKAGAWA, KENJI ANDO, KAZUSHIGE KADOTA, SATOSHI SHIZUTA, KOH ONO, YUKIHITO SATO, KOICHIRO KUWAHARA, NEIKO OZASA, and TAKESHI KIMURA
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Cardiology and Cardiovascular Medicine - Published
- 2023
36. Effect of Anagliptin versus Sitagliptin on Renal Function: Subanalyzes from the REASON Trial
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Hiroki Teragawa, Takeshi Morimoto, Yuichi Fujii, Tomohiro Ueda, Mio Sakuma, Michio Shimabukuro, Osamu Arasaki, Koichi Node, Takashi Nomiyama, and Shinichiro Ueda
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Pharmacology ,Internal Medicine ,Targets and Therapy [Diabetes, Metabolic Syndrome and Obesity] - Abstract
Hiroki Teragawa,1 Takeshi Morimoto,2 Yuichi Fujii,1 Tomohiro Ueda,1 Mio Sakuma,2 Michio Shimabukuro,3 Osamu Arasaki,4 Koichi Node,5 Takashi Nomiyama,6 Shinichiro Ueda7 1Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan; 2Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan; 3Deparment of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan; 4Department of Cardiology, Yuuai Medical Center, Tomigusuku, Okinawa, Japan; 5Department of Cardiovascular Medicine, Saga University, Saga, Japan; 6Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan; 7Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Okinawa, JapanCorrespondence: Hiroki Teragawa, Department of Cardiovascular Medicine, JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0052, Japan, Tel +81-82-262-1171, Fax +81-82-262-1449, Email hiroteraga71@gmail.comPurpose: The effects of two types of dipeptidyl peptidase-4 (DPP-4) inhibitors on renal function remain unclear. Thus, we investigated the effect of anagliptin (ANA) and sitagliptin (SITA) on renal function in patients with type 2 diabetes who participated in the randomized evaluation of ANA versus SITA on low-density lipoprotein-cholesterol (LDL-C) in diabetes (REASON) trial.Patients and methods: We measured the estimated glomerular filtration rate (eGFR) and urinary albuminâcreatinine ratio (UACR) before and after the REASON trial. ANA 200 mg/day was administered to 177 patients for 52 weeks, while SITA 50 mg/day was given to 176 patients. We investigated the relationship between differences in renal function and differences in hemoglobin A1c (HbA1c) levels, LDL-C levels, and blood pressure (BP).Results: No significant differences were found in baseline eGFR and UACR between the two groups. The eGFR levels were significantly decreased in both groups; however, the UACR level was unchanged in the ANA group but elevated in the SITA group, although the difference did not reach significance between the two groups. The difference in eGFR was affected by the differences in HbA1c level and BP, and the difference in the UACR was affected by the differences in LDL-C level and BP, which were reduced only in the ANA group.Conclusion: These findings imply that the effects of DPP-4 inhibitors on renal function, especially on UACR, may be different between the types of DPP-4 inhibitors.Keywords: glomerular filtration rate, dipeptidyl peptidase 4, dipeptidyl peptidase 4 inhibitors, albuminuria
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- 2022
37. Association between dihydropyridine calcium channel blockers and ischemic strokes in patients with nonvalvular atrial fibrillation
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Fumihiro Sakakibara, Shinichiro Ueda, Kazutaka Uchida, Norito Kinjo, Hideki Arai, Mari Nezu, and Takeshi Morimoto
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Male ,Dihydropyridines ,Physiology ,Anticoagulants ,Hemorrhage ,Calcium Channel Blockers ,Cohort Studies ,Stroke ,Hemorrhagic Stroke ,Atrial Fibrillation ,Internal Medicine ,Humans ,Female ,Cardiology and Cardiovascular Medicine ,Aged ,Ischemic Stroke - Abstract
Outside of clinical trials, the prophylactic effect of dihydropyridine calcium channel blockers (CCBs) on ischemic events in patients with nonvalvular atrial fibrillation (NVAF) has not been confirmed. We compared the effect of dihydropyridine CCBs on ischemic events in anticoagulated NVAF patients. We conducted a multicenter historical cohort study at 71 centers in Japan. The inclusion criterion was taking vitamin K antagonists for NVAF. The exclusion criteria were mechanical heart valves and a history of pulmonary thrombosis or deep vein thrombosis. Consecutive patients (N = 7826) were registered in February 2013 and were followed until February 2017. The primary outcomes were ischemic events and ischemic strokes; the secondary outcomes were all-cause mortality, major bleeding, and hemorrhagic strokes. The mean patient age was 73 years old, and 67% of the patients were male. Seventy-eight percent of the patients had hypertension, and dihydropyridine CCBs were used by 2693 (34%) patients (CCB group). The cumulative incidences of ischemic events and ischemic strokes at 4 years in the CCB and No-CCB groups were 5.9% vs. 5.2% and 5.6% vs. 4.8%, respectively. The adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) of the CCB group for ischemic events and ischemic strokes were 1.22 (0.95-1.57) and 1.32 (1.02-1.71), respectively; the adjusted HRs (95% CIs) of the CCB group for all-cause mortality, major bleeding, and hemorrhagic strokes were 0.85 (0.69-1.04), 1.12 (0.92-1.35), and 1.08 (0.62-1.88), respectively. Dihydropyridine CCB use by anticoagulated NVAF patients significantly increased ischemic strokes in a real-world setting.
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- 2022
38. Matched comparison of catheter ablation versus conservative management for atrial fibrillation
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Tetsuma Kawaji, Satoshi Shizuta, Kyohei Yamaji, Munekazu Tanaka, Kazuki Kitano, Takanori Aizawa, Shintaro Yamagami, Akihiro Komasa, Takashi Yoshizawa, Masashi Kato, Takafumi Yokomatsu, Shinji Miki, Koh Ono, Takeshi Morimoto, and Takeshi Kimura
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Heart Failure ,Stroke ,Treatment Outcome ,Atrial Fibrillation ,Catheter Ablation ,Humans ,Conservative Treatment ,Cardiology and Cardiovascular Medicine - Abstract
It is still controversial whether catheter ablation for atrial fibrillation (AF) could improve clinical outcomes in general AF population. Among 4398 patients with diagnosis of AF in the outpatient department of Kyoto University Hospital between January 2005 and March 2015, we identified 537 pairs of patients who received first-time catheter ablation (ablation group) or conservative management (conservative group), matched for age, gender, AF duration, AF type, AF symptoms, and previous heart failure (HF). The primary outcome measure was a composite of cardiovascular death, HF hospitalization, ischemic stroke, or major bleeding. Most baseline characteristics were well balanced between the 2 groups, except for the higher prevalence of low body weight, history of malignancy, and severe chronic kidney disease in the conservative group. Median follow-up duration was 5.3 years. The cumulative 5-year incidence of the primary outcome measure was significantly lower in the ablation group than in the conservative group (5.2% versus 15.6%, log-rank P 0.001). Even after adjusting for the imbalances in the baseline characteristics, the lower risk of the ablation group relative to the conservative group for the primary outcome measure remained highly significant (HR 0.32, 95% CI 0.21-0.47, P 0.001). Ablation compared with conservative management was also associated with significantly lower risks for the individual components of the primary outcome. In this matched analysis in AF patients, ablation as compared with conservative management was associated with better long-term clinical outcomes, although we could not deny the possibility of selection bias and unmeasured confounding.
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- 2022
39. Coronary Artery Disease Without Standard Cardiovascular Risk Factors
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CREDO-Kyoto Pci, Takeshi Kimura, Kenji Ando, Yusuke Yoshikawa, Hiroshi Eizawa, Toshihiro Tamura, Moriaki Inoko, Yukiko Matsumura-Nakano, Mitsuo Matsuda, Erika Yamamoto, Shinji Miki, Tomoya Onodera, Mamoru Takahashi, Manabu Shirotani, Masahiro Natsuaki, Hidenori Yaku, Ko Yamamoto, Masayuki Fuki, Tsukasa Inada, Kenji Nakatsuma, Eiji Shinoda, Takeshi Aoyama, Yasuaki Takeji, Satoru Suwa, Yukihito Sato, Takeshi Morimoto, Yutaka Furukawa, Hiroki Watanabe, Kyohei Yamaji, Hiroshi Mabuchi, Mamoru Toyofuku, Hiroki Sakamoto, Eri Kato, Kazushige Kadota, Katsuhisa Ishii, Cabg Registry Cohort Investigators, Yoshihisa Nakagawa, Hiroki Shiomi, Takashi Yamamoto, and Yugo Yamashita
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Male ,Acute coronary syndrome ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,Body Mass Index ,Time-to-Treatment ,Coronary artery disease ,Sex Factors ,Cause of Death ,Neoplasms ,Internal medicine ,Atrial Fibrillation ,Diabetes Mellitus ,Myocardial Revascularization ,medicine ,Humans ,Myocardial infarction ,Acute Coronary Syndrome ,Mortality ,Risk factor ,Aged ,Dyslipidemias ,Proportional Hazards Models ,Aged, 80 and over ,business.industry ,Smoking ,Hazard ratio ,Age Factors ,Percutaneous coronary intervention ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Heart Disease Risk Factors ,Chronic Disease ,Hypertension ,Cardiology ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business ,Dyslipidemia - Abstract
Recently, one observational study showed that patients with ST-segment elevation myocardial infarction (STEMI) without standard cardiovascular risk factors were associated with increased mortality compared with patients with risk factors. This unexpected result should be evaluated in other populations including those with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and chronic coronary syndrome (CCS). Among 30,098 consecutive patients undergoing first coronary revascularization in the CREDO-Kyoto PCI/CABG (Coronary Revascularization Demonstrating Outcome Study in Kyoto Percutaneous Coronary Intervention/Coronary Artery Bypass Grafting) registry cohort-2 and 3, we compared clinical characteristics and outcomes between patients with and without risk factors stratified by their presentation (STEMI n = 8,312, NSTE-ACS n = 3,386, and CCS n = 18,400). Patients with risk factors were defined as having at least one of the following risk factors: hypertension, dyslipidemia, diabetes, and current smoking. The proportion of patients without risk factors was low (STEMI: 369 patients [4.4%], NSTE-ACS: 110 patients [3.2%], and CCS: 462 patients [2.5%]). Patients without risk factors compared with those with risk factors more often had advanced age, low body weight, and malignancy and less often had history of atherosclerotic disease and prescription of optimal medical therapy. In patients with STEMI, patients without risk factors compared with those with risk factors were more often women and more often had atrial fibrillation, long door-to-balloon time, and severe hemodynamic compromise. During a median of 5.6 years follow-up, patients without risk factors compared with those with risk factors had higher crude incidence of all-cause death. After adjusting confounders, the mortality risk was significant in patients with CCS (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.01 to 1.49, p = 0.04) but not in patients with STEMI (HR 1.06, 95% CI 0.89 to 1.27, p = 0.52) and NSTE-ACS (HR 1.07, 95% CI, 0.74 to 1.54, p = 0.73). In conclusion, among patients undergoing coronary revascularization, patients without standard cardiovascular risk factors had higher crude incidence of all-cause death compared with those with at least one risk factor. After adjusting confounders, the mortality risk was significant in patients with CCS but not in patients with STEMI and NSTE-ACS.
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- 2022
40. Venous thromboembolism: Recent advancement and future perspective
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Takeshi Morimoto, Yugo Yamashita, and Takeshi Kimura
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medicine.medical_specialty ,Vena Cava Filters ,medicine.drug_class ,Deep vein ,medicine.medical_treatment ,Lower risk ,Inferior vena cava ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Intensive care medicine ,Venous Thrombosis ,business.industry ,Anticoagulants ,Venous Thromboembolism ,Thrombolysis ,Vitamin K antagonist ,equipment and supplies ,medicine.disease ,Thrombosis ,Pulmonary embolism ,Clinical trial ,medicine.anatomical_structure ,medicine.vein ,Cardiology ,Pulmonary Embolism ,Cardiology and Cardiovascular Medicine ,business - Abstract
Clinicians have been more and more often encountering patients with venous thromboembolism (VTE), including pulmonary embolism and deep vein thrombosis, leading to the increased importance of VTE in daily clinical practice. VTE is becoming a common issue in Asian countries including Japan. The management strategies of VTE have changed dramatically in the past decade including the introduction of direct oral anticoagulants (DOACs). In addition, there have been several landmark clinical trials assessing acute treatment strategies including thrombolysis and inferior vena cava (IVC) filter. The current VTE guidelines do not recommend the routine use of thrombolysis or IVC filters based on recent evidence; Nevertheless, the prevalence of thrombolysis and IVC filter use in Japan was strikingly high. The novel profiles of DOACs with rapid onset of action and potential benefit of a lower risk for bleeding compared with vitamin K antagonist could make home treatment feasible and is safer even with extended anticoagulation therapy. One of the most clinically relevant issues for VTE treatment is optimal duration of anticoagulation for the secondary prevention of VTE. Considering recent evidence, optimal duration of anticoagulation should be determined based on the risk for recurrence as well as the risk for bleeding in an individual patient. Despite the recent advances for VTE management, there are still a number of uncertain issues that challenge clinicians in daily clinical practice, such as cancer-associated VTE and minor VTE including subsegmental pulmonary embolism and distal deep vein thrombosis, warranting future research. Several clinical trials are now ongoing for these issues, globally as well as in Japan. The current review is aimed to overview the recent advances in VTE management, describe the current status including some domestic issues in Japan, and discuss the future perspective of VTE.
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- 2022
41. Coronary angiography in patients with acute heart failure: from the KCHF registry
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Takeshi Morimoto, Takashi Morinaga, Kchf Study Investigators, Yasutaka Inuzuka, Kenji Ando, Koichiro Kuwahara, Erika Yamamoto, Takeshi Kimura, Yuichi Kawase, Neiko Ozasa, Yugo Yamashita, Takafumi Kawai, Ryusuke Nishikawa, Mamoru Toyofuku, Moritake Iguchi, Takeshi Kitai, Yodo Tamaki, Ryoji Taniguchi, Akihiro Komasa, Yuta Seko, Masayuki Shiba, Takefumi Kishimori, Hidenori Yaku, Kazushige Kadota, Yusuke Yoshikawa, Kazuya Nagao, Yukihito Sato, Yutaka Furukawa, and Takao Kato
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Male ,medicine.medical_specialty ,Acute coronary syndrome ,Coronary angiography ,Lower risk ,Ventricular Dysfunction, Left ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,Registries ,Outcome ,Aged, 80 and over ,Heart Failure ,Ejection fraction ,business.industry ,Hazard ratio ,Acute heart failure ,Atrial fibrillation ,Odds ratio ,Original Articles ,medicine.disease ,Confidence interval ,Hospitalization ,RC666-701 ,Heart failure ,Cardiology ,Original Article ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Little is known about the characteristics and outcomes of patients who undergo coronary angiography during heart failure (HF) hospitalization, as well as those with coronary stenosis, and those who underwent coronary revascularization. Methods and results We analysed 2163 patients who were hospitalized for HF without acute coronary syndrome or prior HF hospitalization. We compared patient characteristics and 1 year clinical outcomes according to (i) patients with versus without coronary angiography, (ii) patients with versus without coronary stenosis, and (iii) patients with versus without coronary revascularization. The primary outcome measure was the composite of all‐cause death or HF hospitalization. Coronary angiography was performed in 37.0% of patients. In the multivariable logistic regression analysis, factors independently associated with coronary angiography were age
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- 2021
42. Characteristics of Elderly Patients with Heart Failure and Impact on Activities of Daily Living: A Registry Report from Super-Aged Society
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Tohru Izumi, Shinichi Noto, Mitsuaki Isobe, Keisuke Suzuki, Hiroaki Obata, Wataru Mitsuma, Takeshi Morimoto, and Masashi Yamashita
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Male ,medicine.medical_specialty ,Octogenarians ,Activities of daily living ,medicine.medical_treatment ,Aftercare ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Activities of Daily Living ,Health care ,Registry report ,Humans ,Medicine ,Registries ,030212 general & internal medicine ,Disease management (health) ,Aged ,Aged, 80 and over ,Heart Failure ,Rehabilitation ,business.industry ,Incidence (epidemiology) ,medicine.disease ,Patient Discharge ,Heart failure ,Cohort ,Emergency medicine ,Female ,Cardiology and Cardiovascular Medicine ,business ,human activities - Abstract
Background To assess the health care burden of elderly patients with heart failure (HF) in an aging Japanese community-based hospital, we investigated the outcomes of cardiac rehabilitation. Methods and Results We enrolled all patients with HF aged ≥65 years admitted to 3 hospitals in the Niigata Prefecture. We prospectively collected data on their hospital stays and for 2 years postdischarge. The cohort comprised 617 patients (46.5% men; mean age 84.7 years), 76.2% of whom were aged ≥80 years. Among these patients, 15.6% were nursing home residents, 57.7% required long-term care insurance, only 37.6% could walk unaided at the time of admission, and 70.5% required cardiac rehabilitation; age had no significant rehabilitative effect on the degree of improvement in activities of daily living (ADLs). Two years postdischarge, all-cause mortality, and HF rehospitalization were 41.1% and 38.6%, respectively. The ADL score at discharge was an independent prognostic factor for mortality. The incidence of mortality and rehospitalization was lower in elderly patients with preserved ADLs at discharge. Conclusions Elderly patients with HF in our super-aged society were mainly octogenarians who required disease management and personalized care support. Although their ADL scores increased with comprehensive cardiac rehabilitation, improved scores at discharge were closely associated with prognosis.
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- 2021
43. Severity of pulmonary embolism at initial diagnosis and long-term clinical outcomes: From the COMMAND VTE Registry
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Kensuke Takabayashi, Takeshi Morimoto, Koh Ono, Seiichi Hiramori, Hiroshi Mabuchi, Toru Takase, Masaharu Akao, Kitae Kim, Yohei Kobayashi, Maki Oi, Mamoru Toyofuku, Kiyonori Togi, Takao Kato, Tomohisa Tada, Command Vte Registry Investigators, Kazushige Kadota, Yugo Yamashita, Toshiaki Izumi, Minako Kinoshita, Tomoki Sasa, Jiro Sakamoto, Takeshi Kimura, Koichiro Murata, Moriaki Inoko, Po-Min Chen, Yoshiaki Tsuyuki, and Yuji Nishimoto
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Venous Thrombosis ,medicine.medical_specialty ,business.industry ,Confounding ,Hazard ratio ,Anticoagulants ,Venous Thromboembolism ,medicine.disease ,Confidence interval ,Pulmonary embolism ,Recurrence ,Risk Factors ,Interquartile range ,Internal medicine ,Landmark analysis ,medicine ,Humans ,Population study ,Registries ,Pulmonary Embolism ,Cardiology and Cardiovascular Medicine ,business ,Venous thromboembolism - Abstract
Background There is a paucity of data on the long-term clinical outcomes according to the severity of pulmonary embolism (PE) at initial diagnosis. Methods The COMMAND VTE Registry is a multicenter registry enrolling 3027 consecutive patients with acute symptomatic venous thromboembolism (VTE). After excluding 1312 patients without PE, the current study population consisted of 1715 patients with PE, who were divided into 3 groups according to the clinical severity; massive PE, sub-massive PE and low-risk PE. Results There were 179 patients (10%) with massive PE, 742 patients (43%) with sub-massive PE, and 794 patients (46%) with low-risk PE. By the landmark analysis at 3 months, the cumulative incidences of recurrent VTE were similar among the 3 groups both within and beyond 3 months (Massive PE: 2.9%, Sub-massive PE: 4.2%, and Low-risk PE: 3.3%, P = 0.61, and 4.3%, 8.8%, and 7.8% at 5 years, P = 0.47, respectively). After adjusting confounders, the risk of massive PE relative to low-risk PE for recurrent VTE beyond 3 months remained insignificant (adjusted HR 0.54, 95% CI: 0.13–1.51, P = 0.27). Patients with massive PE at initial diagnosis more often presented as severe recurrent PE events than those with sub-massive and low-risk PE. Conclusions In the current real-world large registry, the long-term risk of overall recurrent VTE in patients with massive PE at initial diagnosis did not significantly differ from those with sub-massive and low-risk PE beyond 3 months, although patients with massive PE at initial diagnosis more frequently developed recurrent VTE as PE with severe clinical presentation.
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- 2021
44. Differences in adverse drug events and medication errors among pediatric inpatients aged <3 and ≥3 years: The JADE study
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Jiro Takeuchi, Yoshinori Ohta, Hiroyuki Ida, Mio Sakuma, and Takeshi Morimoto
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Drug ,medicine.medical_specialty ,Medication use ,business.industry ,media_common.quotation_subject ,JADE (particle detector) ,Medication error ,Patient safety ,Adverse drug event ,Emergency medicine ,Epidemiology ,medicine ,business ,media_common - Abstract
Background Adverse drug events (ADEs) are defined as any injuries due to medication use. We hypothesized that the incidences of ADEs and medication errors (MEs) could be associated with linguistic skills of pediatric patients. Methods We analyzed data from the Japan Adverse Drug Events study on pediatric inpatients. This study included inpatients aged one months and older and less than seven years old. We compared the primary outcome of ADEs and MEs between patients aged under three years and three years and older as children typically do not acquire sufficient linguistic skills until around three years of age. Results This study included 639 patients; 412 (64%) patients aged under three years and 227 (36%) patients aged three years and older. We identified 241 ADEs in 639 patients; 152 ADEs among patients aged under three years (37 ADEs per 100 patients) and 89 ADEs among those aged three years and older (39 ADEs per 100 patients). ADEs among patients aged under three years were less likely to be found (49 ADEs) during their hospital stay than those aged three years and older (20 ADEs) ( P = 0.02). Among 172 MEs identified in 639 patients, 25 MEs (15%) resulted in ADEs; 23 (92%) occurred to those aged under three years and two (8%) occurred to those aged three years and older ( P = 0.0008). Conclusion ADEs were less likely to be found and MEs resulted in ADEs more frequently in patients under three years old, and these differences could be explained by differences in their linguistic skill levels.
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- 2021
45. Five-year outcomes after coronary artery bypass grafting and percutaneous coronary intervention in octogenarians with complex coronary artery disease
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Hiroki Watanabe, Shingo Hirao, Tatsuhiko Komiya, Naoki Kanemitsu, Jiro Esaki, Kenji Minatoya, Hiroyuki Hara, Takeshi Morimoto, Yuki Hori, and Takeshi Kimura
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Octogenarians ,medicine.medical_treatment ,Myocardial Infarction ,Coronary Artery Disease ,Lower risk ,Coronary artery disease ,Percutaneous Coronary Intervention ,Interquartile range ,Internal medicine ,Humans ,Medicine ,cardiovascular diseases ,Coronary Artery Bypass ,Aged ,Aged, 80 and over ,business.industry ,Percutaneous coronary intervention ,Drug-Eluting Stents ,General Medicine ,medicine.disease ,Cardiac surgery ,Death ,Stroke ,Treatment Outcome ,surgical procedures, operative ,medicine.anatomical_structure ,Cardiothoracic surgery ,Conventional PCI ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
We assessed the clinical effectiveness of coronary artery bypass grafting (CABG) in comparison with that of percutaneous coronary intervention (PCI) in octogenarians with triple-vessel disease (TVD) or left main coronary artery (LMCA) disease. From the CREDO-Kyoto registry cohort-2, 527 patients, who were ≥ 80 years of age and underwent the first coronary revascularization for TVD or LMCA disease, were divided into the CABG group (N = 151) and the PCI group (N = 376). The median and interquartile range of patient’s age was 82 (81–84) in the CABG group and 83 (81–85) in the PCI group (P = 0.10). Patients > = 85 years of age accounted for 19% and 31% in the CABG and PCI groups, respectively (P = 0.01). The cumulative 5-year incidence of all-cause death was similar between CABG and PCI groups (35.8% vs. 42.9%, log-rank P = 0.18), while CABG showed a lower rate of the composite of cardiac death/MI than PCI (21.7% vs. 33.9%, log-rank P = 0.005). After adjusting for confounders, the lower risk of CABG relative to PCI was significant for all-cause death (HR 0.61, 95% CI 0.43–0.86, P = 0.005), any coronary revascularization (HR 0.25, 95% CI 0.14–0.43, P
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- 2021
46. Clinical characteristics, management strategies and outcomes of patients with recurrent venous thromboembolism in the real world
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Yugo Yamashita, Takeshi Morimoto, Kazushige Kadota, Toru Takase, Seiichi Hiramori, Kitae Kim, Maki Oi, Masaharu Akao, Yohei Kobayashi, Mamoru Toyofuku, Moriaki Inoko, Tomohisa Tada, Po-Min Chen, Koichiro Murata, Yoshiaki Tsuyuki, Yuji Nishimoto, Jiro Sakamoto, Kiyonori Togi, Hiroshi Mabuchi, Kensuke Takabayashi, Takao Kato, Koh Ono, and Takeshi Kimura
- Subjects
Multidisciplinary ,Risk Factors ,Recurrence ,Neoplasms ,Cardiology ,Humans ,Anticoagulants ,Diseases ,Hemorrhage ,Venous Thromboembolism - Abstract
There is a paucity of data on management strategies and clinical outcomes after recurrent venous thromboembolism (VTE). In a multicenter registry enrolling 3027 patients with acute symptomatic VTE, the current study population was divided into the following 3 groups: (1) First recurrent VTE during anticoagulation therapy (N = 110); (2) First recurrent VTE after discontinuation of anticoagulation therapy (N = 116); and (3) No recurrent VTE (N = 2801). Patients with first recurrent VTE during anticoagulation therapy more often had active cancer (45, 25 and 22%, P
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- 2022
47. Sex Differences in Clinical Outcomes After Percutaneous Coronary Intervention
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Yasuaki Takeji, Takeshi Morimoto, Hiroki Shiomi, Eri Toda Kato, Kazuaki Imada, Yusuke Yoshikawa, Yukiko Matsumura-Nakano, Ko Yamamoto, Kyohei Yamaji, Toshiaki Toyota, Tomohisa Tada, Junichi Tazaki, Erika Yamamoto, Kenji Nakatsuma, Satoru Suwa, Natsuhiko Ehara, Ryoji Taniguchi, Toshihiro Tamura, Hiroki Watanabe, Mamoru Toyofuku, Takashi Yamamoto, Eiji Shinoda, Hiroshi Mabuchi, Moriaki Inoko, Tomoya Onodera, Hiroki Sakamoto, Tsukasa Inada, Kenji Ando, Yutaka Furukawa, Yukihito Sato, Kazushige Kadota, Yoshihisa Nakagawa, and Takeshi Kimura
- Subjects
General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
There is a scarcity of studies comparing the clinical outcomes after percutaneous coronary intervention (PCI) for women and men stratified by the presentation of acute coronary syndromes (ACS) or stable coronary artery disease (CAD).Methods and Results: The study population included 26,316 patients who underwent PCI (ACS: n=11,119, stable CAD: n=15,197) from the CREDO-Kyoto PCI/CABG registry Cohort-2 and Cohort-3. The primary outcome was all-cause death. Among patients with ACS, women as compared with men were much older. Among patients with stable CAD, women were also older than men, but with smaller difference. The cumulative 5-year incidence of all-cause death was significantly higher in women than in men in the ACS group (26.2% and 17.9%, log rank P0.001). In contrast, it was significantly lower in women than in men in the stable CAD group (14.2% and 15.8%, log rank P=0.005). After adjusting confounders, women as compared with men were associated with significantly lower long-term mortality risk with stable CAD but not with ACS (hazard ratio [HR]: 0.75, 95% confidence interval [CI]: 0.69-0.82, P0.001, and HR: 0.92, 95% CI: 0.84-1.01, P=0.07, respectively). There was a significant interaction between the clinical presentation and the mortality risk of women relative to men (interaction P=0.002).Compared with men, women had significantly lower adjusted mortality risk after PCI among patients with stable CAD, but not among those with ACS.
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- 2022
48. Psychometrics of the kiddie schedule for affective disorders and schizophrenia present and lifetime version for DSM-5 in Japanese outpatients
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Takuya Makino, Futoshi Suzuki, Takeshi Nishiyama, Saeko Ishibashi, Hidetaka Nakamichi, Tomoko Iida, Shoko Shimada, Shinji Tomari, Eiji Imanari, Takuma Higashi, Shintaro Fukumoto, Sawa Kurata, Yoshifumi Mizuno, Takuma Kimura, Yukiko Kuru, Takeshi Morimoto, and Hirotaka Kosaka
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Psychiatry and Mental health - Abstract
The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) is a widely used semi-structured diagnostic interview in child and adolescent psychiatry. However, the psychometric properties of its updated version, the K-SADS-PL for DSM-5, have scarcely been examined, especially for criterion validity. This study was designed to examine the inter-rater reliability, criterion validity and construct validity of the K-SADS-PL for DSM-5 in 137 Japanese outpatients.Two of 12 experienced clinicians independently performed the K-SADS interview for each patient in a conjoint session, and the resulting consensus diagnosis was compared with a "best-estimate" diagnosis made by two of eight experienced clinicians using all available information for the patient.The inter-rater reliability was excellent, as shown by κ 0.75 for all disorders, with the exception of current separation anxiety disorder. The criterion validity was fair to good, as shown by κ 0.40 for all disorders, with the exception of current and lifetime agoraphobia. The construct validity was also good, as shown by theoretically expected associations between the K-SADS-PL diagnoses and subscales of the child behavior checklist.The K-SADS-PL for DSM-5, now available in Japanese, generates valid diagnoses in child and adolescent psychiatry.
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- 2022
49. Impact of chronic lung disease on long-term clinical outcomes in patients with venous thromboembolism: From the COMMAND VTE registry
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Shinya Ikeda, Yugo Yamashita, Takeshi Morimoto, Koh Ono, and Takeshi Kimura
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Internal Medicine - Published
- 2022
50. Periprocedural management and clinical outcomes of invasive procedures after venous thromboembolism: from the COMMAND VTE registry
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Kazuki Matsushita, Kiyonori Togi, Tomohisa Tada, Yugo Yamashita, Seiichi Hiramori, Kazushige Kadota, Takeshi Morimoto, Yoshiaki Tsuyuki, Hidewo Amano, Mamoru Toyofuku, Yuta Tsujisaka, Syunsuke Saga, Hiroshi Mabuchi, Command Vte Registry Investigators, Yuji Nishimoto, Tomoki Sasa, Arata Sano, Masaharu Akao, Kosuke Doi, Minako Kinoshita, Kensuke Takabayashi, Fumiya Yoneda, Ryosuke Murai, Takeshi Kimura, Jiro Sakamoto, Maki Oi, Toshiaki Izumi, Kohei Osakada, Takao Kato, Kitae Kim, Yuta Seko, Toru Takase, Reo Hata, Yohei Kobayashi, Koh Ono, Po-Min Chen, and Koichiro Murata
- Subjects
medicine.medical_specialty ,Hematology ,business.industry ,Heparin ,Surgery ,Internal medicine ,Medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Venous thromboembolism ,Invasive Procedure ,Major bleeding ,medicine.drug - Abstract
Anticoagulation therapy is prescribed for the prevention of recurrence in patients with venous thromboembolism, which could be temporarily interrupted during invasive procedures. The COMMAND VTE Registry is a multicenter registry enrolling 3027 consecutive patients with acute symptomatic VTE in Japan between January 2010 and August 2014. We identified patients who underwent invasive procedures during the entire follow-up period and evaluated periprocedural managements and clinical outcomes at 30 days after invasive procedures. During a median follow-up period of 1213 (IQR: 847–1764) days, 518 patients underwent invasive procedures with the cumulative incidences of 5.8% at 3 months, 11.1% at 1 year, and 24.0% at 5 years. Among 382 patients in high bleeding-risk category of invasive procedures, anticoagulation therapy had been discontinued already in 62 patients (16%) and interrupted temporarily in 288 patients (75%) during the invasive procedures with bridging anticoagulation therapy with heparin in 214 patients (56%). Among 80 patients in low bleeding-risk category, anticoagulation therapy had been already discontinued in 15 patients (19%) and interrupted temporarily in 31 patients (39%) during invasive procedure with bridging anticoagulation therapy with heparin in 17 patients (21%). At 30 days after the invasive procedures, 14 patients (2.7%) experienced recurrent VTE, while 28 patients (5.4%) had major bleeding. This study elucidated the real-world features of peri-procedural management and prognosis in patients with VTE who underwent invasive procedures during follow-up in the large multicenter VTE registry. The 30-day incidence rates of recurrent VTE and major bleeding events were 2.7% and 5.4%.
- Published
- 2021
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