Circulation Journal最新文献

{"title":"Prognostic Value of the 6-Minute Walk Test in Patients With Severe Aortic Stenosis.","authors":"Norio Kanamori, Yasuaki Takeji, Tomohiko Taniguchi, Takeshi Morimoto, Shinichi Shirai, Kenji Ando, Hiroyuki Tabata, Takeshi Kitai, Nobuhisa Ohno, Ryosuke Murai, Kohei Osakada, Koichiro Murata, Masanao Nakai, Hiroshi Tsuneyoshi, Tomohisa Tada, Masashi Amano, Shin Watanabe, Hiroki Shiomi, Hirotoshi Watanabe, Yusuke Yoshikawa, Ryusuke Nishikawa, Yuki Obayashi, Ko Yamamoto, Mamoru Toyofuku, Shojiro Tatsushima, Makoto Miyake, Hiroyuki Nakayama, Kazuya Nagao, Masayasu Izuhara, Kenji Nakatsuma, Moriaki Inoko, Takanari Fujita, Masahiro Kimura, Mitsuru Ishii, Shunsuke Usami, Fumiko Nakazeki, Kiyonori Togi, Yasutaka Inuzuka, Tatsuhiko Komiya, Koh Ono, Takeshi Aoyama, Kenji Minatoya, Takeshi Kimura","doi":"10.1253/circj.CJ-25-0056","DOIUrl":"10.1253/circj.CJ-25-0056","url":null,"abstract":"<p><strong>Background: </strong>The prognostic significance of the 6-minute walk distance (6MWD) in patients with severe aortic stenosis (AS) has not been thoroughly investigated.</p><p><strong>Methods and results: </strong>This study evaluated 998 patients with severe AS who underwent a 6-min walk test as part of a large multicenter prospective cohort. Patients were categorized as either fast walkers (6MWD ≥300 m; n=515) or slow walkers (6MWD <300 m; n=483). During a median follow-up of 2.3 years, 861 (86.3%) patients underwent surgical or transcatheter aortic valve replacement (AVR; 87.0% of fast walkers vs. 85.5% of slow walkers). The cumulative 3-year incidence of death was significantly lower among fast walkers than slow walkers (10.9% vs. 31.7%; P<0.001). After adjusting for confounders, slow walkers had a significantly higher risk of all-cause mortality than fast walkers (hazard ratio 2.36; 95% confidence interval 1.55-3.58; P<0.001). Stratified analysis by initial treatment strategy revealed that the cumulative 3-year incidence of all-cause death was consistently lower among fast walkers than slow walkers (initial AVR strategy: 10.1% vs. 28.1% [P<0.001]; conservative strategy: 13.4% vs. 46.7% [P<0.001]). Among asymptomatic patients managed conservatively, fast walkers demonstrated a remarkably low cumulative 3-year incidence of all-cause death (8.1%).</p><p><strong>Conclusions: </strong>The 6MWD is a reliable prognostic marker for patients with severe AS, regardless of initial treatment strategy.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1566-1574"},"PeriodicalIF":3.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Oral Administration of Colchicine on Progression of Aortic Aneurysm in Mice.","authors":"Hideyuki Okawa, Aika Yamawaki-Ogata, Yuji Narita, Masato Mutsuga","doi":"10.1253/circj.CJ-24-0854","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0854","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis of aortic aneurysm (AA) is characterized by chronic inflammation of the aortic wall, the associated accumulation of macrophages, and degradation of the extracellular matrix, including elastin. Colchicine (COL) has long been known for its anti-inflammatory effects, so in this study we investigated its effects on AA.</p><p><strong>Methods and results: </strong>In vitro, tumor necrosis factor (TNF)-α-stimulated macrophages and vascular smooth muscle cells (VSMCs) were treated with and without COL for 24 h. Unstimulated cells were used as controls. COL significantly reduced interleukin (IL)-1β, TNF-α, monocyte chemotactic protein (MCP)-1, nuclear factor kappa B (NF-κB), matrix metalloproteinase (MMP)-9, and activated caspase-1 in macrophages, and increased lysyl oxdase (Lox) and tissue inhibitor of metalloproteinase (TIMP)-2 expression in VSMCs. In vivo, aged male apolipoprotein E-deficient (ApoE^-/^-) mice were infused with angiotensin II (Ang II) for 28 days. The mice received either normal saline (NS) or COL orally. The control group of ApoE^-/^-mice did not receive Ang II infusion or treatment. COL significantly suppressed aortic enlargement and reduced AA incidence by preserving elastin and decreasing IL-1β, TNF-α, MCP-1, NLRP3 inflammasome, neutrophil elastase, and myeloperoxidase expression. No significant differences were observed in the enzymatic activities of MMP-2 and MMP-9 between the 2 groups.</p><p><strong>Conclusions: </strong>The results suggested that COL prevents AA progression in a clinically relevant model and is expected to be a novel preventive agent for AA.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Regurgitation Jet Increases Left Ventricular Energy Loss Associated With the Progression of Cardiac Failure　- A Vector Flow Mapping Analysis Study.","authors":"Shohei Yoshida, Koichi Toda, Yasushi Yoshikawa, Hiroki Hata, Daisuke Yoshioka, Satoshi Kainuma, Takuji Kawamura, Ai Kawamura, Koichi Inoue, Yumi Kakizawa, Scott DeRoo, Christopher R Burke, Satoshi Nakatani, Kazuo Shimamura, Yoshiki Sawa, Shigeru Miyagawa","doi":"10.1253/circj.CJ-24-0965","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0965","url":null,"abstract":"<p><strong>Background: </strong>Aortic valve regurgitation (AR) impairs cardiac function, but the underlying mechanisms remain unclear. Vector flow mapping (VFM) enables evaluation of blood flow patterns and energy loss in the left ventricle (LV). This study investigated the effect of AR on LV blood flow patterns, energy loss, and heart failure progression using VFM.</p><p><strong>Methods and results: </strong>Forty patients with severe AR undergoing aortic valve replacement (AVR) between January 2016 and March 2018 were included. Echocardiogram-based VFM in apical long-axis and 4-chamber views was performed before and after AVR, with results compared to a control group without valvular diseases (n=21). Preoperative LV energy loss due to an AR jet was significantly higher in patients with AR (median 8.7 J; interquartile range [IQR] 5.7-13.3 J) than in controls (1.7 J; IQR 0.7-2.6 J; P<0.001), and was positively correlated with preoperative serum B-type natriuretic peptide (BNP) concentrations (P=0.029). LV energy loss was not associated with LV systolic function or regurgitant volume, but was significantly affected by AR jet direction. Postoperatively, after AVR, LV energy loss (median 2.0 J; IQR 1.5-2.7 J) decreased to the same level as in the control group.</p><p><strong>Conclusions: </strong>The regurgitant jet in severe AR increases LV energy loss, which is positively correlated with serum BNP concentrations, indicating that the AR jet contributes to the progression of heart failure through LV energy loss.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter Ablation of Ventricular Tachycardia in Histologically Confirmed, Clinically Diagnosed, and Suspected Cardiac Sarcoidosis.","authors":"Juan F Rodriguez-Riascos, Hema Srikanth Vemulapalli, Poojan Prajapati, Padmapriya Muthu, Dan Sorajja, Clinton E Jokerst, Carlos A Rojas, Hicham El Masry, Komandoor Srivathsan","doi":"10.1253/circj.CJ-25-0285","DOIUrl":"https://doi.org/10.1253/circj.CJ-25-0285","url":null,"abstract":"<p><strong>Background: </strong>Cardiac sarcoidosis (CS) is a rare, potentially life-threatening condition associated with ventricular tachycardia (VT). Outcomes of catheter ablation for VT in patients with histologically diagnosed sarcoidosis and those with suspected or clinically diagnosed sarcoidosis have not been well studied. This study addressed this knowledge gap.</p><p><strong>Methods and results: </strong>We conducted an observational retrospective chart review of patients with CS who underwent VT ablation between 2007 and 2024 at Mayo Clinic Hospital. The cohort was divided into 2 groups: those with histologically diagnosed sarcoidosis and those with clinical or suspected sarcoidosis diagnosed according to Japanese Circulation Society 2016 guidelines. The primary endpoints were VT recurrence, cardiovascular mortality, and heart transplantation. Eighty-eight patients were included in the study: 33 with histologically confirmed CS and 55 with clinical/suspected CS. Systemic sarcoidosis was more common in the group with histologically confirmed CS, whereas mid-myocardial non-ischemic late gadolinium enhancement was more prevalent in the group with clinical/suspected CS. The 1-year composite event-free survival rate was 56.1%. In multivariate analysis, systemic sarcoidosis was independently associated with lower event-free survival rates.</p><p><strong>Conclusions: </strong>Patients with histologically confirmed CS had worse VT ablation outcomes than those with clinical/suspected CS. This difference may be driven by a higher prevalence of systemic sarcoidosis in the former group. These findings highlight the need for a comprehensive management approach in both groups.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Level of Estimated Small Dense Low-Density Lipoprotein Cholesterol as an Independent Risk Factor for the Development of Ischemic Heart Disease Regardless of Low-Density Lipoprotein Cholesterol Level　- A 10-Year Cohort Study.","authors":"Keisuke Endo, Marenao Tanaka, Tatsuya Sato, Masafumi Inyaku, Kei Nakata, Wataru Kawaharata, Hiroki Aida, Itaru Hosaka, Yukinori Akiyama, Nagisa Hanawa, Masato Furuhashi","doi":"10.1253/circj.CJ-24-0770","DOIUrl":"10.1253/circj.CJ-24-0770","url":null,"abstract":"<p><strong>Background: </strong>We previously reported that a high level of small dense low-density lipoprotein cholesterol (sdLDL-C) calculated by the Sampson equation was independently associated with the development of ischemic heart disease (IHD), but it remains unclear whether the effect depends on the level of low-density lipoprotein cholesterol (LDL-C).</p><p><strong>Methods and results: </strong>We investigated the associations of new onset of IHD with categorized groups of high (H-) and low (L-) levels of estimated sdLDL-C and LDL-C using 25^thpercentile levels of sdLDL-C level (25.2 mg/dL) and LDL-C (100 mg/dL) as cutoff values in 17,963 Japanese individuals (men/women: 11,508/6,455, mean age: 48 years) who underwent annual health checkups. During a 10-year follow-up period, 570 subjects (men/women: 449/121) had new development of IHD. Multivariable Cox proportional hazard analyses after adjustment of age, sex, smoking habit, hypertension and diabetes mellitus at baseline showed that the hazard ratio (HR) [95% confidence interval (CI)] for new onset of IHD was significantly higher in subjects with H-sdLDL-C/H-LDL-C (1.49 [1.06-2.08]) and subjects with H-sdLDL-C/L-LDL-C (1.49 [1.00-2.22]) than in subjects with L-sdLDL-C/L-LDL-C as the reference.</p><p><strong>Conclusions: </strong>A high level of sdLDL-C estimated by the Sampson equation was a predominant predictor for the development of IHD, regardless of the level of LDL-C, in a general Japanese population.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1182-1189"},"PeriodicalIF":3.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Effects of Supervised Cardiac Rehabilitation in Patients With Angina and Non-Obstructive Coronary Artery Disease and Impaired Myocardial Flow Reserve Assessed Using ¹³N-Ammonia Positron Emission Tomography.","authors":"Shiro Miura, Atsutaka Okizaki, Hiraku Kumamaru, Osamu Manabe, Chihoko Miyazaki, Takehiro Yamashita","doi":"10.1253/circj.CJ-24-0128","DOIUrl":"10.1253/circj.CJ-24-0128","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of exercise-based cardiac rehabilitation (CR) in patients with angina and non-obstructive coronary artery disease (ANOCA) remains unclear. This study investigated whether a multidisciplinary CR program improves myocardial flow reserve (MFR), symptom status, and exercise capacity in patients with ANOCA.</p><p><strong>Methods and results: </strong>Myocardial blood flow at rest and during ATP-induced hyperemia was quantified using ¹³N-ammonia positron emission tomography (PET) in 29 patients diagnosed with ANOCA and impaired MFR (<2.5). Overall, 16 patients completed the 5-month CR program (complete CR group) and 13 did not (non-complete CR group). At baseline and the 5-month follow-up PET, symptom status and exercise capacity were assessed using the Seattle Angina Questionnaire (SAQ)-7 and cardiopulmonary exercise testing, respectively. The MFR in the complete CR group increased significantly (P=0.001) from a median of 1.60 (interquartile range [IQR] 1.43-1.98) to 2.09 (IQR 1.83-2.48). Significant improvements were also seen in the median SAQ-7 total score (from 16 [IQR 11-20] to 11 [IQR 8-14]; P=0.008) and peak oxygen consumption (V̇O₂; from 14.2 [IQR 12.4-15.8] to 15.3 [13.0-17.9] mL/kg/min; P=0.02). In contrast, there were no improvements in MFR (P=0.83) or peak V̇O₂(P=0.27) in the non-complete CR group.</p><p><strong>Conclusions: </strong>The 5-month exercise-based CR significantly improved MFR, symptom status, and exercise capacity in patients with ANOCA and impaired MFR.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1162-1171"},"PeriodicalIF":3.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Extended Dual Antiplatelet Therapy After Coronary Artery Bypass Grafting in Patients With High Inflammatory Risk.","authors":"Woo Jin Jang, Ki Hong Choi, Chang Hoon Kim, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Kiick Sung, Wook Sung Kim, Dong Seop Jeong, Young Bin Song","doi":"10.1253/circj.CJ-24-0989","DOIUrl":"10.1253/circj.CJ-24-0989","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the efficacy of dual antiplatelet therapy (DAPT) on the long-term prognosis of coronary artery bypass grafting (CABG) patients with high inflammatory risk.</p><p><strong>Methods and results: </strong>We analyzed 2,409 patients who underwent isolated CABG between January 2001 and December 2017 and had baseline high-sensitivity C-reactive protein (hs-CRP) levels >2.0 mg/L. Patients were divided into 2 groups: those on DAPT for ≥12 months (n=545) and those on single antiplatelet therapy (SAPT; n=1,864). The primary outcome was all-cause death or myocardial infarction (MI) after CABG. Propensity score (PS) matching was used to minimize confounding factors and selection bias. During follow-up, the ≥12-month DAPT group had a significantly lower risk of the primary outcome than the SAPT group (7.5% vs. 13.3%; hazard ratio [HR] 0.42; 95% confidence interval [CI] 0.24-0.72; P=0.002). After PS matching, the incidence of the primary outcome remained lower in the DAPT group (HR 0.36; 95% CI 0.19-0.71; P=0.003). The benefit of prolonged DAPT was consistent across subgroups.</p><p><strong>Conclusions: </strong>In CABG patients with high inflammatory risk, prolonged DAPT (≥12 months) was associated with significantly lower rates of all-cause death or MI compared with SAPT.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1153-1161"},"PeriodicalIF":3.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Clinical Alliance Path for Secondary Prevention of Acute Coronary Syndrome　- Impact on Low-Density Lipoprotein Cholesterol Levels.","authors":"Tomomi Watanabe, Satoshi Kobara, Ryosuke Amisaki, Hisashi Noma, Masaharu Fukuki, Akira Ohtahara, Kensaku Yamada, Masashi Fujise, Yoshihito Nozaka, Hiroki Nakamura, Hiroki Omodani, Kazuhiro Yamamoto","doi":"10.1253/circj.CJ-25-0059","DOIUrl":"10.1253/circj.CJ-25-0059","url":null,"abstract":"<p><strong>Background: </strong>The prognosis for survivors of acute coronary syndrome (ACS) remains substantially worse compared with the general population. In Japan, regional clinical alliance paths (RCAPs) have been promoted to support the secondary prevention of ACS within community settings. However, the implementation of RCAPs is currently low, and their clinical efficacy has not been established. This study evaluated the impact of RCAP implementation on secondary prevention outcomes in ACS patients.</p><p><strong>Methods and results: </strong>Of 405 patients admitted to Tottori University Hospital for ACS between May 2020 and April 2023, 136 who underwent primary percutaneous coronary intervention (PCI) and received follow-up care at primary care clinics were included in the study. Sixty-five (47.8%) patients received care under an RCAP, whereas 71 received standard care. RCAP implementation was associated with a higher proportion of patients achieving low-density lipoprotein cholesterol (LDL-C) levels below 70 mg/dL and with greater reductions in LDL-C levels overall. Propensity score-weighted analysis confirmed that the RCAP group achieved significantly better LDL-C control after adjustment for baseline characteristics using inverse probability weighting.</p><p><strong>Conclusions: </strong>RCAP implementation improved the rate of LDL-C target achievement and the degree of LDL-C reduction in post-ACS patients receiving follow-up care from family physicians. RCAP implementation is an effective strategy for the secondary prevention of ACS, particularly by enhancing adherence to established pharmacological therapies.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1197-1203"},"PeriodicalIF":3.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Stent Underexpansion for Severely Calcified Lesions After Debulking.","authors":"Masami Nishino, Yasuyuki Egami, Naotaka Okamoto, Ayako Sugino, Noriyuki Kobayashi, Masaru Abe, Mizuki Ohsuga, Hiroaki Nohara, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Yasuharu Matsunaga-Lee, Masamichi Yano","doi":"10.1253/circj.CJ-24-0778","DOIUrl":"10.1253/circj.CJ-24-0778","url":null,"abstract":"<p><strong>Background: </strong>There are few studies regarding the predictors of stent underexpansion (SUE) in post-debulking calcified lesions. We investigated predictors of SUE in severely calcified lesions after debulking using optical coherence tomography-guided rotational atherectomy (RA) or orbital atherectomy (OA).</p><p><strong>Methods and results: </strong>As a post hoc analysis of the DIRO trial, we compared various parameters, including calcium and lipid parameters (lipid-rich plaque, thin cap fibroatheroma [TCFA], maximum lipid arc, mean lipid arc, lipid length, and lipid volume index), between groups with adequate stent expansion (ASE) and SUE. To find predictors of SUE, multivariable analysis was performed using significant factors from the univariable analysis. We also evaluated adverse events 8 months after the procedure. The SUE group consisted of 57 (65.5%) patients. After suitable debulking of severely calcified lesions using RA or OA, there was no correlation between calcium parameters and SUE; however, the lipid parameters of maximum lipid arc ≥224° and TCFA were significantly and independently correlated with SUE Approximately 45% of severely calcified lesions contained lipid-rich plaques. Adverse events occurred more frequently in the SUE than ASE group.</p><p><strong>Conclusions: </strong>The role of calcium parameters in predicting SUE in severely calcified lesions after suitable debulking using RA or OA is weak; however, maximum lipid arc and TCFA are important predictors of SUE.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1121-1128"},"PeriodicalIF":3.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of High-Intensity Statins in Japanese Patients After Percutaneous Coronary Intervention　- Insights From the Clinical Deep Data Accumulation System (CLIDAS^®).","authors":"Tetsuya Matoba, Shunsuke Katsuki, Yasuhiro Nakano, Takuro Kawahara, Mitsukuni Kimura, Rissei Hino, Takuya Tabuchi, Mitsuhiro Fukata, Michinari Hieda, Takanori Yamashita, Naoki Nakashima, Takahide Kohro, Tomoyuki Kabutoya, Yusuke Oba, Kazuomi Kario, Yasushi Imai, Hideo Fujita, Naoyuki Akashi, Arihiro Kiyosue, Yoshiko Mizuno, Satoshi Kodera, Masaharu Nakayama, Kotaro Nochioka, Yoshihiro Miyamoto, Takamasa Iwai, Kenichi Tsujita, Taishi Nakamura, Masanobu Ishii, Hisahiko Sato, Yuri Matoba, Ryozo Nagai","doi":"10.1253/circj.CJ-25-0066","DOIUrl":"10.1253/circj.CJ-25-0066","url":null,"abstract":"<p><strong>Background: </strong>Lipid-lowering therapy with high-intensity statins has not been widely implemented in Japan for patients with coronary artery disease who undergo percutaneous coronary intervention (PCI). We examined the efficacy and safety of high-intensity statin therapy in a real-world setting.</p><p><strong>Methods and results: </strong>We used the Clinical Deep Data Accumulation System (CLIDAS) to accumulate multimodal data from the electronic medical records of 7 cardiovascular centers. We analyzed 9,690 patients who underwent PCI between 2013 and 2019 and completed a median 2.5-year follow-up (CLIDAS-PCI database). The risk of developing major adverse cardiac and cerebrovascular events (MACCE) was significantly greater in patients with acute (ACS) than chronic (CCS) coronary syndrome. High-intensity statins were prescribed to 49% of ACS patients and 33% of CCS patients within the first 30 days after the index PCI. After propensity score matching, MACCE event rates were similar between the high- and moderate-intensity statin groups. Importantly, among ACS patients, Cox proportional hazard analysis revealed that the rate of myocardial infarction was lower (adjusted hazard ratio [aHR] 0.65; 95% confidence interval [CI] 0.44-0.97) and the rate of stroke was greater (aHR 1.71; 95% CI 1.12-2.62) in the high-intensity statin group, driven mostly by intracranial hemorrhage.</p><p><strong>Conclusions: </strong>The CLIDAS-PCI database provides real-world evidence for the efficacy and safety of high-intensity statins in Japanese ACS patients who have undergone PCI.</p>","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1204-1215"},"PeriodicalIF":3.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}