Circulation reports最新文献

{"title":"One-Week Postoperative Valvuloarterial Impedance as a Predictor of Left Ventricular Hypertrophy Regression 1 Year After Surgical Aortic Valve Replacement in Patients With Aortic Stenosis.","authors":"Hirotaka Waki, Kenji Harada, Yusuke Suzuki, Yutaka Aoyama, Masafumi Sato, Sumika Wachi, Yusuke Ishiyama, Yukiyo Ogata, Koji Kawahito, Kazuomi Kario","doi":"10.1253/circrep.CR-24-0158","DOIUrl":"10.1253/circrep.CR-24-0158","url":null,"abstract":"<p><strong>Background: </strong>Persistent left ventricular hypertrophy (LVH) after surgical aortic valve replacement (SAVR) for aortic stenosis (AS) worsens prognosis. We investigated predictors of LVH regression 1 year after SAVR in AS patients, including patient-prosthesis mismatch (PPM) and valvuloarterial impedance (Zva).</p><p><strong>Methods and results: </strong>We retrospectively studied 175 patients who underwent SAVR for AS at Jichi Medical University between 2014 and 2019. Echocardiography was performed at preoperative baseline, 1-week postoperative, and 1-year postoperative. The left ventricular mass index (LVMI) regression rate (RR) was defined as the difference between baseline LVMI and 1-year LVMI divided by baseline LVMI. Patients were divided into 2 groups based on their median LVMI RR as follows: (1) a poor LVH regression (PR-LVH) group with values below the median LVMI RR; and (2) a good LVH regression (GR-LVH) group with values above the median LVMI RR. The median LVMI RR was 25.4%. There were 88 (50.3%) patients in the PR-LVH group. In the multivariable analysis, 1-week postoperative Zva (odds ratio [OR] 2.777; 95% confidence interval [CI] 1.584-4.869; P<0.001) and baseline LVMI per 10-unit increment (OR 0.974; 95% CI 0.960-0.988; P=0.001) were independent predictors of PR-LVH. The receiver operating characteristic curve analysis identified Zva ≥3.5 mmHg/mL/m² as a cut-off value associated with PR-LVH.</p><p><strong>Conclusions: </strong>One-week postoperative Zva was a better predictor of improved LVH at 1 year after SAVR than PPM.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 6","pages":"473-480"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268331","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}

{"title":"Population Gap for Chronic Heart Failure Patients Between Randomized Controlled Trials and Japan's Super-Aged Society.","authors":"Jun-Ichi Noiri, Wataru Fujimoto, Makoto Takemoto, Koji Kuroda, Soichiro Yamashita, Junichi Imanishi, Masamichi Iwasaki, Takafumi Todoroki, Masanori Okuda, Manabu Nagao, Akihide Konishi, Masakazu Shinohara, Ryuji Toh, Kunihiro Nishimura, Hidekazu Tanaka","doi":"10.1253/circrep.CR-25-0002","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0002","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) management has been improved by guideline-directed medical therapy (GDMT) based on findings of major randomized controlled trials (RCTs). However, the applicability of these findings to real-world HF populations, especially Japan's current super-aged society, remains uncertain.</p><p><strong>Methods and results: </strong>We analyzed findings for chronic HF patients from the KUNIUMI registry, a prospective observational study conducted on Awaji Island, Japan, representative of a super-aged society (aging rate ≈37%). We determined what percentage of these patients met the inclusion criteria as well as the exclusion criteria of 6 major representative RCTs (PARADIGM-HF, PARAGON-HF, DAPA-HF, DELIVER, EMPEROR-Reduced, EMPEROR-Preserved) and compared the incidence of cardiovascular death and HF hospitalization over 3 years for patients who did and did not meet the exclusion criteria. Of the 1,646 patients from the KUNIUMI registry, 225 were eligible for PARADIGM-HF, DAPA-HF and EMPEROR-Reduced, 554 for PARAGON-HF, and 631 for DELIVER and EMPEROR-Preserved. The exclusion percentages for the overall eligible population were 48.4% (PARADIGM-HF), 36.4% (DAPA-HF), 42.7% (EMPEROR-Reduced), 57.9% (PARAGON-HF), 32.3% (DELIVER), and 31.4% (EMPEROR-Preserved). It should be noted that ineligible patients had a poorer prognosis than eligible patients (P<0.05 for each trial).</p><p><strong>Conclusions: </strong>The population gap between HF patients in major RCTs and the current super-aged society underscores the need for further evidence of GDMT in real-world settings.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"331-340"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056939","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}

{"title":"Neutrophil Extracellular Traps Capturing SARS-CoV-2 in the Lung Tissue (Alveoli and Parenchyma) Cause Microthrombi　- A Strategy to Eliminate SARS-CoV-2 From the Circulation as Degraded Fibrin Clots.","authors":"Hiroshi Katayama","doi":"10.1253/circrep.CR-24-0157","DOIUrl":"https://doi.org/10.1253/circrep.CR-24-0157","url":null,"abstract":"<p><strong>Background: </strong>It has been thought that neutrophil extracellular traps (NETs) and thrombosis exacerbate COVID-19, but, on the other hand, NETs are an important player in innate immunity. The precise roles of NETs and thrombosis in the course of COVID-19 have not been fully elucidated.</p><p><strong>Methods and results: </strong>The roles were investigated in the literature and a new theory was formulated. When neutrophils encounter SARS-CoV-2 in the lung tissue, they undergo NETosis and capture the virus. This capture is triggered by electrostatic interaction between histones in NETs and SARS-CoV-2; histones are highly positively charged, and viruses, including SARS-CoV-2, have a net negative charge under physiological pH. NETs that capture SARS-CoV-2 fall into alveolar capillaries through the collapsed endothelium to spare the lung tissue from the toxicity of NETs. NETs in the microvessels cause microthrombosis; positively charged histones induce the aggregation of negatively charged platelets, which leads to microthrombi. Microthrombi engulfing SARS-CoV-2 are consolidated into fibrin clots, which are eventually degraded by increased fibrinolysis and eliminated from the circulation.</p><p><strong>Conclusions: </strong>This novel theory suggests that NETosis and microthrombosis are phenomena inevitably elicited in COVID-19, and in combination they are a system newly termed \"NETombosis\". Undegraded fibrin clots remaining in the microcirculation may be the cause of the sequelae, because they cause long-lasting circulatory failure in various organs.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"379-382"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056330","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}

{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Is an Independent Risk Factor for the Development of Ischemic Heart Disease　- A 10-Year Cohort Study.","authors":"Toshifumi Ogawa, Tatsuya Sato, Marenao Tanaka, Yukinori Akiyama, Kei Nakata, Hidemichi Kouzu, Kazuma Mori, Hiroki Aida, Wataru Kawaharata, Itaru Hosaka, Toru Suzuki, Nagisa Hanawa, Masato Furuhashi","doi":"10.1253/circrep.CR-25-0019","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0019","url":null,"abstract":"<p><strong>Background: </strong>The association of each of the recently classified steatotic liver diseases (SLDs), including metabolic dysfunction-associated SLD (MASLD), MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD), with new development of ischemic heart disease (IHD) remains unclear.</p><p><strong>Methods and results: </strong>We investigated the associations of various SLDs with the development of IHD during a 10-year follow-up period in 13,815 Japanese individuals without a history of IHD (men/women 8,933/4,882; mean age 48 years) who underwent annual health checkups including an abdominal ultrasound examination. Among the participants, 4,639 (33.6%) subjects were diagnosed as having SLDs, and the proportions of subjects with MASLD, MetALD and ALD were 25.4%, 4.7% and 1.9%, respectively. During the follow-up period, 1,963 (16.2%; men/women 1,374 [17.2%]/589 [14.2%]) subjects had new development of IHD. Multivariable Cox proportional hazard model analysis after adjustment of age, sex, estimated glomerular filtration rate (eGFR), current smoking habit, diabetes, hypertension and dyslipidemia showed that the adjusted risk for new onset of IHD was significantly higher in subjects with MASLD (hazard ratio 1.20 [95% confidence interval 1.01-1.55]; P=0.042) than in those without SLD. Other SLDs were not selected as independent risk factors for the development of IHD.</p><p><strong>Conclusions: </strong>The presence of MASLD, but not other SLDs, is an independent risk factor for new onset of IHD during a 10-year follow-up period.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"350-358"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056326","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}

{"title":"Effect of Intensified Multifactorial Treatments on Coronary Atherosclerosis in Patients With Coronary Artery Disease and Type 2 Diabetes Mellitus　- Rationale and Design of the Randomized IMPACT-DM Trial.","authors":"Kozo Okada, Shinnosuke Kikuchi, Nobuhiko Maejima, Noriyuki Kawaura, Sho Kodama, Naoki Nakayama, Kenichiro Saka, Shunsuke Kataoka, Hiroyuki Suzuki, Hiroyuki Ishikawa, Shotaro Kuji, Yuki Saigusa, Chika Kawashima, Hidekuni Kirigaya, Yohei Hanajima, Hidefumi Nakahashi, Masaomi Gohbara, Jun Okuda, Kengo Tsukahara, Kazuki Fukui, Tsutomu Endo, Teruyasu Sugano, Kiyoshi Hibi","doi":"10.1253/circrep.CR-25-0021","DOIUrl":"10.1253/circrep.CR-25-0021","url":null,"abstract":"<p><strong>Background: </strong>The effect of Intensified Multifactorial treatments on coronary atherosclerosis in PAtients with Coronary artery disease and Type 2 Diabetes Mellitus (IMPACT-DM) trial was designed to investigate the effects of intensified multifactorial treatments (IMT) on coronary plaque progression in patients with coronary artery disease (CAD) and diabetes.</p><p><strong>Methods and results: </strong>In this prospective, randomized, open-label, parallel assignment, multicenter study, eligible patients with diabetes who underwent successful percutaneous coronary intervention in culprit lesions are randomly assigned to receive either IMT or guideline-oriented standard treatments (Control) for 18 months. The IMT are managed according to strict target goals and step-by-step medical treatment protocols based on modern medical treatments. Target goals in IMT and Control groups are set to hemoglobin A1c <6.2% vs. <7.0%; low-density lipoprotein cholesterol <55 mg/dL for any type of CAD vs. <70 mg/dL for acute coronary syndrome, or <100 mg/dL for stable CAD; and blood pressure <120/80 mmHg vs. <130/80 mmHg, respectively. Non-culprit lesions are evaluated using intravascular ultrasound (IVUS) at post-procedure and 18 months follow up. The primary endpoint is absolute changes in percent plaque volumes in non-culprit lesions as assessed using IVUS from post-procedure to 18 months.</p><p><strong>Conclusions: </strong>The IMPACT-DM trial will clarify the clinical benefits of IMT on non-culprit coronary plaques in patients with diabetes undergoing successful PCI in culprit lesions.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 6","pages":"486-490"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268326","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}

{"title":"Early Changes in Left Ventricular Myocardial Mechanics After Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis.","authors":"Takeru Ikenaga, Yuta Kato, Yuto Kawahira, Midori Miyazaki, Tetsuo Hirata, Hiromitsu Teratani, Go Kuwahara, Makoto Sugihara, Hideichi Wada, Masahiro Ogawa, Shin-Ichiro Miura","doi":"10.1253/circrep.CR-24-0139","DOIUrl":"https://doi.org/10.1253/circrep.CR-24-0139","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) improves left ventricular (LV) deformation by aortic stenosis (AS). However, the early effects of TAVR on LV mechanics as assessed by echocardiography have not been fully elucidated.</p><p><strong>Methods and results: </strong>Between 2021 and 2024, we included 81 patients who underwent transfemoral TAVR for severe AS. We used the natural logarithm of B-type natriuretic peptide (lnBNP) 1 week after TAVR as an indicator of the early effects on LV mechanics. To determine the association with echocardiographic parameters (LV ejection fraction [LVEF], global longitudinal strain [GLS], E/e', and Tei index) and postprocedural lnBNP, we used regression models while adjusting for covariates. There were no significant differences in LVEF, GLS or E/e' between before and after TAVR, but the postprocedural Tei index was significantly higher than the preprocedural Tei index (0.40 vs. 0.26, P<0.01). In a univariate linear regression, the preprocedural LVEF (β=-0.28, P=0.01), GLS (β=-0.24, P=0.04), E/e' (β=0.36, P<0.01), and Tei index (β=0.27, P=0.02) correlated with postprocedural lnBNP. Regarding the postprocedural parameters, GLS (β=-0.27, P=0.02) and E/e' (β=0.36, P<0.01) also correlated with postprocedural lnBNP, but the LVEF and Tei index did not. After adjustment for covariates, these correlations remained significant.</p><p><strong>Conclusions: </strong>Preprocedural echocardiographic parameters reflecting LV function correlated with BNP after TAVR, but the utility of postprocedural parameters may depend on preprocedural LV function or perioperative factors.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"365-371"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061203","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}

{"title":"Angiogenesis Using Recombinant Basic Fibroblast Growth Factor With Atelocollagen in Normal and Hind Limb Ischemia Models.","authors":"Atsushi Kotani, Shin Watanabe, Takao Kato, Takayuki Kikuchi, Keiji Toya, Katsuhiko Hori, Noriko Minobe, Kaori Musumi, Yasuko Kimura, Yoji Nagai, Jun Yoshimura, Hirofumi Kawamata, Kenji Yanishi, Satoaki Matoba","doi":"10.1253/circrep.CR-25-0011","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0011","url":null,"abstract":"<p><strong>Background: </strong>Basic fibroblast growth factor (bFGF) is an angiogenic factor with a short half-life. Because recombinant bFGF is in clinical use, we hypothesized that the localization of recombinant bFGF with atelocollagen would have angiogenic effects at the injection site in normal and hind limb ischemic animal models.</p><p><strong>Methods and results: </strong>We administered the recombinant bFGF with atelocollagen intramuscularly to hind limbs in normal rabbits or in a mouse model of femoral artery ligation to explore the pharmacological action for ischemia. We evaluated blood flow in the ischemic/normal limb using laser speckle perfusion imaging and the density of blood vessels by pathological examination. At the administration site in normal rabbits, a significant increase in the number of blood vessels was noted at 14 days post-administration of recombinant bFGF with atelocollagen compared with saline or atelocollagen alone. In mice with femoral artery ligation, blood flow and vessels in the ischemic hind limb increased at 2 weeks after injection and more at 4 weeks after injection, and the effect was most significant in mice administered 100 μg of recombinant bFGF with 3% of atelocollagen.</p><p><strong>Conclusions: </strong>Intramuscular administration of recombinant bFGF with atelocollagen induced angiogenesis between 2 and 4 weeks in both normal and ischemic hind limbs.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"372-378"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047571","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}

{"title":"Promoting Diversity in Cardiac Rehabilitation Programs at Community Hospitals.","authors":"Noriko Fukue, Masakazu Miura, Ikki Tokumoto, Yuka Hajima, Sanae Namba, Shinya Kohtoku, Yasuhiro Ikeda","doi":"10.1253/circrep.CR-25-0017","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0017","url":null,"abstract":"<p><strong>Background: </strong>Although comprehensive cardiac rehabilitation (CR) is an effective treatment for cardiovascular diseases, its implementation in Japan remains insufficient. Following the 2022 Basic Act on Cardiovascular Disease Prevention, each prefecture has established specific targets.</p><p><strong>Methods and results: </strong>We report our experience implementing and managing CR programs across hospitals of different sizes in Yamaguchi Prefecture, Japan, including Tokuyama Medical Association Hospital (initiated in 2019), Mitajiri Hospital (initiated in 2022), and Yamaguchi Prefectural Grand Medical Center. Hospital size and functionality correlated with the diversity and number of healthcare professionals available to provide CR services. In mixed-care hospitals, both inpatient and outpatient CR participants were older compared with acute-care hospitals. Insurance reimbursement calculations and bed-type restrictions affected CR service delivery. The CR team exemplifies interprofessional collaboration in cardiovascular care.</p><p><strong>Conclusions: </strong>Even without all the necessary professional roles, patients can benefit significantly from CR implemented using available resources. Building effective organizations requires embracing diversity and enabling each profession to demonstrate its expertise while ensuring the psychological safety of team members.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 4","pages":"219-222"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039519","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}

{"title":"The First Experience of Transjugular Transcatheter Tricuspid Valve Replacement With LuX-Valve Plus System in Japan.","authors":"Ryo Horita, Daisuke Hachinohe, Ryo Otake, Shah Sagar, Hidemasa Shitan, Kazuki Mizutani","doi":"10.1253/circrep.CR-25-0020","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0020","url":null,"abstract":"","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 5","pages":"393-394"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056471","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}

{"title":"Triphasic Changes in Ischemic Stroke Incidence With Age in Non-Valvular Atrial Fibrillation Patients　- Pooled Analysis of the Shinken Database, J-RHYTHM Registry, and Fushimi AF Registry.","authors":"Shinya Suzuki, Takeshi Yamashita, Ken Okumura, Hirotsugu Atarashi, Masaharu Akao, Hiroshi Inoue","doi":"10.1253/circrep.CR-25-0009","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0009","url":null,"abstract":"<p><strong>Background: </strong>The basis for the specific age threshold for increasing of ischemic stroke in non-valvular atrial fibrillation (NVAF) patients has not been fully evaluated.</p><p><strong>Methods and results: </strong>We conducted a pooled analysis of 3,588 Japanese NVAF patients without anticoagulation therapy from the Shinken Database (n=1,099), the J-RHYTHM Registry (n=1,002), and the Fushimi AF Registry (n=1,487) to determine the incidence of ischemic stroke by age group; patients aged between 31 and 90 years (n=3,455) were analyzed. During a follow-up period of 1.47 years, 69 ischemic strokes occurred (1.33% per year). The incidence of ischemic stroke exhibited triphasic changes as follows: first, it ranged from 0.00% per year to 0.41% per year across the age groups between 31-35 and 46-50 years. Second, it then rose to 1.58% per year in the 56-60-years age group, remaining around 1% per year across the age groups between 56-60 and 71-75 years, with rates ranging from 0.83% to 1.58% per year. Last, it further increased to 2.35% per year in the 76-80-year age group, remaining around 2.5% per year across the age groups between 76-80 and 86-90 years.</p><p><strong>Conclusions: </strong>The incidence of ischemic stroke in NVAF patients exhibits triphasic changes with age, with notable increases observed in patients aged in their late 50s and late 70s.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 4","pages":"303-307"},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053680","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}