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There is a paucity of data on the influence of low body weight on clinical outcomes in patients with acute venous thromboembolism (VTE). The COMMAND VTE registry is a multicenter cohort study enrolling 3027 consecutive patients with acute symptomatic VTE. The current study population consisted of 2778 patients with available body weight value, who were divided into 2 groups; 1705 patients with lower body weight (≤60 kg) and 1073 patients with higher body weight (>60 kg). Patients with lower body weight were older (70.8 versus 60.9 years, P < 0.001), and more often women (75% versus 38%, P < 0.001), and more often had active cancer (27% versus 19%, P < 0.001) than those with higher body weight. The cumulative 5-year incidence of recurrent VTE was not significantly different between the 2 groups (10.6% versus 10.7%, P = 0.51). The cumulative 5-year incidences of major bleeding and all-cause death were significantly higher in patients with lower body weight than in those with higher body weight (14.6% versus 9.6%, P < 0.001, and 35.8% versus 19.8%, P < 0.001, respectively). The excess adjusted risk of patients with lower body weight relative to those with higher body weight remained significant for major bleeding and all-cause death (HR 1.57, 95%CI: 1.16–2.12, P = 0.003, and HR 1.50, 95%CI: 1.24–1.81, P < 0.001, respectively). In the current Japanese real-world registry, there were a high proportion of patients with low body weight, who had a higher risk for major bleeding and mortality without significant excess risk for recurrent VTE. • Patients with low body weight less than 60 kg was common in Japan. • Lower body weight showed a higher risk for major bleeding and all-cause death. • Lower body weight had similar long-term risk for recurrence as higher body weight. [ABSTRACT FROM AUTHOR]

Background: Due to concern about bleeding complications, a maintenance dose of prasugrel 2.5 mg may be used in elderly or low-body-weight patients in Japan. There is little information, however, on the efficacy and safety of a 2.5-mg maintenance dose of prasugrel., Methods and results: In this single-center, prospective, open-label, cross-over study, a total of 44 elderly (≥75 years old) or low body-weight (<50 kg) Japanese patients >1 month after percutaneous coronary intervention who were treated with aspirin 81-100 mg and clopidogrel 75 mg were randomized to either prasugrel 2.5 mg or 3.75 mg instead of clopidogrel for 14 days, with a cross-over directly to the alternate treatment for another 14 days. Platelet inhibition was assessed with the VerifyNow assay (Accumetrics, San Diego, CA, USA) at 3 time points: baseline; day 14; and day 28. P2Y12 reaction units (PRU) ≤95 was defined as low on-treatment platelet reactivity (LPR), and PRU ≥262 as high on-treatment platelet reactivity (HPR). The prevalence of LPR was 2.2% in patients treated with clopidogrel, 2.2% in those with prasugrel 2.5 mg, and 22.7% in those with prasugrel 3.75 mg (P<0.001). Clopidogrel resulted in the higher prevalence of HPR compared with 2.5-mg and 3.75-mg prasugrel (40.9% vs. 18.2% vs. 6.8%, P<0.001)., Conclusions: Prasugrel 2.5 mg may be more appropriate in elderly or lower-body-weight Japanese patients.

Background: It is unknown whether low serum pepsinogen I and pepsinogen I/II ratio (PGI-PGI/II), a marker for chronic atrophic gastritis, is associated with low or high body weight., Methods: We investigated the association between low PGI-PGI/II and both ends of the spectrum of body mass index (BMI) in 819 apparently healthy Japanese men aged 20-75 years who received a medical check-up in 2008., Results: In univariate analysis, serum pepsinogen I, but not pepsinogen II or pepsinogen I/II, was significantly reduced across the increasing BMI categories. Multivariate regression analysis showed that, compared with BMI 21.0-22.9 kg/m(2), BMI of 20.9 kg/m(2) and less or 25.0 kg/m(2) and above was significantly associated with low PGI-PGI/II (pepsinogen I<50 ng/ml combined with PG I/II<3.0), even after adjustment for relevant confounders. These associations showed a J-shaped curve against BMI., Conclusion: Low PGI-PGI/II may be independently associated with both low body weight and obesity in Japanese men., (© 2013.)