Journal of atherosclerosis and thrombosis最新文献

{"title":"Regional Disparities in Incidence, Therapeutic Approaches, and In-hospital Mortality of Critical Limb Ischemia in Japan.","authors":"Manabu Nitta, Kiwamu Iwata, Makoto Kaneko, Kiyohide Fushimi, Shinichiro Ueda, Sayuri Shimizu","doi":"10.5551/jat.65621","DOIUrl":"https://doi.org/10.5551/jat.65621","url":null,"abstract":"<p><strong>Aim: </strong>This study investigated regional disparities in the incidence, management, and in-hospital outcomes of critical limb ischemia (CLI) in Japan to inform standardized care practices.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the nationwide Diagnosis Procedure Combination database, including patients ≥ 18 years old who were discharged from acute-care hospitals between April 2018 and March 2020. Patients with CLI were identified using ICD-10 codes and restricted to those undergoing invasive treatments including endovascular therapy (EVT), bypass surgery, or amputation. Regional differences in patient demographics, in-hospital management, and outcomes were analyzed across seven regions in Japan.</p><p><strong>Results: </strong>In total, 19,699 records were identified. CLI admissions per million population were highest in the Kyushu region (112.1) and lowest in the Kanto region (59.9). The proportion of patients with a body mass index (BMI) ＜18.5 kg/m² ranged from 17.8% (Kanto) to 23.9% (Kansai), while the proportion with a BMI ≥ 30.0 kg/m² ranged from 3.3% (Kyushu) to 8.2% (Okinawa). The proportion of patients requiring dialysis ranged from 33.8% in the Chugoku-Shikoku region to 38.2% in the Okinawa region (P = 0.005). Anti-platelet agents were prescribed to 82.1% of patients with CLI, whereas statins were prescribed to 36.1% of patients. The EVT rates varied from 67.6% (Hokkaido-Tohoku) to 84.8% (Kansai) (P＜0.001), while the amputation rates varied from 22.2% (Kansai) to 33.4% (Chugoku-Shikoku) (P＜0.001). The in-hospital mortality rates varied from 5.7% (Chugoku-Shikoku) to 10.9% (Okinawa) (P = 0.001).</p><p><strong>Conclusions: </strong>This study revealed significant regional disparities in CLI incidence, management, and outcomes across Japan. These findings highlight the need for standardized, evidence-based care strategies that address regional disparities to improve outcomes for patients with CLI.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Per- and Polyfluoroalkyl Substances, Serum Lipidome, and Clinical Outcomes after Percutaneous Coronary Intervention in Type 2 Diabetic Patients: A Prospective Nested Case-control Study.","authors":"Dan Cai, Zi-Qi Fang, Ning-Hua Cui, Bing Wang, Mi-Jie Gao, Xue-Bin Wang","doi":"10.5551/jat.65708","DOIUrl":"https://doi.org/10.5551/jat.65708","url":null,"abstract":"<p><strong>Aim: </strong>Per- and polyfluoroalkyl substances (PFASs) are widespread environmental pollutants that were previously associated with dyslipidemia and type 2 diabetes mellitus (T2DM). We therefore investigated the association between PFAS exposure and clinical outcomes after percutaneous coronary intervention (PCI) in patients with T2DM and assessed the extent to which lipidomic alterations mediate this association.</p><p><strong>Methods: </strong>This case-control study was nested within a prospective cohort of patients with type 2 diabetes who underwent primary PCI for obstructive coronary artery disease between September 2017 and September 2019. During the 2-year follow-up after PCI, 150 matched pairs of patients with T2DM who did not experience major adverse cardiovascular and cerebrovascular events (MACCEs) were included. Serum PFASs and lipidomes were measured at baseline using liquid chromatography-mass spectrometry and analyzed using multipollutant models and integrative approaches.</p><p><strong>Results: </strong>Overall, a higher exposure to a mixture of nine PFASs was associated with an increased odds of two-year MACCEs after PCI, with perfluoroundecanoic acid and perfluorodecanoic acid contributing the most to the association. Integration with the serum lipidome generated a network of 110 PFAS-associated lipids with differential contributions to discriminating MACCEs, half of which were identified as significant mediators explaining 9.6%-56.4% of the PFAS-MACCE association. Furthermore, we estimated a cluster of patients with high probabilities of developing MACCEs after PCI, characterized by high PFAS levels; increased abundance of phosphatidylcholine, triacylglycerol, diacylglycerol, and acylcarnitine lipids; and decreased abundance of phosphatidylethanolamine and phosphatidylethanol lipids.</p><p><strong>Conclusion: </strong>With mediation by serum lipidomic perturbations, PFAS exposure contributes to poor outcomes after PCI in patients with T2DM.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poly (ADP-Ribose) Polymerase Inhibition Attenuates Atherosclerotic Plaque Development in ApoE-/- Mice with Hyperhomocysteinemia.","authors":"Jiang-Jiao Xie, Xian Yu, Yu-Hua Liao, Jian Chen, Rui Yao, Yong Chen, Meng-Yang Liao, Ying-Jun Ding, Ting-Ting Tang, Xiang Cheng","doi":"10.5551/jat.ER1586","DOIUrl":"https://doi.org/10.5551/jat.ER1586","url":null,"abstract":"","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phocaeicola dorei and Phocaeicola vulgatus Protect against Atherosclerosis by Regulating Gut Immunity.","authors":"Hitomi Nakashima, Ryohei Shinohara, Takuo Emoto, Yoshihiro Saito, Naofumi Yoshida, Ken-Ichi Hirata, Takumi Murakami, Hiroshi Mori, Atsushi Toyoda, Tomomi Sugiyama, Takuji Yamada, Tomoya Yamashita","doi":"10.5551/jat.65460","DOIUrl":"https://doi.org/10.5551/jat.65460","url":null,"abstract":"<p><strong>Aim: </strong>Arteriosclerosis is a condition that leads to coronary artery disease (CAD) and stroke. Basic and clinical studies have suggested a link between the gut microbiota and various diseases, including atherosclerosis. Therefore, we focused on gut microbiota and aimed to develop a probiotic-based treatment for atherosclerosis.</p><p><strong>Method: </strong>From 6 to 14 weeks of age, apoE-deficient mice, a mouse model of atherosclerosis, were orally administered with Phocaeicola dorei and Phocaeicola vulgatus or saline five times/week. The diet was changed to a western diet at eight weeks of age. Finally, the mice were sacrificed at 14 weeks of age, and the atherosclerotic lesion area was evaluated.</p><p><strong>Result: </strong>Previous studies have shown that atherosclerosis is suppressed by the administration of live type strains (TS) of P. dorei and P. vulgatus in apoE-deficient mice. In this study, we isolated P. vulgatus AF299, which highly expresses commensal colonization factors. Oral administration of P. dorei TS and AF299 to model mice further suppressed atherosclerosis compared to the administration of P. dorei TS and P. vulgatus TS. Genetic analysis of lesion tissues showed that the expression levels of genes associated with inflammatory responses were significantly reduced in mice treated with P. dorei TS and AF299. Moreover, gene expression related to immune response and IgA secretion was increased in the ileum.</p><p><strong>Conclusion: </strong>Our results suggest that the bacteria-induced immune response in the gut leads to the suppression of the inflammatory response in atherosclerotic lesions. These results indicate the potential for the development of prophylactic drugs for atherosclerosis.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undiagnosed Coronary Artery Disease in Hemodialysis-Initiating Patients.","authors":"Hirohito Sugawara, Kiryu Yoshida, Hiroya Shigematsu, Yuki Mimura, Takafumi Fujita, Yoshinori Saito, Masanori Kato, Masahiro Yamamoto, Hidetoshi Ito, Suguru Shimazu, Masahiko Ochiai, Hiroaki Ogata","doi":"10.5551/jat.65670","DOIUrl":"https://doi.org/10.5551/jat.65670","url":null,"abstract":"<p><strong>Aims: </strong>To present an update on undiagnosed coronary artery disease (CAD) in patients starting hemodialysis at a Japanese hospital, with a focus on CAD prevalence, risk factors, and coronary lesions' distribution in this population.</p><p><strong>Methods: </strong>A cross-sectional, retrospective study of patients who began hemodialysis due to end-stage renal disease (ESRD) in a Japanese hospital between January 2009 and December 2023 and underwent coronary computed tomography (CCT) was carried out. Coronary artery disease was screened using CCT immediately after the initiation of hemodialysis and then confirmed by CCT/coronary angiography (CAG). Based on these evaluations, patients were divided into CAD and non-CAD groups, and their demographic and clinical characteristics were compared. Logistic regression analysis was performed to detect factors associated with CAD. Additionally, variations in CAD prevalence and coronary artery calcification scores (CACS) over time were assessed considering 3-year intervals.</p><p><strong>Results: </strong>Data from 272 patients were included. CAD was observed in nearly half (47%) of them. Lesions were mainly observed in the left anterior descending artery (73%). The prevalence of a coronary artery calcification score of ＞65 notoriously increased from 2012-2014 to 2015-2017 and thereafter stabilized, while the proportion of patients diagnosed with CAD tended to decrease overall. Multiple regression analysis indicated that only a history of smoking, statin use, low albumin levels, and low HDL-C levels were independently and significantly associated with CAD occurrence in these ESRD patients.</p><p><strong>Conclusions: </strong>Many well-known CAD risk factors in the general population were not predictors of undiagnosed CAD in our target population.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and Physical Activity in PAD: Addressing the Missing Link.","authors":"Takanori Yasu","doi":"10.5551/jat.ED286","DOIUrl":"https://doi.org/10.5551/jat.ED286","url":null,"abstract":"","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Serum Levels of Interleukin-6 and Stroke, Cardiovascular Events, and Alzheimer's Disease Dementia.","authors":"Kazuo Kitagawa, Sono Toi, Hiroshi Yoshizawa, Yasuto Sato, Kenichi Todo","doi":"10.5551/jat.65763","DOIUrl":"https://doi.org/10.5551/jat.65763","url":null,"abstract":"<p><strong>Aims: </strong>The blood inflammatory marker interleukin 6 (IL-6) has been shown to predict future stroke, major adverse cardiovascular events (MACEs), and dementia. However, no study has yet examined this relationship in the same population. The present study compared the predictive utility of IL-6 levels in stroke, MACEs, and Alzheimer's disease (AD) dementia.</p><p><strong>Methods: </strong>In this post-hoc analysis, we derived data from a Japanese observational registry in which 1011 patients with evidence of cerebral vessel disease were enrolled. After excluding patients who required assistance with daily tasks, were suspected of having dementia, and lacked IL-6 measurement, 471 patients were included. The patients were followed up until March 2023. The outcomes were incident stroke, MACEs, and AD dementia.</p><p><strong>Results: </strong>During a median follow-up period of 4.6 years, stroke, MACEs, and AD dementia occurred in 24, 36, and 21 patients, respectively. Serum IL-6 levels are associated with age, sex, and vascular factors. A Cox proportional hazard analysis revealed that the highest IL-6 tertile (≥ 2.5 pg/mL) was associated with a significantly higher risk of stroke and MACEs than the lowest IL-6 tertile after adjusting for confounding factors (stroke, adjusted hazard ratio 4.84 [95% confidence interval, 1.02-23.05], P = 0.048; MACEs, adjusted hazard ratio 3.68 [95% confidence interval, 1.01-13.51], P = 0.049). However, no association was found between IL-6 tertile groups and AD dementia.</p><p><strong>Conclusion: </strong>Serum IL-6 levels predicted stroke and cardiovascular events but not AD dementia in patients with vascular risk factors. The involvement of low-grade systemic inflammation appears to be significantly greater in atherothrombotic events than that in AD dementia.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for Familial Hypercholesterolemia in Children and its Cost-Effectiveness.","authors":"Keiko Nagahara","doi":"10.5551/jat.ED285","DOIUrl":"https://doi.org/10.5551/jat.ED285","url":null,"abstract":"","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANGPTL3: A Breakthrough Target in Treatment for Dyslipidemia and Atherosclerosis.","authors":"Hirotaka Fukami, Yuichi Oike","doi":"10.5551/jat.RV22038","DOIUrl":"https://doi.org/10.5551/jat.RV22038","url":null,"abstract":"<p><p>Dyslipidemia is a major risk factor for atherosclerosis and subsequent cardiovascular disease (CVD). Despite conventional treatment with statins, ezetimibe, or PCSK9 inhibitors, there are cases of familial hypercholesterolemia (FH) in which LDL-C levels cannot be sufficiently lowered to the target level, resulting in failure to prevent CVD. Inhibition of Angiopoietin-like protein 3 (ANGPTL3) has emerged as a new therapeutic strategy to reduce LDL-C levels independent of the LDL receptor function. Since ANGPTL3 suppresses lipoprotein lipase (LDL) and endothelial lipase (EL) activities, its inhibition facilitates the clearance of very low-density lipoprotein cholesterol, decreasing both LDL-C and triglyceride (TG) levels. In fact, evinacumab, an anti-ANGPTL3 monoclonal antibody, has been shown to substantially reduce LDL-C and TG levels, even in FH patients with LDL receptor gene mutations who are resistant to the conventional treatments described above. Clinical trials have also shown that siRNA therapeutics, such as zodasiran and solbinsiran, improve lipid profiles in patients with dyslipidemia. Recently, we have begun developing a peptide-based anti-ANGPTL3 vaccine and confirmed in a preclinical FH mouse model that it significantly decreases LDL-C and TG levels, reduces atherosclerotic lesions and maintains long-term efficacy without adverse effects. In this review, we discuss the promising advances in ANGPTL3-targeted therapeutics that may overcome treatment-resistant dyslipidemia and reduce CVD risk in high-risk populations.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Limitations of Intravenous rt-PA Therapy in Patients with Mild Cerebral Infarction.","authors":"Ichiro Deguchi, Shinichi Takahashi, Satoshi Suda","doi":"10.5551/jat.RV22034","DOIUrl":"10.5551/jat.RV22034","url":null,"abstract":"<p><p>Recombinant tissue plasminogen activator (rt-PA), specifically alteplase, remains the standard treatment for acute cerebral infarction across all stroke subtypes. However, per recent randomized controlled trials (RCTs), individuals with mild cerebral infarction, medical management alone without rt-PA can yield functional outcomes comparable to those achieved with thrombolytic therapy. This has sparked ongoing debate regarding the necessity of rt-PA administration in cases of mild stroke. Nonetheless, certain individuals with mild cerebral infarction derive clear benefits from rt-PA therapy. Therefore, an individualized treatment approach should be prioritized over a uniform thrombolytic strategy in these cases. This review examines the therapeutic efficacy and limitations of rt-PA therapy for mild cerebral infarction, integrating evidence from prior clinical studies with the authors' perspectives.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"661-669"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}