Publications by authors named "Hiroshi Ito"

1,277 Publications

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Global transcriptional and circadian regulation in a halotolerant cyanobacterium Halothece sp. PCC7418.

Sci Rep 2022 Aug 12;12(1):13190. Epub 2022 Aug 12.

Department of Chemistry, Faculty of Science and Technology, Meijo University, 1-501 Shiogamaguchi, Tenpaku-ku, Nagoya, Aichi, 468-8502, Japan.

Substantial evidence has been accumulated about the molecular basis underlying halotolerance; however, insights into the regulatory networks for relevant genes and mechanisms of their interplay remain elusive. Here, we present a comprehensive transcriptome investigation, using RNA sequencing, of specific metabolic pathways and networks in a halotolerant cyanobacterium, Halothece sp. PCC7418, including the circadian rhythm profile. Dissecting the transcriptome presented the intracellular regulation of gene expressions, which was linked with ion homeostasis, protein homeostasis, biosynthesis of compatible solutes, and signal transduction, for adaptations to high-salinity environments. The efficient production and distribution of energy were also implicated in this acclimation process. Furthermore, we found that high-salinity environments had a dramatic effect on the global transcriptional expression regulated by the circadian clock. Our findings can provide a comprehensive transcriptome for elucidating the molecular mechanisms underlying halotolerance in cyanobacteria.
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http://dx.doi.org/10.1038/s41598-022-17406-6DOI Listing
August 2022

Two cases of pancreaticoduodenal aneurysm with median arcuate ligament syndrome treated with coil embolization and median arcuate ligament incision.

Radiol Case Rep 2022 Oct 1;17(10):3663-3668. Epub 2022 Aug 1.

Department of Radiology and Nuclear Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan.

Median arcuate ligament syndrome is a clinical condition in which the median arcuate ligament causes compression and narrowing of the celiac artery. It has been reported that collateral pathways, which is developed by the decrease of blood flow from the celiac artery, facilitates the formation of aneurysms. Aneurysms around the pancreas in particular require aggressive therapeutic intervention, because a rupture can be fatal. We herein report two cases of pancreaticoduodenal aneurysms associated with median arcuate ligament syndrome treated by coil embolization and median arcuate ligament incision. Case 1 required a hybrid procedure in which median arcuate ligament incision and coil embolization were performed simultaneously. In Case 2, the median arcuate ligament incision was performed about 3 months after emergency endovascular hemostasis for hemorrhagic duodenal ulcer. In both cases, there were no major postoperative complications and no recurrence of aneurysm. Median arcuate ligament incision may be effective to prevent organ ischemia and aneurysm recurrence after coil embolization of intra-abdominal aneurysms associated with median arcuate ligament syndrome.
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http://dx.doi.org/10.1016/j.radcr.2022.07.048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9352807PMC
October 2022

Pitfalls for blood culture diagnostic stewardship.

Authors:
Hiroshi Ito

Eur J Intern Med 2022 Aug 1. Epub 2022 Aug 1.

Division of Hospital Medicine, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, Japan. Electronic address:

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http://dx.doi.org/10.1016/j.ejim.2022.07.021DOI Listing
August 2022

The Fibrosis-4 Index Predicts Cardiovascular Prognosis in Patients With Severe Isolated Tricuspid Regurgitation.

Circ J 2022 Aug 4. Epub 2022 Aug 4.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

Background: The fibrosis-4 (FIB-4) index is used to evaluate liver disease patients. It can also be used to evaluate the prognosis for heart disease patients; however, its ability to determine the prognosis of severe isolated tricuspid regurgitation (TR) patients is unclear. This study aimed to clarify the association between FIB-4 index scores and the cardiovascular prognosis for severe isolated TR patients.Methods and Results: This was a dual-center, retrospective study. From 2011 to 2019, 111 consecutive outpatients with severe isolated TR (mean age, 68.6 years; 53.2% male) were evaluated. Major adverse cardiovascular events (MACEs) were defined as the composite of cardiovascular death, hospitalization for heart failure, myocardial infarction, and stroke. The association between FIB-4 index scores and echocardiography was also evaluated. During a median follow up of 3.0 years, 24 patients were lost to follow up and 40 MACEs occurred. Baseline FIB-4 index scores for patients with MACEs were significantly higher than those for patients without MACEs. A multivariate analysis revealed that FIB-4 index scores are significantly associated with MACEs (hazard ratio, 1.89; 95% confidence interval, 1.01-3.54; P=0.046). A linear regression analysis indicated that FIB-4 index scores were correlated with echocardiographic parameters, including the left atrial volume index and left ventricular end-diastolic diameter.

Conclusions: The FIB-4 index score may be a useful predictor of MACEs for patients with severe isolated TR.
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http://dx.doi.org/10.1253/circj.CJ-22-0109DOI Listing
August 2022

Klebsiella meningitis: Several issues to be discussed.

Authors:
Hiroshi Ito

Infect Dis Now 2022 Jul 30. Epub 2022 Jul 30.

Division of Hospital Medicine, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan. Electronic address:

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http://dx.doi.org/10.1016/j.idnow.2022.07.003DOI Listing
July 2022

Ablation for unmappable ventricular tachycardia in a patient with complete transposition of the great arteries who underwent Rastelli repair.

J Cardiol Cases 2022 Apr 23;25(4):218-224. Epub 2021 Oct 23.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

Catheter ablation (CA) of ventricular tachycardia (VT) after repair of congenital heart disease may be difficult because of complex anatomy and sometimes unmappable VT. Here, we report a 41-year-old woman with successful CA of unmappable VT in a patient with complete transposition of the great arteries after Rastelli repair. Clinical VT was induced by programmed electrical stimulation, when the mapping catheter was placed at the high anterior right ventricular outflow tract (RVOT). During VT, the local potential at the high anterior RVOT under the right ventricle (RV) - pulmonary artery (PA) conduit was equal to that at the timing of onset of QRS. The VT was unmappable because the hemodynamics deteriorated. Pace mapping was also tried at the aortic cusp and the left ventricular outflow tract (LVOT). Fractionated potential during sinus rhythm was observed at the noncoronary cusp, and the paced QRS morphology at this site was similar to that of the clinical VT, with a delay of 55 ms from pacing to the onset of QRS. However, mapping at the LVOT was impossible due to the difficulty of catheter manipulation. Radiofrequency energy was successfully applied at the noncoronary cusp and the high anterior RVOT under the RV-PA conduit. < This report is a rare case of successful catheter ablation of unmappable ventricular tachycardia (VT) in a patient with complete transposition of the great arteries after Rastelli repair. The VT was unmappable because of intolerable hemodynamics. However, we could speculate the exit or isthmus of the VT by pace mapping or local potential and eliminate the VT.>.
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http://dx.doi.org/10.1016/j.jccase.2021.09.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326013PMC
April 2022

High platelet reactivity is a predictor of left ventricular remodelling in patients with acute myocardial infarction.

ESC Heart Fail 2022 Jul 31. Epub 2022 Jul 31.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Aims: Acute myocardial infarction (AMI) is associated with left ventricular remodelling (LVR), which leads to progressive heart failure. Platelets play a pivotal role in promoting systemic and cardiac inflammatory responses during the complex process of myocardial wound healing or repair following AMI. This study aimed to investigate the impact of platelet reactivity immediately after primary percutaneous coronary intervention (PCI) on LVR in AMI patients with ST-segment (STEMI) and non-ST-segment elevation (NSTEMI).

Methods And Results: This prospective, single-centre, observational study included 182 patients with AMI who underwent primary PCI (107 patient with STEMI and 75 patients with NSTEMI). Patients were administered a loading dose of aspirin plus prasugrel before the procedure, and platelet reactivity was assessed using the VerifyNow P2Y12 assay immediately after PCI. Echocardiography was performed before discharge and during the chronic phase (8 ± 3 months after discharge). LVR was defined as a relative ≥20% increase in left ventricular end-diastolic volume index (LVEDVI). LVR in chronic phase was found in 34 patients (18.7%) whose platelet reactivity was significantly higher than those without LVR (259.6 ± 61.5 and 213.1 ± 74.8 P2Y12 reaction units [PRU]; P = 0.001). The occurrence of LVR did not differ between patients with STEMI and patients with NSTEMI (21.5% and 14.7%; P = 0.33). The optimal cut-off value of platelet reactivity for discriminating LVR was ≥245 PRU. LVEDVI significantly decreased at chronic phase in patients without high platelet reactivity (<245 PRU) (from 49.2 ± 13.5 to 45.4 ± 15.8 mL/m ; P = 0.02), but not in patients with high platelet reactivity (≥d245 PRU) (P = 0.06). Multivariate logistic analysis showed that high platelet reactivity was an independent predictor of LVR after adjusting for LVEDVI before discharge (odds ratio, 4.13; 95% confidence interval, 1.85-9.79).

Conclusions: High platelet reactivity measured immediately after PCI was a predictor of LVR in patients with AMI during the chronic phase. The role of antiplatelet therapy on inflammation in the myocardium is a promising area for further research.
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http://dx.doi.org/10.1002/ehf2.14100DOI Listing
July 2022

Measurement of Striatal Dopamine Release Induced by Neuropsychological Stimulation in Positron Emission Tomography With Dual Injections of [C]Raclopride.

Front Psychiatry 2022 12;13:811136. Epub 2022 Jul 12.

Department of Functional Brain Imaging, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan.

Objectives: Positron emission tomography (PET) with [C]raclopride has been applied to measure changes in the concentration of endogenous dopamine induced by pharmacological challenge or neuropsychological stimulation by evaluating the binding potential (BP) between the baseline and activated state. Recently, to reliably estimate BP in the activated state, a new approach with dual-bolus injections in a single PET scan was developed. In this study, we investigated the feasibility of applying this dual-bolus injection approach to measure changes in endogenous dopamine levels induced by cognitive tasks in humans.

Methods: First, the reproducibility of BP estimation using the dual-bolus injection approach was evaluated using PET scans without stimulation in nine healthy volunteers. A 90-min scan was performed with bolus injections of [C]raclopride administered at the beginning of the scan and 45 min after the first injection. BPs in the striatum for the first injection (BP) and second injection (BP) were estimated using an extended simplified reference tissue model, and the mean absolute difference (MAD) between the two BPs was calculated. The MAD was also compared with the conventional bolus-plus-continuous infusion approach. Next, PET studies with a cognitive reinforcement learning task were performed on 10 healthy volunteers using the dual-bolus injection approach. The BP at baseline and BP at the activated state were estimated, and the reduction in BP was evaluated.

Results: In the PET scans without stimulation, the dual-bolus injection approach showed a smaller MAD (<2%) between BP and BP than the bolus-plus-continuous infusion approach, demonstrating good reproducibility of this approach. In the PET scans with the cognitive task performance, the reduction in BP was not observed in the striatum by either approach, showing that the changes in dopamine level induced by the cognitive tasks performed in this study were not sufficient to be detected by PET.

Conclusion: Our results indicate that the cognitive task-induced changes in dopamine-related systems may be complex and difficult to measure accurately using PET scans. However, the proposed dual-bolus injection approach provided reliable BP estimates with high reproducibility, suggesting that it has the potential to improve the accuracy of PET scans for measuring changes in dopamine concentrations.
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http://dx.doi.org/10.3389/fpsyt.2022.811136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314751PMC
July 2022

Effect of Novel Stratified Lipid Risk by "LDL-Window" and Flow-Mediated Dilation on the Prognosis of Coronary Artery Disease Using the FMD-J Study A Data.

Circ J 2022 Jul 23. Epub 2022 Jul 23.

Department of Cardiology, Tokyo Medical University.

Background: Elevated levels of triglyceride (TG) and non-high-density lipoprotein cholesterol (non-HDL-C) are regarded as a residual lipid risk in low-density lipoprotein cholesterol (LDL-C)-lowering therapy. This study investigated the association between lipid risk stratified by TG and non-HDL-C and the prognosis of patients with coronary artery disease (CAD), and the association between stratified lipid risk and flow-mediated dilatation (FMD) index.Methods and Results: The 624 CAD patients enrolled in flow-mediated dilation (FMD)-J study A were divided into 4 groups: low-risk group (n=413) with TG <150 mg/dL and non-HDL-C <170 mg/dL; hyper-TG group (n=180) with TG ≥150 mg/dL and non-HDL-C <170 mg/dL; hyper-non-HDL group (n=12) with TG <150 mg/dL and non-HDL-C ≥170 mg/dL; and high-risk group (n=19) with TG ≥150 mg/dL and non-HDL-C ≥170 mg/dL. Comparison of the groups showed the cumulative incidence of a 3-point major adverse cardiovascular event (MACE) was different and highest in the high-risk group in all the patients (P=0.009), and in patients with a FMD index ≥7.0% (P=0.021), but not in those with a FMD index <7.0%. Multivariable regression analysis showed that high lipid risk (P=0.019) and FMD <7.0% (P=0.040) were independently correlated with the incidence of a 3-point MACE.

Conclusions: Novel stratification of lipid risk, simply using TG and non-HDL-C levels, combined with FMD measurement, is useful for predicting cardiovascular outcomes in patients with CAD.
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http://dx.doi.org/10.1253/circj.CJ-21-1068DOI Listing
July 2022

Association between high oxidized high-density lipoprotein levels and increased pericoronary inflammation determined by coronary computed tomography angiography.

J Cardiol 2022 Jul 16. Epub 2022 Jul 16.

Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

Background: Impaired high-density lipoprotein (HDL) function is a risk factor for cardiac mortality. We aimed to investigate the association between oxidized HDL (oxHDL) and pericoronary adipose tissue (PCAT) attenuation, a novel imaging biomarker of pericoronary inflammation, by using coronary computed tomography angiography (CTA).

Methods: A total of 287 outpatients with suspected coronary artery disease who had undergone both oxHDL measurement and coronary CTA were examined. PCAT attenuation values were assessed at the proximal 10-50 mm segments of the right coronary artery on coronary CTA. The presence of significant stenosis (luminal narrowing of >50 %) and high-risk plaque characteristics were also evaluated. Patients were then classified into tertiles according to their oxHDL level: low (n = 95), moderate (n = 96), and high (n = 96) groups.

Results: PCAT attenuation in the high oxHDL group was significantly higher than that in other groups after adjusting for age and apolipoprotein-A-I. Multivariate linear regression analysis revealed that oxHDL was significantly associated with PCAT attenuation in the right coronary artery (β = 3.832, p < 0.001), whereas HDL cholesterol was not. Furthermore, subgroup analyses demonstrated that the association between oxHDL and PCAT attenuation remained significant in older patients (β = 6.367, p < 0.001) and in those with hypertension (β = 4.922, p < 0.011), dyslipidemia (β = 3.264, p = 0.010), diabetes mellitus (β = 4.284, p = 0.015), and significant stenosis (β = 3.075, p = 0.021).

Conclusions: High oxHDL levels were significantly associated with increased pericoronary inflammation, as assessed using coronary CTA. Our results may explain the association between impaired HDL function and the development of coronary atherosclerosis.
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http://dx.doi.org/10.1016/j.jjcc.2022.06.015DOI Listing
July 2022

Pemafibrate Prevents Rupture of Angiotensin II-Induced Abdominal Aortic Aneurysms.

Front Cardiovasc Med 2022 30;9:904215. Epub 2022 Jun 30.

Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

Background: Abdominal aortic aneurysm (AAA) is a life-threatening disease that lacks effective preventive therapies. This study aimed to evaluate the effect of pemafibrate, a selective peroxisome proliferator-activated receptor alpha (PPARα) agonist, on AAA formation and rupture.

Methods: Experimental AAA was induced by subcutaneous angiotensin II (AngII) infusion in mice for 4 weeks. Pemafibrate (0.1 mg/kg/day) was administered orally. Dihydroethidium staining was used to evaluate the reactive oxygen species (ROS).

Results: The size of the AngII-induced AAA did not differ between pemafibrate- and vehicle-treated groups. However, a decreased mortality rate due to AAA rupture was observed in pemafibrate-treated mice. Pemafibrate ameliorated AngII-induced ROS and reduced the mRNA expression of interleukin-6 and tumor necrosis factor-α in the aortic wall. Gelatin zymography analysis demonstrated significant inhibition of matrix metalloproteinase-2 activity by pemafibrate. AngII-induced ROS production in human vascular smooth muscle cells was inhibited by pre-treatment with pemafibrate and was accompanied by an increase in catalase activity. Small interfering RNA-mediated knockdown of catalase or PPARα significantly attenuated the anti-oxidative effect of pemafibrate.

Conclusion: Pemafibrate prevented AAA rupture in a murine model, concomitant with reduced ROS, inflammation, and extracellular matrix degradation in the aortic wall. The protective effect against AAA rupture was partly mediated by the anti-oxidative effect of catalase induced by pemafibrate in the smooth muscle cells.
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http://dx.doi.org/10.3389/fcvm.2022.904215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9280056PMC
June 2022

Incidence and Risk Factors for Hospital-acquired Cholecystitis.

J Hosp Infect 2022 Jul 10. Epub 2022 Jul 10.

Division of Hospital Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.

Background: Acute cholecystitis can occur both inside and outside hospital settings. However, little is known about the clinical characteristics of hospital-acquired cholecystitis (HAC).

Aim: The objective of our study is to investigate the clinical characteristics of HAC in a tertiary academic hospital.

Methods: This retrospective cohort study included hospitalized patients who were found to have gallstones without cholecystitis or cholangitis on admission between January 2018 and December 2021. We used multivariate logistic regression analysis to make comparisons between patients with and without HAC.

Findings: A total of 890 patients met the inclusion criteria and were evaluated in this study. Forty-one patients (4.6%) developed HAC during the study period. Multivariate logistic regression analysis showed that a history of cholecystitis or cholangitis, fasting at least one day, and gallstones in the gallbladder neck were independently associated with increased risk of HAC. HAC occurred most frequently after about several weeks of admission, and only four patients (9.8%) had bacteremia.

Conclusions: HAC was relatively common among hospitalized patients. Physicians should be aware of the possibility of HAC in symptomatic hospitalized patients with certain risk factors.
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http://dx.doi.org/10.1016/j.jhin.2022.07.003DOI Listing
July 2022

Bovine lactoferrin increases the poly(I:C)-induced antiviral response in vitro.

Biochem Cell Biol 2022 Jul 13. Epub 2022 Jul 13.

Ohu University School of Dentistry, 600775, Department of Preventive Dentistry, Koriyama, Fukushima, Japan;

Bovine lactoferrin (bLF) is a naturally occurring glycoprotein with antibacterial and antiviral activities. We evaluated whether bLF can prevent viral infections in the human intestinal epithelial cell line Caco-2. To assess antiviral responses, we measured the levels of interferon (IFN) expression, IFN-stimulated gene expression, and infection with a pseudotyped virus bearing either severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein or vesicular stomatitis virus (VSV)-G protein after treatment of cells with both bLF and polyinosinic-polycytidylic acid, an analog of double-stranded RNA that mimics viral infection. Combination treatment of cells with both bLF and polyinosinic-polycytidylic acid increased mRNA and protein expression of several IFN genes (IFNB, IFN L1, and IFNL2) and IFN-stimulated genes (ISG15, MX1, IFITM1, and IFITM3) in Caco-2 cells. However, treatment with bLF alone did not induce an antiviral response. Furthermore, combination treatment suppressed infection of the SARS-CoV-2 pseudotyped virus more efficiently than did bLF treatment alone, even though combination treatment increased mRNA expression of ACE2. These results indicate that bLF treatment increases the antiviral response that is associated with the double-stranded RNA-stimulated signaling pathway. Our results also suggest that bLF and double-stranded RNA analogs can be used to treat viral infection, including that by SARS-CoV-2.
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http://dx.doi.org/10.1139/bcb-2021-0342DOI Listing
July 2022

Differences in extracellular fluid volume between acute heart failure patients with and without high systolic blood pressure.

ESC Heart Fail 2022 Jul 13. Epub 2022 Jul 13.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Aims: Some reports have suggested that hypertensive acute heart failure (AHF) is caused by intravascular congestion, not interstitial congestion. We evaluated the differences in extracellular fluid volume assessed by bioelectrical impedance analysis (BIA) between AHF patients with and without high systolic blood pressure (sBP).

Methods: This prospective single-centre study (UMIN000030266) included 178 patients hospitalized due to AHF between September 2017 and August 2018. We calculated extracellular water (ECW), intracellular water (ICW), total body water (TBW), and ECW-to-TBW ratio (oedema index: EI) by BIA and evaluated conventional parameters as follows: weight, N-terminal pro brain natriuretic peptide values, and echocardiography parameters on admission and before discharge. One-year outcomes included all-cause death and re-admission due to heart failure. We compared patients with sBP > 140 mmHg on admission [clinical scenario 1 (CS1) group] and with sBP of ≤140 mmHg on admission (non-CS1 group).

Results: The mean age of the patients was 79.5 ± 11.1 years, and 48.9% of the patients were female. EI on admission of 83 patients in the CS1 group was lower than that of 95 patients in the non-CS1 group. The change in EI from admission to before discharge was no significant in the CS1 group but was significant in the non-CS1 group. Comparing the changes from admission to before discharge between the CS1 and the non-CS1 group, delta ECW, delta ICW, delta TBW, and delta EI of the CS1 group were significantly smaller than those of the non-CS1 group. During the 1-year follow-up period after discharge of the 178 patients, the numbers of deaths and re-admissions due to acute HF were 26 (15%) and 49 (28%), respectively. Patients with high EI before discharge [>0.408 (median)] had significantly more cardiac events than patients with low EI [hazard ratio (HR): 2.15, 95% confidence interval (CI): 1.30-3.55]. Cox regression analysis revealed that higher EI as a continuous variable was significantly associated with worse outcome in non-CS1 group (HR: 1.46, 95% CI: 1.13-1.87), but not significantly associated with worse outcome in CS1 group (HR: 1.29, 95% CI: 0.98-1.69).

Conclusions: EI on admission in patients with high sBP was not elevated, and changes in ECW, ICW, TBW, and EI in patients with high sBP were smaller than those in patients without high sBP. EI measured by BIA could distinguish AHF with interstitial or intravascular congestion.
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http://dx.doi.org/10.1002/ehf2.14067DOI Listing
July 2022

Rheological Behavior and Dynamic Mechanical Properties for Interpretation of Layer Adhesion in FDM 3D Printing.

Polymers (Basel) 2022 Jul 3;14(13). Epub 2022 Jul 3.

Research Center for GREEN Materials and Advanced Processing, Yamagata University, 4-3-16 Jonan, Yamagata 992-8510, Japan.

Commercial filaments of poly(lactic acid) (PLA) composites with particulate filler, carbon fiber, and copper powder with different contents were fabricated by FDM 3D printing in XZ-direction at bed temperatures of 45 °C and 60 °C. The effects of additives and bed temperatures on layer adhesion, fracture behavior, and mechanical performance of the PLA composites 3D printing were evaluated. Rheological properties informed viscous nature of all filaments and interface bonding in the PLA composites, which improved printability and dimensional stability of the 3D printing. Crystallinity of the PLA composites 3D printing increased with increasing bed temperature resulting in an improvement of storage modulus, tensile, and flexural properties. On the contrary, the ductility of the 3D printing was raised when printed at low bed temperature. Dynamic mechanical properties, the degree of entanglement, the adhesion factor, the effectiveness coefficient, the reinforcing efficiency factor, and the Cole-Cole analysis were used to understand the layer adhesion, and the interfacial interaction of the composites as compared to the compression molded sheets. SEM images revealed good adhesion between the additives and the PLA matrix. However, the additives induced faster solidification and showed larger voids in the 3D printing, which indicated lower layer adhesion as compared to neat PLA. It can be noted that the combination of the additives and the optimized 3D printing conditions would be obtain superior mechanical performance even layer adhesion has been restricted.
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http://dx.doi.org/10.3390/polym14132721DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9268954PMC
July 2022

Intermittent orthodromic capture of the earliest activation site during atrial pacing in a case with reentrant atrial tachycardia originating from the atrioventricular node vicinity.

J Arrhythm 2022 Jun 22;38(3):473-477. Epub 2022 Mar 22.

Department of Cardiovascular Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan.

Constant pacing (S1-S1: 520 ms) from the right atrial appendage (RAA) during reentrant atrial tachycardia originating from the atrioventricular node vicinity. RA-FW 1-2 was constantly captured antidromically. However, the earliest atrial activation site (EAAS = His1-2) was orthodromically (red circle) and antidromically (blue square) captured at a ratio of 3:1. The electrogram morphology at the EAAS was different between orthodromically and antidromically electrograms captured during pacing. Moreover, the interval between the S1 and orthodromically captured electrogram was gradually prolonged.
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http://dx.doi.org/10.1002/joa3.12702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9237296PMC
June 2022

Impact of direct oral anticoagulant use on mortality in very old patients with non-valvular atrial fibrillation.

Age Ageing 2022 Jul;51(7)

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, Okayama 700-8558, Japan.

Background: the efficacy and safety of direct oral anticoagulants (DOACs) compared with that of warfarin in very old patients with non-valvular atrial fibrillation (NVAF) have been reported in terms of thromboembolisms and bleeding. However, the association of DOAC use and mortality in such patients remains unclear.

Objectives: this study aimed to investigate the incidence of mortality, as well as thromboembolisms and major bleeding, in very old patients with NVAF using DOACs as compared with warfarin.

Methods: we conducted a single-centre historical cohort study of consecutive patients with NVAF aged ≥80 years who used oral anticoagulants. We compared the 5-year outcomes (all-cause mortality, thromboembolism, major bleeding and intracranial haemorrhage) between the DOAC and Warfarin groups.

Results: of 1,676 patients with atrial fibrillation aged 80 years and over, 1,208 with NVAF were included. Propensity score matching provided 461 patients in each group, and the risk of all-cause mortality, thromboembolisms, major bleeding and intracranial haemorrhages was significantly lower in the DOAC group than Warfarin group (hazard ratio [95% confidence interval] for DOAC use, 0.68 [0.54-0.87], 0.31 [0.19-0.53], 0.56 [0.36-0.88], 0.23 [0.10-0.56], log-rank P = 0.002, P < 0.001, P = 0.010, P < 0.001). The mortality rate within 1 year after major bleeding was significantly lower in the DOAC group than Warfarin group (14% versus 38%, P = 0.03), however, that after a thromboembolism was similar between the two groups (33% versus 35%).

Conclusion: patients with NVAF aged ≥80 years and using DOACs had a lower mortality than those using warfarin.
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http://dx.doi.org/10.1093/ageing/afac146DOI Listing
July 2022

Rhabdomyolysis secondary to carbon monoxide poisoning: A retrospective cohort study.

Am J Emerg Med 2022 Jun 25. Epub 2022 Jun 25.

Division of Hospital Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.

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http://dx.doi.org/10.1016/j.ajem.2022.06.051DOI Listing
June 2022

Passive mode-locking and terahertz frequency comb generation in resonant-tunneling-diode oscillator.

Nat Commun 2022 Jun 29;13(1):3740. Epub 2022 Jun 29.

Department of Physics, Graduate School of Science, Kyoto University, Kyoto, Sakyo-ku, 606-8502, Japan.

Optical frequency combs in the terahertz frequency range are long-awaited frequency standards for spectroscopy of molecules and high-speed wireless communications. However, a terahertz frequency comb based on a low-cost, energy-efficient, and room-temperature-operating device remains unavailable especially in the frequency range of 0.1 to 3 THz. In this paper, we show that the resonant-tunneling-diode (RTD) oscillator can be passively mode-locked by optical feedback and generate a terahertz frequency comb. The standard deviation of the spacing between the comb lines, i.e., the repetition frequency, is reduced to less than 420 mHz by applying external bias modulation. A simulation model successfully reproduces the mode-locking behavior by including the nonlinear capacitance of RTD and multiple optical feedback. Since the mode-locked RTD oscillator is a simple semiconductor device that operates at room temperature and covers the frequency range of 0.1 to 2 THz (potentially up to 3 THz), it can be used as a frequency standard for future terahertz sensing and wireless communications.
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http://dx.doi.org/10.1038/s41467-022-31071-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243027PMC
June 2022

Overview of the 86 Annual Scientific Meeting of the Japanese Circulation Society - Cardiology Spreading Its Wings.

Circ J 2022 07 29;86(8):1312-1318. Epub 2022 Jun 29.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.

The 86Annual Scientific Meeting of the Japanese Circulation Society was held in a web-based format on March 11-13, 2022. In accordance with the internationalization policy of the JCS, the meeting was held with the Asian Pacific Society of Cardiology Congress 2022. The main theme was "Cardiology Spreading its Wings". The number of patients with heart failure and other cardiovascular diseases is increasing dramatically, and the fields dealt with by cardiovascular medicine are also greatly expanding. This conference was both intellectually satisfying and exciting for all participants, who numbered over 14,900. The meeting was completed with great success, and the enormous amount of cooperation and support from all involved was greatly appreciated.
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http://dx.doi.org/10.1253/circj.CJ-22-0349DOI Listing
July 2022

Association between High Pericoronary Adipose Tissue Computed Tomography Attenuation and Impaired Flow-Mediated Dilation of the Brachial Artery.

J Atheroscler Thromb 2022 Jun 24. Epub 2022 Jun 24.

Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University.

Aims: Pericoronary adipose tissue (PCAT) attenuation on coronary computed tomography angiography (CTA) is a noninvasive biomarker for pericoronary inflammation and is associated with cardiac mortality. We aimed to investigate the association between PCAT attenuation and endothelial dysfunction assessed using flow-mediated dilation (FMD).

Methods: A total of 119 outpatients who underwent both coronary CTA and FMD measurements were examined. PCAT attenuation values were assessed at the proximal 40-mm segments of all three major coronary arteries on coronary CTA. Endothelial function was assessed using FMD. Patients were then classified into two groups: those with endothelial dysfunction (FMD <4%, n=44) and those without endothelial dysfunction (FMD ≥ 4%, n=75).

Results: In all three coronary arteries, PCAT attenuation was significantly higher in patients with endothelial dysfunction than in those without endothelial dysfunction. Multivariate logistic regression analysis revealed that PCAT attenuation in the right coronary artery (odds ratio [OR]=1.543; 95% confidence interval [CI]=1.004-2.369,p=0.048) and left anterior descending artery (OR=1.525, 95% CI=1.004-2.369, p=0.049) was an independent predictor of endothelial dysfunction. Subgroup analysis of patients with adverse CTA findings (significant stenosis and/or high-risk plaque) and those with coronary artery calcium score >100 showed that high PCAT attenuation in all three coronary arteries was a significant predictor of endothelial dysfunction.

Conclusion: High PCAT attenuation was significantly associated with FMD-assessed endothelial dysfunction in patients with suspected coronary artery disease. Our results suggest that endothelial dysfunction is one of the pathophysiological mechanisms linking pericoronary inflammation to cardiac mortality.
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http://dx.doi.org/10.5551/jat.63580DOI Listing
June 2022

Low incidence of restenosis after successful balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension.

Cardiovasc Interv Ther 2022 Jun 22. Epub 2022 Jun 22.

Department of Cardiology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.

Balloon pulmonary angioplasty (BPA) is now a treatment option for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). However, the incidence of restenosis and long-term changes in vessel diameters in pulmonary arteries after BPA are unknown. The present study investigated the incidence of restenosis by measuring changes in vessel diameter after BPA. We reviewed 58 patients (168 lesions) with CTEPH who underwent single dilation for the target lesion (type A/B/C lesions) during BPA procedure followed by selective pulmonary angiography more than 6 months after the final BPA procedure. The outcomes of BPA were assessed in terms of pulmonary artery diameters. In a median follow-up of 1.9 (1.2-2.7) years, restenosis occurred in only one case with a type C lesion after BPA (0.6%). In type A/B lesions, the minimal lumen diameter was significantly enlarged at follow-up after BPA [3.48 (2.59-4.34) to 4.22 (3.31-4.90) mm]. In type C lesions, the minimal lumen diameter was unchanged at follow-up after BPA [3.15 (1.96-3.64) to 3.28 (2.38-4.61) mm]. The present results revealed that restenosis after BPA rarely occurs in type A/B/C lesions. Minimal lumen diameters for type A/B lesions continually increased and those for type C lesions did not decrease. Stent implantation in type A/B/C lesions would be unnecessary after BPA.
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http://dx.doi.org/10.1007/s12928-022-00866-yDOI Listing
June 2022

Sepsis-Associated Encephalopathy: A Mini-Review of Inflammation in the Brain and Body.

Front Aging Neurosci 2022 27;14:912866. Epub 2022 May 27.

Department of Traumatology and Acute Critical Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.

Sepsis is defined as a life-threatening multi-organ dysfunction triggered by an uncontrolled host response to infectious disease. Systemic inflammation elicited by sepsis can cause acute cerebral dysfunction, characterized by delirium, coma, and cognitive dysfunction, known as septic encephalopathy. Recent evidence has reported the underlying mechanisms of sepsis. However, the reasons for the development of inflammation and degeneration in some brain regions and the persistence of neuroinflammation remain unclear. This mini-review describes the pathophysiology of region-specific inflammation after sepsis-associated encephalopathy (SAE), clinical features, and future prospects for SAE treatment. The hippocampus is highly susceptible to inflammation, and studies that perform treatments with antibodies to cytokine receptors, such as interleukin-1β, are in progress. Future development of clinically applicable therapies is expected.
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http://dx.doi.org/10.3389/fnagi.2022.912866DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9195626PMC
May 2022

Amphiphilic Polymers for Color Dispersion: Toward Stable and Low-Viscosity Inkjet Ink.

Langmuir 2022 Jun 9;38(24):7618-7627. Epub 2022 Jun 9.

Environment and Materials Development Department, Corporate Research and Development Division, Seiko Epson Corporation, 80 Harashinden, Hirooka, Shiojiri, Nagano 399-0785, Japan.

Amphiphilic random and block copolymers were synthesized as potential inkjet inks. This study evaluated the potential of these polymers for color dispersion by examining the following factors: surface tension, zeta potential, viscosity, and particle size. Acrylic acid and (ethoxyethoxy)ethyl acrylate were used as the hydrophilic molecular units. Styrene, butyl acrylate, and phenoxyethyl acrylate were used as hydrophobic units. Color dispersions were prepared by using organic dye and these amphiphilic polymers. The color dispersions containing random copolymers exhibited low viscosity, which is preferable for jetting, but the dye particles tended to sediment after the thermal aging test. In contrast, those containing block copolymers showed high viscosity, which was unsuitable for jetting. However, they retained their initial dispersion state after the aging test. The advantages and disadvantages of each monomer arrangement (random or block) were demonstrated, providing a future outlook on the molecular design of polymer dispersants for color dispersions.
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http://dx.doi.org/10.1021/acs.langmuir.2c01010DOI Listing
June 2022

Prognostic value of pericoronary adipose tissue attenuation in patients with non-alcoholic fatty liver disease with suspected coronary artery disease.

Heart Vessels 2022 Jun 7. Epub 2022 Jun 7.

Department of Cardiovascular Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.

Pericoronary adipose tissue (PCAT) attenuation on coronary computed tomography angiography (CTA) has been emerged as a marker of pericoronary inflammation. We aimed to investigate the prognostic value of PCAT attenuation in patients with non-alcoholic fatty liver disease (NAFLD). We enrolled 232 NAFLD patients with suspected coronary artery disease and underwent coronary CTA. NAFLD was defined by abdominal CT as the ratio of hepatic attenuation to spleen attenuation less than 1.0. PCAT attenuation values were assessed by the crude analysis of mean CT attenuation value of the left anterior descending artery (LAD) and right coronary artery (RCA). As coronary CTA findings, luminal stenosis and high-risk plaque features were examined. Primary outcome was the composite of cardiovascular (CV) death, nonfatal acute coronary syndrome, and hospitalization for heart failure. During a median follow-up of 4.9 years, 17 patients had CV events. LAD-PCAT attenuation in patients with CV events was higher than that without CV events (-66.9 ± 7.0 versus -70.5 ± 6.6; p = 0.032), while RCA-PCAT attenuation was not. LAD-PCAT attenuation and high-risk plaque features were independent predictors of CV events. The addition of LAD-PCAT attenuation to high-risk plaque features increased the C-statistics and global chi-square from 0.66 to 0.75 (p = 0.042) and 6.8 to 12.7 (p = 0.015), respectively. The net reclassification achieved by adding LAD-PCAT attenuation to high-risk plaque features was 0.494 (p = 0.041). High-LAD-PCAT attenuation was an independent predictor of CV events in NAFLD patients, regardless of CTA-verified high-risk plaque features. In addition, LAD-PCAT attenuation had an incremental prognostic value over high-risk plaque features.
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http://dx.doi.org/10.1007/s00380-022-02107-xDOI Listing
June 2022

Assessment of clinical conditions associated with Mondor disease.

Breast Dis 2022 ;41(1):273-278

Division of Hospital Medicine, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, Japan.

Background: Mondor disease is superficial thrombophlebitis of the thoracoabdominal wall, mid-upper arm, and penis. Although it is usually a benign disease requiring no specific treatment, little is known about this disease owing to its rarity.

Objective: The aim of this retrospective observational study was to investigate the epidemiology and prognosis of Mondor disease.

Methods: We conducted a single-center observational study of patients with Mondor disease. Patients who received a diagnosis of Mondor disease between 2015 and 2020 were analyzed. The patients' medical records were manually reviewed to obtain the following variables: date of diagnosis, patient's age, sex, department of diagnosing physicians, underlying diseases, medications, surgery, and time until resolution of the lesion. We also reviewed the 1-year mortality, 1-year occurrence of malignancy, and recurrence of Mondor disease.

Results: 20 patients were included in the study. The age of the patients ranged from 7 to 83 years, with a median of 47.5 years. Most of the patients presented with thoracoabdominal wall lesions. The underlying conditions included skin diseases, surgical procedures, breast cancer, smoking, and collagenous diseases, although more than half of the patients did not have plausible predisposing factors. About three-quarters of the patients saw a spontaneous resolution of the lesions within 4 weeks without medical or surgical treatments.

Conclusions: Considering the good prognosis of this disease, it is essential to avoid unnecessary invasive tests or treatment once the diagnosis is confirmed.
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http://dx.doi.org/10.3233/BD-210056DOI Listing
June 2022

Relating Amorphous Structure to the Tear Strength of Polylactic Acid Films.

Polymers (Basel) 2022 May 11;14(10). Epub 2022 May 11.

Research Center for GREEN Materials and Advanced Processing (GMAP), 4-3-16 Jonan, Yonezawa, Yamagata 992-8510, Japan.

Compared with polyolefins that are used as single-use plastics, polylactic acid (PLA) has a lower tear strength in films. The relationship between the tear strength and the higher-order structure of films was investigated using PLA films that absorbed moisture at 30 °C and 95% relative humidity (RH) or that had been annealed under reduced pressure conditions. Although the mobile amorphous (MAm) amount did not change under high humidity, the film became brittle due to enthalpy relaxation. The crystallization by annealing also caused embrittlement, and the MAm amount decreased to 10%. The displacement until tearing is lowered from 2.5 to 0.5 mm in both cases. However, in situ retardation measurements revealed that there was a significant difference in the fracture morphology of the torn tip. When crystallized, the molecular chains and crystals are oriented in the tensile direction of the film, and a fragmented structure is observed in the ligament. Embrittlement due to enthalpy relaxation caused a weak orientation perpendicular to the tensile direction of the film, and cracks occurs along with this orientation.
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http://dx.doi.org/10.3390/polym14101965DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145306PMC
May 2022

Quantification of Lung Perfusion Blood Volume in Dual-Energy Computed Tomography in Patients with Pulmonary Hypertension.

Life (Basel) 2022 May 5;12(5). Epub 2022 May 5.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan.

Dual-energy computed tomography (DECT) is a promising technique for the assessment of the lung perfused blood volume (LPBV) in the lung parenchyma. This study was performed to compare the LPBV by DECT of patients with pulmonary hypertension (PH) and controls and to evaluate the association between the LPBV and the perfusion ratio derived by lung perfusion scintigraphy. This study involved 45 patients who underwent DECT (25 patients with PH and 20 controls). We measured the total LPBV and distribution of the LPBV in each lung. The total LPBV was significantly lower in the PH group than the control group (38 ± 9 vs. 45 ± 8 HU, = 0.024). Significant differences were observed between the LPBV of the upper lung of the PH and control groups (34 ± 10 vs. 47 ± 10, = 0.021 and 37 ± 10 vs. 47 ± 8, < 0.001). A significant correlation was observed between the LPBV and the lung perfusion scintigraphy. A lower total LPBV and lower LPBV of the upper lung as detected by DECT might be specific findings of PH.
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http://dx.doi.org/10.3390/life12050684DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143856PMC
May 2022

Association of Oxidized Low-Density Lipoprotein in Nonalcoholic Fatty Liver Disease with High-Risk Plaque on Coronary Computed Tomography Angiography: A Matched Case-Control Study.

J Clin Med 2022 May 17;11(10). Epub 2022 May 17.

Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan.

Nonalcoholic fatty liver disease (NAFLD) is a risk factor for the development of atherosclerotic cardiovascular diseases (CVDs), and oxidative stress has been proposed as a shared pathophysiological condition. This study examined whether oxidized low-density lipoprotein (LDL) is involved in the underlying mechanism that links coronary atherosclerosis and NAFLD. This study included 631 patients who underwent coronary computed tomography angiography (CTA) for suspected coronary artery disease. NAFLD was defined on CT images as a liver-to-spleen attenuation ratio of <1.0. Serum-malondialdehyde-modified LDL (MDA-LDL) and coronary CTA findings were analyzed in a propensity-score-matched cohort of patients with NAFLD ( = 150) and those without NAFLD ( = 150). This study analyzed 300 patients (median age, 65 years; 64% men). Patients with NAFLD had higher MDA-LDL levels and a greater presence of CTA-verified high-risk plaques than those without NAFLD. In the multivariate linear regression analysis, MDA-LDL was independently associated with NAFLD (β = 11.337, = 0.005) and high-risk plaques (β = 12.487, = 0.007). Increased MDA-LDL may be a mediator between NAFLD and high-risk coronary plaque on coronary CTA. Increased oxidative stress in NAFLD, as assessed using MDA-LDL, may be involved in the development of CVDs.
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http://dx.doi.org/10.3390/jcm11102838DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144234PMC
May 2022

Effect of Early Initiation of Evolocumab on Lipoprotein(a) in Patients with Acute Myocardial Infarction: Sub-Analysis of a Randomized Controlled Trial.

J Cardiovasc Dev Dis 2022 May 12;9(5). Epub 2022 May 12.

Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.

Elevated circulating lipoprotein(a) levels are associated with an increased risk of cardiovascular events. We reported that early initiation of evolocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, in addition to a statin substantially reduced the lipoprotein(a) levels in patients with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI). This sub-analysis sought to investigate the effect of evolocumab on lipoprotein(a) based on baseline lipoprotein(a) levels and characteristics. This study was a prespecified analysis of a randomized controlled trial that enrolled 102 patients who underwent primary PCI for AMI. Patients received pitavastatin (2 mg/day) alone or pitavastatin and evolocumab 140 mg subcutaneously within 24 h and 2 weeks after the index PCI. The evolocumab group showed significantly suppressed lipoprotein(a) levels in patients with baseline lipoprotein(a) levels of ≤10 mg/dL, 10 < lipoprotein(a) ≤ 20 mg/dL, and >20 mg/dL compared with the control group, as well as similar reductions in lipoprotein(a) levels in all patient subgroups. Among these subgroups, evolocumab tended to show more favorable effects in patients with diabetes mellitus. In AMI patients, early initiation of evolocumab therapy within 24 h of primary PCI suppressed the increase in lipoprotein(a) levels within 4 weeks, regardless of baseline levels and characteristics.
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http://dx.doi.org/10.3390/jcdd9050153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144976PMC
May 2022
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