|
所属 |
医学部 医学科 内科学講座循環器・腎臓内科学分野 |
|
外部リンク |
|
論文 【 表示 ／ 非表示 】
-
Nitroglycerin use and adverse clinical outcomes in elderly patients with acute coronary syndrome 査読あり
Komaki S., Matsuura Y., Tanaka H., Moribayashi K., Yamamura Y., Kurogi K., Ideguchi T., Yamamoto N., Nakai M., Tsuruda T., Kaikita K.
Open Heart 11 ( 1 ) 2024年1月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Open Heart
Objective The primary care for acute coronary syndrome (ACS) includes the administration of nitroglycerin (GTN). This study aimed to investigate the association between the use of GTN before percutaneous coronary intervention (PCI) for ACS and clinical outcomes. Methods Nine-hundred and forty-seven patients who underwent PCI for ACS were examined and classified into two groups: those who were treated with GTN before PCI (GTN group) and those who were not (non-GTN group). The incidence of major adverse cardiovascular events (MACE), which consist of all-cause mortality, non-fatal myocardial infarction, stroke and rehospitalisation for heart failure at 1 year, was compared between the two groups. Results This study identified 289 patients with ACS who used GTN preceding PCI. Pre-PCI systolic blood pressure was significantly lower in the GTN group than in the non-GTN group (median (IQR); 132.0 (110.0-143.5) mm Hg vs 134.0 (112.0-157.0) mm Hg, respectively, p=0.03). Multivariate Cox regression analysis indicated that GTN use preceding PCI showed an independent association with the incidence of MACE (HR 1.57; 95% CI 1.09-2.28; p=0.016). Overall, the incidence of MACE 1 year after PCI for ACS was significantly higher in the GTN group than in the non-GTN group (log-rank test, p=0.024); however, this trend was consistently found in elderly patients aged ≥75 years (p=0.002) but not in non-elderly patients aged <75 years (p=0.773). Conclusions GTN use preceding PCI for ACS is associated with lower blood pressure and adverse clinical outcomes in elderly patients.
-
Tsuruda T., Funamoto T., Suzuki C., Yamamura Y., Nakai M., Chosa E., Kaikita K.
Archives of Osteoporosis 18 ( 1 ) 129 2023年12月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Archives of Osteoporosis
Purpose: The purpose of this study was to investigate the morphological characteristics of the aortic valve and identify factors associated with the progression of aortic valve stenosis (AS) in osteoporosis patients. Methods: In this single-center prospective cohort study, we recruited 10 patients (mean age: 75 ± 7 years, 90% female) who were taking anti-resorptive medicines at the outpatient clinic of University of Miyazaki Hospital, Japan. Baseline assessments, including transthoracic echocardiogram, blood sampling, and dual energy X-ray absorptiometry, were performed. Follow-up assessments were conducted at 6, 12, 18, and 24 months. Results: During the 2-year follow-up, three patients with aortic valve peak flow velocity (AV PFV) ≥2 m/s at baseline developed moderate AS, which is defined as AV PFV ≥3 m/s. However, seven patients with AV PFV <2 m/s did not exhibit any progression of AS. There were significant variations in terms of bone mineral density, T-score values, and biomarkers associated with bone turnover (i.e., bone alkaline phosphatase, tartrate-resistance acid phosphatase-5b) among the enrolled patients, but none of these factors were found to be associated with the progression of AS. All patients exhibited low vitamin D status, with a median level of 16.1 ng/mL (25th percentile, 9.7 ng/mL; 75th percentile, 23 ng/mL). The baseline levels of AV PFV values were negatively correlated with 25-hydroxyvitamin D levels, determined by univariate linear regression analysis (beta coefficient = -0.756, 95% confidence interval, -0.136 ̶ -0.023, p = 0.011). Conclusion: Our data suggest that low vitamin D status might be a potential risk factor for the progression of AS in osteoporosis patients undergoing treatment with anti-resorptive medicines. Summary : Elderly patients with osteoporosis patients exhibited a subset of aortic valve stenosis. Our data suggest that the baseline aortic valve peak flow velocity predicts the progression of aortic valve stenosis, and there might be an association between the progression and the co-existing low vitamin D status in these patients.
-
特集 心エコー計測/抽出のコツ,身につけたい考え方/進め方 Ⅱ 身につけたい考え方/進め方 3 病気を識る,病気を診る b. 僧帽弁狭窄症･僧帽弁逆流症(一次性)
山村 善政, 渡邉 望
Heart View 25 ( 12 ) 122 - 129 2021年11月
-
Takeuchi T., Matsuura Y., Yamamura Y., Ohkusu M., Koyama S., Kawaguchi T., Akaki Nagayasu M., Komatsu H., Okayama A., Ishikawa T., Atsumi T., Kitamura K.
Clinical Case Reports 9 ( 9 ) e04805 2021年9月
記述言語：日本語 掲載種別：症例報告 出版者・発行元：Clinical Case Reports
Patients with immune thrombocytopenia have increased risks of bleeding and thrombosis. The acute-phase treatment for venous thromboembolism complicated with severe immune thrombocytopenia involves a “platelet dilemma” in therapeutic decision-making.
DOI： 10.1002/ccr3.4805