Circulation reports最新文献_第2页

Identification of Physician Concerns Regarding Implementation of the Nagasaki Acute Myocardial Infarction Secondary Prevention Clinical Pathway. 医师对实施长崎急性心肌梗死二级预防临床路径的关注。

Circulation reports Pub Date : 2024-11-15 eCollection Date: 2024-12-10 DOI: 10.1253/circrep.CR-24-0124

Masaya Kurobe, Yosuke Yamanaka, Akihito Uda, Katsuya Mori, Takeshi Akiyama, Ayumi Morishita, Yuta Ishikawa, Louis P Watanabe, Satoshi Ikeda, Koji Maemura

{"title":"Identification of Physician Concerns Regarding Implementation of the Nagasaki Acute Myocardial Infarction Secondary Prevention Clinical Pathway.","authors":"Masaya Kurobe, Yosuke Yamanaka, Akihito Uda, Katsuya Mori, Takeshi Akiyama, Ayumi Morishita, Yuta Ishikawa, Louis P Watanabe, Satoshi Ikeda, Koji Maemura","doi":"10.1253/circrep.CR-24-0124","DOIUrl":"10.1253/circrep.CR-24-0124","url":null,"abstract":"Background: The Nagasaki Acute Myocardial Infarction Secondary Prevention Clinical Pathway (NASP) is a regional pathway that aims to standardize practices related to the treatment of acute myocardial infarction in order to improve patient prognoses. This study aimed to understand physician backgrounds and concerns regarding implementation of the NASP.Methods and results: This exploratory sequential mixed-methods study was developed around the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Following focus group interviews, the web-based, self-administered questionnaire survey with a cross-sectional study design was given to 62 physicians who practiced at acute care hospitals (ACHs), primary care hospitals (PCHs), or outpatient clinics (OCs) in the Nagasaki prefecture. Hayashi's quantitative theory type II analysis was used to assess the quantitative relationship between physician characteristics and their concerns. In addition, physicians were clustered based on the types of concerns they had. Our results demonstrated that specialists in cardiovascular disease held more concerns regarding implementation of the NASP. Furthermore, workload burden was found to be the most common concern among these physicians. Cooperation between physicians at ACHs and physicians at PCHs/OCs was also found to be vital for the NASP.Conclusions: Interventions such as modifications to the NASP operation may assist in alleviating concerns regarding the NASP and allow for the development of tailored interventions and effective expansion of the pathway.","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"6 12","pages":"555-563"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between Amount of Physical Activity and Clinical Outcomes After Treatment for Cardiovascular Disease in Cancer Survivors. 癌症幸存者心血管疾病治疗后身体活动量与临床结果的关系

Circulation reports Pub Date : 2024-11-14 eCollection Date: 2024-12-10 DOI: 10.1253/circrep.CR-24-0105

Kohei Nozaki, Nobuaki Hamazaki, Kentaro Kamiya, Kensuke Ueno, Takashi Miki, Yuta Nanri, Ken Ogura, Shota Uchida, Emi Maekawa, Takeru Nabeta, Yuichiro Iida, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Jiichiro Sasaki, Junya Ako

{"title":"Association Between Amount of Physical Activity and Clinical Outcomes After Treatment for Cardiovascular Disease in Cancer Survivors.","authors":"Kohei Nozaki, Nobuaki Hamazaki, Kentaro Kamiya, Kensuke Ueno, Takashi Miki, Yuta Nanri, Ken Ogura, Shota Uchida, Emi Maekawa, Takeru Nabeta, Yuichiro Iida, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Jiichiro Sasaki, Junya Ako","doi":"10.1253/circrep.CR-24-0105","DOIUrl":"10.1253/circrep.CR-24-0105","url":null,"abstract":"Background: The present study aimed to investigate the association between physical activity before the incidence of cardiovascular disease (CVD) and clinical outcomes in cancer survivors.Methods and results: We analyzed 904 cancer survivors (median age [interquartile range] 75 [68-80] years; 297 [32.9%] patients were female) who required hospitalization for treatment of CVD. The amount of physical activity 1 month before the admission was assessed using the 3-question (3Q) assessment tool, and categorized as minimal, low, adequate, and high according to physical activity level. The primary outcome was the composite events of all-cause death and/or rehospitalization for CVD up to 1 year after discharge. The total amount of physical activity was identified in 544 (60.2%) patients in the minimal group, 95 (10.5%) in the low group, 253 (28.0%) in the adequate group, and 12 (1.3%) in the high group. A total of 686 (75.9%) patients completed follow up, with 252 (27.9%) composite events occurring. Even after adjustment for various confounders, higher physical activity was significantly associated with a lower composite event rate (adjusted hazard ratio [95% confidence interval] 0.859 [0.833-0.900]).Conclusions: High physical activity in cancer survivors was associated with a lower composite event rate after treatment for CVD. Assessment of prehospital physical activity using the 3Q score may be useful in their risk stratification.","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"6 12","pages":"547-554"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Machine Learning for Evaluating Vulnerable Plaque on Coronary Computed Tomography Using Spectral Imaging. 利用光谱成像评估冠状动脉计算机断层易损斑块的机器学习。

Circulation reports Pub Date : 2024-11-13 eCollection Date: 2024-12-10 DOI: 10.1253/circrep.CR-24-0086

Junji Mochizuki, Yoshiki Hata, Takeshi Nakaura, Katsushi Hashimoto, Hiroyuki Uetani, Yasunori Nagayama, Masafumi Kidoh, Yoshinori Funama, Toshinori Hirai

{"title":"Machine Learning for Evaluating Vulnerable Plaque on Coronary Computed Tomography Using Spectral Imaging.","authors":"Junji Mochizuki, Yoshiki Hata, Takeshi Nakaura, Katsushi Hashimoto, Hiroyuki Uetani, Yasunori Nagayama, Masafumi Kidoh, Yoshinori Funama, Toshinori Hirai","doi":"10.1253/circrep.CR-24-0086","DOIUrl":"10.1253/circrep.CR-24-0086","url":null,"abstract":"Background: This study aimed to determine whether spectral imaging with dual-energy computed tomography (CT) can improve diagnostic performance for coronary plaque characterization.Methods and results: We conducted a retrospective analysis of 30 patients with coronary plaques, using coronary CT angiography (dual-layer CT) and intravascular ultrasound (IVUS) studies. Based on IVUS findings, patients were diagnosed with either vulnerable or stable plaques. We computed 7 histogram parameters for plaque CT numbers in 120 kVp images and virtual monochromatic images ranging from 40 to 140 keV at 5-keV intervals. A predictive model was developed using histogram data of optimal energy, plaque volume or stenosis, and a combination of both. The model's performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) using 5-fold cross-validation. Peak diagnostic performances for each histogram parameter were observed at various energy levels (40-110 keV) in the univariate logistic regression model. The histogram model demonstrated optimal diagnostic performance at 65 keV, with an AUC of 0.81. The combined model, incorporating histogram data and plaque volume, achieved an AUC of 0.85, which was similar to the performance of qualitative CT characteristics (AUC=0.88; P=0.70).Conclusions: Spectral imaging with dual-energy CT can enhance the diagnostic performance of machine learning using CT histograms for coronary plaque characterization.","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"6 12","pages":"564-572"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Nutritional Status and Cardiopulmonary Exercise Testing-Based Exercise Education on Long-Term Outcomes in Acute Coronary Syndrome　- Insights From the Mie ACS Registry. 营养状况和基于心肺运动试验的运动教育对急性冠脉综合征长期预后的影响——来自Mie ACS登记处的见解

Circulation reports Pub Date : 2024-11-09 eCollection Date: 2024-12-10 DOI: 10.1253/circrep.CR-24-0128

Hiroaki Murakami, Naoki Fujimoto, Keishi Moriwaki, Hiromasa Ito, Akihiro Takasaki, Kiyotaka Watanabe, Atsushi Kambara, Naoto Kumagai, Takashi Omura, Tairo Kurita, Ryo Momosaki, Kaoru Dohi

{"title":"Impact of Nutritional Status and Cardiopulmonary Exercise Testing-Based Exercise Education on Long-Term Outcomes in Acute Coronary Syndrome　- Insights From the Mie ACS Registry.","authors":"Hiroaki Murakami, Naoki Fujimoto, Keishi Moriwaki, Hiromasa Ito, Akihiro Takasaki, Kiyotaka Watanabe, Atsushi Kambara, Naoto Kumagai, Takashi Omura, Tairo Kurita, Ryo Momosaki, Kaoru Dohi","doi":"10.1253/circrep.CR-24-0128","DOIUrl":"10.1253/circrep.CR-24-0128","url":null,"abstract":"Background: Exercise training based on cardiopulmonary exercise testing (CPET) improves outcomes in patients with acute coronary syndrome (ACS), while nutritional status is also crucial. This study evaluated CPET implementation and the impacts of clinical parameters, including CPET and nutritional status, on 2-year outcomes in ACS patients.Methods and results: Data from 2,621 ACS patients enrolled in the Mie ACS registry were analyzed. Of these, 938 were hospitalized in CPET-equipped facilities, while 1,683 were not. Nutritional status was assessed using controlling nutritional status (CONUT) score. Cox regression analysis evaluated the associations between nutritional status, CPET-based exercise education, and 2-year prognosis. Among the 938 patients in CPET facilities, 359 underwent CPET and received exercise education. During the 2-year follow up, 60 all-cause deaths occurred. Univariate Cox regression revealed that CPET implementation was associated with lower all-cause mortality. Other predictors included hemoglobin levels, age, hospitalization length, Killip class ≥2, mechanical support, and malnutrition. In multivariate Cox regression, CPET implementation remained an independent predictor of mortality (hazard ratio 0.47; P=0.04). However, when nutritional status was included, moderate to severe malnutrition emerged as an independent predictor of all-cause mortality (hazard ratio 2.47; P=0.02), diminishing the significance of CPET (P=0.058).Conclusions: Moderate to severe malnutrition is a powerful independent prognostic factor for mortality in the Mie ACS registry. CPET implementation may enhance survival in ACS patients.","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"6 12","pages":"583-591"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Controlling Serum Low-Density Lipoprotein Cholesterol and Triglycerides on Long-Term Clinical Outcomes in Diabetic Patients Who Have Undergone Percutaneous Coronary Intervention. 控制血清低密度脂蛋白胆固醇和甘油三酯对经皮冠状动脉介入治疗的糖尿病患者长期临床结果的影响

Circulation reports Pub Date : 2024-11-07 eCollection Date: 2024-12-10 DOI: 10.1253/circrep.CR-24-0081

Takashi Maruo, Amane Ike, Yosuke Takamiya, Yuta Matsuoka, Eiji Shigemoto, Yuta Kato, Takashi Kuwano, Makoto Sugihara, Akira Kawamura, Shin-Ichiro Miura

{"title":"Impact of Controlling Serum Low-Density Lipoprotein Cholesterol and Triglycerides on Long-Term Clinical Outcomes in Diabetic Patients Who Have Undergone Percutaneous Coronary Intervention.","authors":"Takashi Maruo, Amane Ike, Yosuke Takamiya, Yuta Matsuoka, Eiji Shigemoto, Yuta Kato, Takashi Kuwano, Makoto Sugihara, Akira Kawamura, Shin-Ichiro Miura","doi":"10.1253/circrep.CR-24-0081","DOIUrl":"10.1253/circrep.CR-24-0081","url":null,"abstract":"Background: We investigated whether patients with diabetes who had good control of both low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) would be associated with better long-term clinical outcomes after percutaneous coronary intervention (PCI).Methods and results: Using our PCI registry (Fu-Registry), the 1,006 cases with diabetes were divided into 4 groups: Group 1, LDL-C ≥100 mg/dL and TG ≥175 mg/dL; Group 2, LDL-C <100 mg/dL and TG ≥175 mg/dL; Group 3, LDL-C ≥100 mg/dL and TG <175 mg/dL; and Group 4, LDL-C <100 mg/dL and TG <175 mg/dL. The primary endpoint during the follow-up period (median follow up of 1,984 days) was defined as major adverse cardiac events (MACEs). Additionally, all coronary events were defined as a secondary endpoint. The incidence rates of MACEs were as follows: Group 1, 38%; Group 2, 26%; Group 3, 31%; and Group 4, 27% (P=0.074), and the rates tended to be higher in Group 1. All coronary events were as follows: Group 1, 66%; Group 2, 56%; Group 3, 58%; and Group 4, 51% (P=0.032).Conclusions: In patients with diabetes who underwent PCI, the LDL-C and TG levels in Group 4 met secondary prevention targets for coronary artery disease and these patients showed better long-term clinical outcomes compared with those in other groups.","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"6 12","pages":"573-582"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Detection of Neovascularization in Achilles Tendon Xanthoma With Familial Hypercholesterolemia. 家族性高胆固醇血症并发跟腱黄色瘤新生血管的检测。

Circulation reports Pub Date : 2024-11-07 eCollection Date: 2024-12-10 DOI: 10.1253/circrep.CR-24-0120

Junji Mochizuki, Yoko Koike, Hiroaki Matsumi, Kentaro Kawada, Yoshiki Hata

引用次数: 0

Atrial Lesion and Diastolic Dysfunction May Be Associated With Atrial Fibrillation in Patients With Cardiac Amyloidosis. 心房病变和舒张功能障碍可能与心脏淀粉样变性患者的心房颤动有关。

Circulation reports Pub Date : 2024-11-06 eCollection Date: 2024-12-10 DOI: 10.1253/circrep.CR-24-0116

Kaishi Otsuka, Hiroaki Kawano, Hirofumi Koike, Eijun Sueyoshi, Shuji Arakawa, Satoki Fukae, Asumi Takei, Tsuyoshi Yoshimuta, Satoshi Ikeda, Koji Maemura

{"title":"Atrial Lesion and Diastolic Dysfunction May Be Associated With Atrial Fibrillation in Patients With Cardiac Amyloidosis.","authors":"Kaishi Otsuka, Hiroaki Kawano, Hirofumi Koike, Eijun Sueyoshi, Shuji Arakawa, Satoki Fukae, Asumi Takei, Tsuyoshi Yoshimuta, Satoshi Ikeda, Koji Maemura","doi":"10.1253/circrep.CR-24-0116","DOIUrl":"10.1253/circrep.CR-24-0116","url":null,"abstract":"Background: Atrial fibrillation (AF) is a common arrhythmia associated with cardiac amyloidosis (CA). Diastolic dysfunction and atrial lesions have been reported in patients with AF fibrillation. We aimed to evaluate the diastolic function and atrial lesions in patients with CA and AF.Methods and results: We included 27 patients (mean age 72 years) with biopsy-confirmed CA. We analyzed the average E/e' as diastolic function using echocardiography and atrial late gadolinium enhancement (LGE) as an atrial lesion using cardiac magnetic resonance imaging (CMRI). We compared these parameters among 20 patients with sinus rhythm (SR) and 7 with AF. Echocardiography examination showed that average E/e' were larger in the AF group than in the SR group (average E/e': AF, 21.3 [14.5-30.3]; SR, 14.2 [10.3-16.9]; P=0.0053). CMRI demonstrated that atrial LGE was more severe in the AF group than in the SR group (AF, 7/7 [100%]; SR, 11/21 [52.4%]; P=0.00228). Univariate logistic regression analysis showed that average E/e' demonstrated significant association with AF in all patients (odds ratio 1.24; [95% confidence interval 1.03-1.51]; P=0.0251).Conclusions: AF may be associated with atrial lesions and diastolic dysfunction in patients with CA.","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"6 12","pages":"539-546"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute Limb Ischemia Due to Paradoxical Thrombus Through Patent Foramen Ovale. 经卵圆孔未闭的异位血栓引起的急性肢体缺血。

Circulation reports Pub Date : 2024-10-29 eCollection Date: 2024-12-10 DOI: 10.1253/circrep.CR-24-0117

Tomohiro Honda, Hiroaki Kawano, Ryosuke Iwasaki, Yuki Ueno, Ryohei Akashi, Tsuyoshi Yonekura, Tsuyoshi Yoshimuta, Koji Maemura

引用次数: 0

Artificial Intelligence (AI)-Driven Frailty Prediction Using Electronic Health Records in Hospitalized Patients With Cardiovascular Disease. 使用电子健康记录对心血管疾病住院患者进行人工智能（AI）驱动的虚弱预测。

Circulation reports Pub Date : 2024-10-29 eCollection Date: 2024-11-08 DOI: 10.1253/circrep.CR-24-0112

Masashi Yamashita, Kentaro Kamiya, Kazuki Hotta, Anna Kubota, Kenji Sato, Emi Maekawa, Hiroaki Miyata, Junya Ako

{"title":"Artificial Intelligence (AI)-Driven Frailty Prediction Using Electronic Health Records in Hospitalized Patients With Cardiovascular Disease.","authors":"Masashi Yamashita, Kentaro Kamiya, Kazuki Hotta, Anna Kubota, Kenji Sato, Emi Maekawa, Hiroaki Miyata, Junya Ako","doi":"10.1253/circrep.CR-24-0112","DOIUrl":"https://doi.org/10.1253/circrep.CR-24-0112","url":null,"abstract":"Background: This study aimed to create a deep learning model for predicting phenotypic physical frailty from electronic medical record information in patients with cardiovascular disease.Methods and results: This single-center retrospective study enrolled patients who could be assessed for physical frailty according to cardiovascular health study criteria (25.5% [691/2,705] of the patients were frail). Patients were randomly separated for training (Train set: 80%) and validation (Test set: 20%) of the deep learning model. Multiple models were created using LightGBM, random forest, and logistic regression for deep learning, and their predictive abilities were compared. The LightGBM model had the highest accuracy (in a Test set: F1 score 0.561; accuracy 0.726; area under the curve of the receiver operating characteristics [AUC] 0.804). These results using only commonly used blood biochemistry test indices (in a Test set: F1 score 0.551; accuracy 0.721; AUC 0.793) were similar. The created models were consistently and strongly associated with physical functions at hospital discharge, all-cause death, and heart failure-related readmission.Conclusions: Deep learning models derived from large sample sizes of phenotypic physical frailty have shown good accuracy and consistent associations with prognosis and physical functions.","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"6 11","pages":"495-504"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of Older Patients With Cardiogenic Shock Using the Impella Device　- Insights From the Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD). 使用 Impella 装置的老年心源性休克患者的预后--日本经皮心室辅助装置注册中心 (J-PVAD) 的启示。

Circulation reports Pub Date : 2024-10-29 eCollection Date: 2024-11-08 DOI: 10.1253/circrep.CR-24-0111

Ryosuke Higuchi, Mamoru Nanasato, Yumiko Hosoya, Mitsuaki Isobe

{"title":"Outcomes of Older Patients With Cardiogenic Shock Using the Impella Device　- Insights From the Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD).","authors":"Ryosuke Higuchi, Mamoru Nanasato, Yumiko Hosoya, Mitsuaki Isobe","doi":"10.1253/circrep.CR-24-0111","DOIUrl":"https://doi.org/10.1253/circrep.CR-24-0111","url":null,"abstract":"Background: Aging has progressed in several regions of the world with more older patients experiencing acute cardiovascular disease. Impella is a percutaneous potent circulatory support device associated with substantial cost and potential device-related complications.Methods and results: We analyzed the Japanese nationwide registry, encompassing consecutive patients with cardiogenic shock using Impella. Among 5,718 patients treated between 2020 and 2022, we compared older patients (≥75 years) with younger patients. The primary outcome was the Kaplan-Meier estimated 30-day mortality, and the secondary outcome was Impella-related complications. The median age of the 5,718 patients was 69 (58-77) years, and 1,807 (31.6%) were older, with smaller body mass index, frequent acute coronary syndrome, and infrequent myocarditis. Comorbidities were frequently observed in older patients with a higher ejection fraction and less frequency of extracorporeal membrane oxygenation. Older patients had a higher 30-day mortality than younger patients (38.9% vs. 32.5%; P<0.0001). The 30-day mortality was statistically equivalent among older subsets (75-79 vs. 80-84 vs. ≥85 years). Device-related complications similarly occurred similarly among the older subsets, except for a modest increase in cardiac tamponade and limb ischemia. Older age, body mass index, myocarditis, prior arrhythmia, shock severity, renal and hepatic impairment, and limb ischemia were associated with 30-day mortality.Conclusions: The selected older patients using Impella exhibited modestly higher 30-day mortality with similar safety profiles. A longer follow up and optimal patient selection are important.","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"6 11","pages":"505-513"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0