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• Is liver fibrosis more advanced in MetALD than in MASLD?

  Fujii H, Kamada Y, Tokushige A, Watanabe T, Kawada N

  Journal of hepatology     2024.07 [ Peer Review Accepted ]

  Type of publication: Research paper (other science council materials etc.)

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• Clinical impact of Academic Research Consortium for High Bleeding-Risk scores on clinical outcomes in patients with stable coronary artery disease undergoing percutaneous coronary intervention

  Shimono, H; Tokushige, A; Kanda, D; Ohno, A; Arikawa, R; Chaen, H; Okui, H; Oketani, N; Ohishi, M

  HEART AND VESSELS ( Heart and Vessels )    2024.06 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  High bleeding risk (HBR), as defined by the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria, has been recently reported to be associated with an increased risk of major bleeding events and cardiovascular events. We investigated the association between the ARC-HBR score and clinical outcomes in patients with stable coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We assessed 328 consecutive patients with stable CAD who underwent PCI between January 2017 and December 2020. We scored the ARC-HBR criteria by assigning 1 point to each major criterion and 0.5 points to each minor criterion. Patients were stratified into low (ARC-HBR score < 1), intermediate (1 ≤ ARC-HBR score < 2), and high (ARC-HBR score ≥ 2) bleeding-risk groups. The primary outcome measure was major adverse cardiovascular events (MACE), defined as a composite of all-cause death, nonfatal myocardial infarction, and nonfatal stroke. We compared the discriminative abilities of the ARC-HBR score with the Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention (TRS2°P) and ARC-HBR score with Coronary Revascularization Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) thrombotic risk score. The mean patient age was 70.1 ± 10.2 years (males, 76.8%). During the median follow-up period of 983 (618-1338) days, 44 patients developed MACE. Kaplan-Meier curves showed that a stepwise significant increase in the cumulative incidence of MACE as the ARC-HBR score increased (log-rank p < 0.001). In the time-dependent receiver-operating characteristic curve analysis for predicting MACE within 2 years, the area under the curve (AUC) of the ARC-HBR score was significantly higher than that of the TRS2°P (AUC: 0.825 vs. 0.725, p value for the difference = 0.023) and similar to that of CREDO-Kyoto thrombotic risk score (AUC: 0.825 vs. 0.813, p value for the difference = 0.627). Conclusions: The ARC-HBR score adequately stratified future risk of MACE in patients with stable CAD who underwent PCI. The ARC-HBR score showed a higher discriminative ability for predicting mid-term MACE than the TRS2°P.

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• Hepatic inflammation and fibrosis are profiles related to mid-term mortality in biopsy-proven MASLD: A multicenter study in Japan

  Tsutsumi, T; Kawaguchi, T; Fujii, H; Kamada, Y; Takahashi, H; Kawanaka, M; Sumida, Y; Iwaki, M; Hayashi, H; Toyoda, H; Oeda, S; Hyogo, H; Morishita, A; Munekage, K; Kawata, K; Sawada, K; Maeshiro, T; Tobita, H; Yoshida, Y; Naito, M; Araki, A; Arakaki, S; Noritake, H; Ono, M; Masaki, T; Yasuda, S; Tomita, E; Yoneda, M; Tokushige, A; Ueda, S; Aishima, S; Nakajima, A; Okanoue, T

  ALIMENTARY PHARMACOLOGY & THERAPEUTICS ( Alimentary Pharmacology and Therapeutics )  59 ( 12 ) 1559 - 1570   2024.06 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  AIMS: A multi-stakeholder consensus has proposed MASLD (metabolic dysfunction-associated steatotic liver disease). We aimed to investigate the pathological findings related to the mid-term mortality of patients with biopsy-proven MASLD in Japan. METHODS: We enrolled 1349 patients with biopsy-proven MASLD. The observational period was 8010 person years. We evaluated independent factors associated with mortality in patients with MASLD by Cox regression analysis. We also investigated pathological profiles related to mortality in patients with MASLD using data-mining analysis. RESULTS: The prevalence of MASH and stage 3/4 fibrosis was observed in 65.6% and 17.4%, respectively. Forty-five patients with MASLD died. Of these, liver-related events were the most common cause at 40% (n = 18), followed by extrahepatic malignancies at 26.7% (n = 12). Grade 2/3 lobular inflammation and stage 3/4 fibrosis had a 1.9-fold and 1.8-fold risk of mortality, respectively. In the decision-tree analysis, the profiles with the worst prognosis were characterised by Grade 2/3 hepatic inflammation, along with advanced ballooning (grade 1/2) and fibrosis (stage 3/4). This profile showed a mortality at 8.3%. Furthermore, the random forest analysis identified that hepatic fibrosis and inflammation were the first and second responsible factors for the mid-term prognosis of patients with MASLD. CONCLUSIONS: In patients with biopsy-proven MASLD, the prevalence of MASH and advanced fibrosis was approximately 65% and 20%, respectively. The leading cause of mortality was liver-related events. Hepatic inflammation and fibrosis were significant factors influencing mid-term mortality. These findings highlight the importance of targeting inflammation and fibrosis in the management of patients with MASLD.

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• Association of schizophrenia with fracture-related femoral neck displacement: A cross-sectional retrospective study.

  Yukiyo Inoue, Akihiro Tokushige, Takeshi Kinjyo, Shinichiro Ueda

  PCN reports : psychiatry and clinical neurosciences   3 ( 2 ) e195   2024.06 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  AIM: Fracture-related femoral neck displacement is more likely in patients with schizophrenia because of delayed diagnosis, as these patients frequently have less severe fracture-associated subjective symptoms. This study aimed to investigate the association of schizophrenia with the risk of fracture-related femoral neck displacement in hospitalized patients. METHODS: We retrospectively analyzed the medical records of patients with femoral neck fractures treated between April 2013 and March 2018 at a single institution. Multivariate logistic regression was used to explore the relationship between schizophrenia and fracture-related femoral neck displacement after adjusting for risk factors. RESULTS: We compared 30 and 194 patients with and without schizophrenia, respectively. The prevalence of fracture-related displacement was 80.0% in patients with schizophrenia and 62.4% in the controls (p = 0.06). After adjusting for confounding variables, schizophrenia significantly correlated with fracture-related femoral neck displacement (odds ratio: 4.74, 95% confidence interval: 1.09-20.60, p = 0.0378). CONCLUSIONS: Schizophrenia is associated with a higher risk of severe femoral neck fracture. To improve outcomes and alleviate the societal burden of femoral neck fractures, early radiographic assessment and surgical intervention for femoral fractures are essential for patients with schizophrenia, even in those without pain symptoms.

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• Association between Estimated Small Dense Low-Density Lipoprotein Cholesterol and Occurrence of New Lesions after Percutaneous Coronary Intervention in Japanese Patients with Stable Angina and Receiving Statin Therapy.

  Daisuke Kanda, Akihiro Tokushige, Mitsuru Ohishi

  Reviews in cardiovascular medicine   25 ( 6 ) 218 - 218   2024.06 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) is considered the most important risk factor for coronary artery disease (CAD). Although lipid-lowering therapy using high-intensity statins for patients with stable CAD is one of the cornerstones of medication therapy, there is still a risk of residual cardiovascular events, even after controlling for LDL-C. Recently, attention has focused on the association between small dense LDL-C as a residual risk factor for CAD, and it has been reported that a formula can be used to calculate the small LDL-C. METHODS: We investigated the association between estimated small dense LDL-C (Esd LDL-C) and the occurrence of new lesions with myocardial ischemia ≤ 2 years after percutaneous coronary intervention (PCI) in 537 patients with stable angina who underwent PCI. In this study, all patients had been prescribed statins. This study was based on previously reported data regarding the relationship between non-high-density lipoprotein cholesterol levels and stable angina pectoris after PCI. RESULTS: Revascularization, including new lesions and in-stent restenosis, and new lesions appeared in 130 and 90 patients, respectively, ≤ 2 years after PCI. Age, diabetes mellitus (DM), LDL-C, and Esd LDL-C were associated with the occurrence of revascularization and new lesions ≤ 2 years after PCI. Multivariate logistic regression analysis models revealed that Esd LDL-C [odds ratio (OR) 1.03, 95% confidence interval (CI) 1.004-1.048, p = 0.020; and OR 1.03, 95% CI 1.009-1.057, p = 0.007, respectively] were associated with the revascularization and occurrence of new lesions ≤ 2 years after PCI. CONCLUSIONS: As well as total cholesterol and LDL-C, Esd LDL-C was an independent risk factor for the revascularization and occurrence of new lesions ≤ 2 years after PCI for stable angina in Japanese patients receiving statin therapy. In patients with stable angina who are on lipid-lowering therapy with statins, calculating the Esd LDL-C may provide useful information for predicting revascularization and the occurrence of new lesions.

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Other Papers 【 display / non-display 】

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• White Blood Cell Count Predicts Cardiovascular Prognosis in Type 2 Diabetic Patients with Established Coronary Artery Disease(和訳中)

  河邉 篤彦, 安隆 則, 森本 剛, 百村 伸一, 坂倉 建一, 徳重 明央, 野出 孝一, 植田 真一郎

  日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  84回   PJ16 - 1   2020.07

   

• Risk Factors of Cardiovascular Death for 2-years after Revascularization in Elderly Critical Limb Ischemia Patients with Coronary Artery Disease(和訳中)

  安崎 和博, 神田 大輔, 有川 亮, 薗田 剛嗣, 徳重 明央, 小瀬戸 一平, 池田 義之, 大石 充

  日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  84回   PJ33 - 8   2020.07

   

• 冠動脈疾患を伴う糖尿病患者における癌生存者の心血管転帰 CHDコホートから(The Cardiovascular Outcome of Cancer Survivor in Patients with Diabetes Mellitus with Coronary Artery Disease: From CHD Cohort)

  徳重 明央, 植田 真一郎, 大石 充

  日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  83回   PJ022 - 4   2019.03

   

• 脂質異常および心血管リスクを有する2型糖尿病患者のLDL cholesterolに対するanagliptinとsitagliptinの効果 Reason試験からの結果(Effect of Anagliptin and Sitagliptin on LDL-cholesterol in Type 2 Diabetic Patients with Dyslipidemia and Cardiovascular Risk Results from Reason Trial)

  植田 真一郎, 佐久間 一郎, 作間 未織, 徳重 明央, 夏秋 政浩, 旭 朝弘, 島袋 充生, 野見山 崇, 新崎 修, 野出 孝一, 森本 剛

  日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  83回   PJ018 - 1   2019.03

   

• 多様化する医療に向けて臨床研究の方向性を再考する 多剤併用高齢CAD患者における最適な減薬方法に関する臨床試験の提唱 患者レジストリに基づいた理論的根拠とデザイン(Proposal of Clinical Trial for Appropriate Deprescribing in Elderly Cad Patients with Polypharmacy: Rationale and Design Based on Patients Registry)

  徳重 明央, 植田 真一郎

  日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  82回   SY09 - 4   2018.03

   

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Grant-in-Aid for Scientific Research 【 display / non-display 】

Grant-in-Aid for Scientific Research 【 display / non-display 】

• Grant-in-Aid for Scientific Research(B)

  Project Year: 2023.04  -  2028.03 

  Direct: 13,400,000 (YEN)  Overheads: 17,420,000 (YEN)  Total: 4,020,000 (YEN)

• Grant-in-Aid for Scientific Research(B)

  Project Year: 2023.04  -  2028.03 

  Direct: 13,400,000 (YEN)  Overheads: 17,420,000 (YEN)  Total: 4,020,000 (YEN)

• Grant-in-Aid for Scientific Research(C)

  Project Year: 2020.04  -  2024.03 

  Direct: 3,300,000 (YEN)  Overheads: 4,290,000 (YEN)  Total: 990,000 (YEN)

• Grant-in-Aid for Scientific Research(C)

  Project Year: 2020.04  -  2024.03 

  Direct: 3,300,000 (YEN)  Overheads: 4,290,000 (YEN)  Total: 990,000 (YEN)