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  • Ovid Technologies (Wolters Kluwer Health)  (73)
  • 1
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    Features and Outcomes of Histologically Proven Myocarditis With Fulminant Presentation
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. 19 ( 2022-11-08), p. 1425-1433
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. 19 ( 2022-11-08), p. 1425-1433
    Abstract: Fulminant myocarditis presentation (FMP) is a rare and severe presentation of myocarditis. The natural history of FMP and its clinical features associated with poor outcomes are incompletely understood because there is a lack of generalizable evidence. Methods: This multicenter retrospective cohort study included patients hospitalized with histologically proven myocarditis who underwent catecholamine or mechanical support from 235 cardiovascular training hospitals across Japan between April 2012 and March 2017. Clinical features and the prognostic predictors of death or heart transplantation within 90 days on the basis of clinical and pathologic findings were determined using the Kaplan-Meier method, log-rank test, and Cox regression analysis. Results: This study included 344 patients with histologically proven FMP (median age, 54 years; 40% female). The median follow-up was 600 days (interquartile range, 36 to 1599 days) and the cumulative risk of death or heart transplantation at 90 days was 29% (n=98). Results from multivariable Cox regression analysis showed that older age, nonsinus rhythm, low left ventricular wall motion ( 〈 40%) on admission, and ventricular tachycardia or fibrillation on admission day were associated with worse 90-day survival. Severe histologic damage (damaged cardiomyocytes comprising ≥50% of the total cardiomyocytes) was associated with a worse 90-day prognosis in patients with lymphocytic myocarditis. Conclusions: The results from analyses of data from this multicenter registry demonstrated that patients with FMP are at a higher risk of death or heart transplantation in real-world settings. These observations inform which clinical and pathologic findings may be useful for prognostication in FMP. Registration: URL: https://www.umin.ac.jp/ctr ; Unique identifier: UMIN000039763.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.121.058869
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 2
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    Blood Pressure Level and Variability During Long-Term Prasugrel or Clopidogrel Medication After Stroke : PRASTRO-I
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Stroke Vol. 52, No. 4 ( 2021-04), p. 1234-1243
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 4 ( 2021-04), p. 1234-1243
    Abstract: High blood pressure increases bleeding risk during treatment with antithrombotic medication. The association between blood pressure levels and the risk of recurrent stroke during long-term secondary stroke prevention with thienopyridines (particularly prasugrel) has not been well studied. Methods: This was a post hoc analysis of the randomized, double-blind, multicenter PRASTRO-I trial (Comparison of Prasugrel and Clopidogrel in Japanese Patients With Ischemic Stroke-I). Patients with noncardioembolic stroke were randomly assigned (1:1) to receive prasugrel 3.75 mg/day or clopidogrel 75 mg/day for 96 to 104 weeks. Risks of any ischemic or hemorrhagic stroke, combined ischemic events, and combined bleeding events were determined based on the mean level and visit-to-visit variability, including successive variation, of systolic blood pressure (SBP) throughout the observational period. These risks were also compared between quartiles of mean SBP level and successive variation of SBP. Results: A total of 3747 patients (age 62.1±8.5 years, 797 women), with a median average SBP level during the observational period of 132.5 mm Hg, were studied. All the risks of any stroke (146 events; hazard ratio, 1.318 [95% CI, 1.094–1.583] per 10-mm Hg increase), ischemic stroke (133 events, 1.219 [1.010–1.466] ), hemorrhagic stroke (13 events, 3.247 [1.660–6.296]), ischemic events (142 events, 1.219 [1.020–1.466] ), and bleeding events (47 events, 1.629 [1.172–2.261]) correlated with increasing mean SBP overall. Similarly, an increased risk of these events correlated with increasing successive variation of SBP (hazard ratio, 3.078 [95% CI, 2.220–4.225] per 10-mm Hg increase; 3.051 [2.179–4.262]; 3.276 [1.172–9.092] ; 2.865 [2.042–4.011]; 2.764 [1.524–5.016] , respectively). Event rates did not differ between the clopidogrel and prasugrel groups within each quartile of SBP or successive variation of SBP. Conclusions: Both high mean SBP level and high visit-to-visit variability in SBP were significantly associated with the risk of recurrent stroke during long-term medication with either prasugrel or clopidogrel after stroke. Control of hypertension would be important regardless of the type of antiplatelet drugs. Registration: URL: https://www.clinicaltrials.jp ; Unique identifier: JapicCTI-111582.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.120.032824
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1467823-8
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  • 3
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    Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Pediatric Infectious Disease Journal Vol. 42, No. 10 ( 2023-10), p. e369-e376
    Details
    In: Pediatric Infectious Disease Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 42, No. 10 ( 2023-10), p. e369-e376
    Abstract: The members of the Japanese Society for Pediatric Infectious Diseases and the Japanese Society of Pediatric Pulmonology have developed Guidelines for the Management of Respiratory Infectious Diseases in Children with the objective of facilitating appropriate diagnosis, treatment and prevention of respiratory infections in children. The first edition was published in 2004 and the fifth edition was published in 2022. The Guideline 2022 consists of 2 parts, clinical questions and commentary, and includes general respiratory infections and specific infections in children with underlying diseases and severe infections. This executive summary outlines the clinical questions in the Guidelines 2022, with reference to the Japanese Medical Information Distribution Service Manual. All recommendations are supported by a systematic search for relevant evidence and are followed by the strength of the recommendation and the quality of the evidence statements.
    Type of Medium: Online Resource
    ISSN: 0891-3668
    URL: Article
    DOI: 10.1097/INF.0000000000004041
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2020216-7
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  • 4
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    GASLESS LAPAROSCOPY-ASSISTED LIVE DONOR NEPHRECTOMY : THE INITIAL 23 CASES
    Ovid Technologies (Wolters Kluwer Health) ; 1999
    In:  The Journal of Urology
    Details
    In: The Journal of Urology, Ovid Technologies (Wolters Kluwer Health)
    Type of Medium: Online Resource
    ISSN: 0022-5347
    URL: Article
    DOI: 10.1097/00005392-199904020-00537
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1999
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  • 5
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    Associations of Acid Suppressive Therapy With Cardiac Mortality in Heart Failure Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of the American Heart Association Vol. 6, No. 5 ( 2017-05-05)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 6, No. 5 ( 2017-05-05)
    Abstract: It has been recently reported that histamine H 2 receptor antagonists (H2 RA s) are associated with impairment of ventricular remodeling and incident heart failure. In addition, favorable pleiotropic effects and adverse effects of proton pump inhibitors ( PPI s) on cardiovascular disease have also been reported. We examined the associations of acid suppressive therapy using H2 RA s or PPI s with cardiac mortality in patients with heart failure. Methods and Results In total, 1191 consecutive heart failure patients were divided into 3 groups: a non–acid suppressive therapy group (n=363), an H2 RA group (n=164), and a PPI group (n=664). In the follow‐up period (mean 995 days), 169 cardiac deaths occurred. In the Kaplan–Meier analysis, cardiac mortality was significantly lower in the PPI group than in the H2 RA and non–acid suppressive therapy groups (11.0% versus 21.3% and 16.8%, respectively; log‐rank P =0.004). In the multivariable Cox proportional hazards analysis, use of PPI s, but not H2 RA s, was found to be an independent predictor of cardiac mortality ( PPI s: hazard ratio 0.488, P =0.002; H2 RA s: hazard ratio 0.855, P =0.579). The propensity‐matched 1:1 cohort was assessed based on propensity score (H2 RA s, n=164; PPI s, n=164). Cardiac mortality was significantly lower in the PPI group than in the H2 RA group in the postmatched cohort (log‐rank P =0.025). In the Cox proportional hazards analysis, the use of PPI s was a predictor of cardiac mortality in the postmatched cohort (hazard ratio 0.528, P =0.028). Conclusions PPI s may be associated with better outcome in patients with heart failure.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.116.005110
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2653953-6
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  • 6
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    Abstract 12050: The CHA2DS2-VASc Score Predicts High Mortality in Hospitalized Heart Failure Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Background: Atrial fibrillation (AF) is common in patients with heart failure (HF). CHA2DS2-VASc score is an originally risk assessment tool for stroke in patients with AF. Recently, it has been reported that CHA2DS2-VASc score is associated with mortality in patients with acute coronary syndrome with or without AF. We aimed to examine the value of the CHA2DS2-VASc score as a risk assessment tool in patients with HF. Methods and Results: Consecutive 1011 patients admitted for treatment of HF were divided into three groups based on CHA2DS2-VASc score: low score group (CHA2DS2-VASc score 1-3, n=316), moderate score group (CHA2DS2-VASc score 4-6, n=549) and high score group (CHA2DS2-VASc score 7-9, n=145). Of 1011 HF patients, 387 (38.3%, mean age 70.5 years, male 247) had AF. We compared patient characteristics and prospectively followed all-cause mortality among the three groups. The high score group, as compared to low and moderate score groups, had higher cardio-ankle vascular index (9.0 vs. 8.5, 7.9, P=0.001), lower levels of hemoglobin (11.2 vs. 12.1, 13.4 g/dl, P 〈 0.001), sodium (138.5 vs. 138.4, 139.4 mEq/l, P=0.002) and estimated GFR (40.0 vs. 52.7, 64.3 ml/min/1.73m 2 , p 〈 0.001). In contrast, left ventricular ejection fraction was similar among the three groups. Importantly, all-cause mortality was higher in high score group than in low and moderate score groups (P 〈 0.001). In the multivariable Cox proportional hazard analyses, CHA2DS2-VASc score was an independent predictor of all-cause mortality (all patients: HR 1.203, P 〈 0.001; AF patients: HR 1.152, P=0.009; non-AF patients: HR 1.228, P 〈 0.001). Conclusions: The CHA2DS2-VASc score was an independent predictor of all-cause mortality in HF patients with or without AF. CHA2DS2-VASc score may help to identify patients at high risk for mortality and need for optimization of risk-reducing treatment in HF patients.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.12050
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
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  • 7
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    Abstract 11155: Impact of Serum Calcium Levels on Mortality of Patients With Heart Failure and Chronic Kidney Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: Chronic kidney disease-mineral and bone disorders (CKD-MBD) are associated with vascular calcification and abnormal electrolyte that lead to cardiovascular disease and mortality. CKD-MBD are identified by imbalances in serum calcium (Ca), phosphate, and parathyroid hormone (PTH). Although, the relation of phosphate and PTH to prognosis of HF patients has been reported, prognostic impact of Ca on patients with heart failure (HF) and CKD remains unclear. Methods and Results: Consecutive 191 patients admitted for HF and CKD (estimated GFR 〈 60 ml/min/1.73 m 2 ) were divided into 3 groups based on levels of corrected Ca: low Ca (Ca 〈 8.4 mg/dl, n = 32), normal Ca (8.4 ≤ Ca 〈 10.0, n = 149), and high Ca (10.0 ≤ Ca, n = 10) groups. We compared echocardiographic findings and levels of hemoglobin, BNP, troponin T, CRP, estimated GFR, intact PTH, phosphate, zinc (Zn), and magnesium (Mg) among the three groups. Furthermore, we prospectively followed cardiac, non-cardiac, and all-cause mortality. The low Ca group, as compared to normal and high Ca groups, had lower levels of hemoglobin and Zn (hemoglobin: 11.2 vs. 12.4, 13.0 g/dl, P 〈 0.001; Zn: 58.1 vs. 70.1, 71.0 mg/dl, P = 0.003). Age, body mass index, BNP, troponin T, CRP, estimated GFR, intact PTH, phosphate, Mg, and left ventricular ejection fraction were similar among the three groups. Importantly, cardiac mortality (log-rank P = 0.003) and all-cause mortality (P 〈 0.001), but not non-cardiac mortality, were higher in low Ca group than in normal and high Ca groups in HF and CKD patients. In the multivariate Cox proportional hazard analyses, hypocalcemia was an independent predictor of cardiac (HR 2.34, P = 0.007) and all-cause mortality (HR 1.89, P = 0.027) in HF and CKD patients. Conclusions: Hypocalcemia was an independent predictor of cardiac and all-cause mortality in HF and CKD patients. Thus, taking appropriate management to control CKD-MBD balance may improve the prognosis of patients with HF and CKD.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.11155
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 8
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    Abstract 12033: Impact of n-3 Polyunsaturated Fatty Acids on Mortality of Patients With Hospitalized Heart Failure Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Background: Intake of n-3 polyunsaturated fatty acids (n-3 PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lowers risk of atherosclerotic cardiovascular events, particularly ischemic heart disease. In addition, a ratio of EPA/arachidonic acid (AA) is recently recognized as a risk marker of ischemic heart disease. In contrast, prognostic impact of the EPA, DHA and EPA/AA ratio on patients with heart failure (HF) still remains unclear. Methods and Results: Consecutive 577 patients admitted for HF were divided into 2 groups based on median levels of EPA/AA ratio: low EPA/AA (EPA/AA ≤ 0.32 mg/dl, n=291) and high EPA/AA (0.32 〈 EPA/AA, n=286) groups. We compared laboratory data, echocardiographic findings and cardio-pulmonary exercise test results, and prospectively followed cardiac and all-cause mortality. The low EPA/AA group, as compared to the high EPA/AA group, had lower levels of EPA and DHA (EPA: 33.9 vs. 86.8 μg/ml, P 〈 0.003; DHA: 107.0 vs. 150.5 μg/ml, P 〈 0.001), and higher levels of AA and dihomosexual linolenic acid (AA: 174.0 vs. 156.5 μg/ml, P 〈 0.001; dihomosexual linolenic acid: 32.4 vs. 29.5 μg/ml, P=0.010). In contrast, body mass index, blood pressure, B-type natriuretic peptide, hemoglobin, estimated GFR, total protein, albumin, sodium, C-reactive protein, left ventricular ejection fraction, peak VO 2 and VE/VCO 2 slope were similar between the two groups. Cardiac mortality (log-rank P=0.004) and all-cause mortality (P 〈 0.001) were higher in the low EPA/AA group than in the high EPA/AA group. In the multivariable Cox proportional hazard analyses, the EPA/AA ratio was an independent predictor of cardiac mortality (HR 0.087, P=0.003) and all-cause mortality (HR 0.233, P=0.009) in HF patients. Conclusions: The EPA/AA ratio was an independent predictor of cardiac and all-cause mortality in HF patients. Thus, taking appropriate management to control EPA/AA balance may improve the prognosis of HF patients.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.12033
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 9
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    Abstract 12221: Impact of Serum Uric Acid on Mortality in Heart Failure With Preserved Ejection Fraction
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Background: Serum uric acid is a predictor of cardiovascular mortality in heart failure with reduced ejection fraction. However, the impact of uric acid on heart failure with preserved ejection fraction (HFpEF) remains unclear. Here we investigated the association between hyperuricemia and mortality in HFpEF patients. Methods and Results: Consecutive 424 patients, who admitted to our hospital for decompensated heart failure and diagnosed as HFpEF, were divided into two groups based on presence of hyperuricemia (serum uric acid ≥ 7 mg/dl). We compared patient characteristics, cardio-ankle vascular index and cardio-pulmonary exercise test findings between the two groups. Furthermore, we prospectively followed cardiac and all-cause mortality. The hyperuricemia group (n=254), as compared with non-hyperuricemia group (n=170), had higher prevalence of male gender (55.5 vs. 41.7%, P=0.005), hypertension (79.9 vs. 69.4%, P=0.013), diabetes mellitus (38.5 vs. 26.4%, P=0.010) and use of diuretics (72.4 vs. 41.7%, P 〈 0.001). Furthermore, the hyperuricemia group had higher levels of B-type natriuretic peptide (112.3 vs. 71.4 pg/ml, P 〈 0.001), lower levels of estimated GFR (53.2 vs. 69.7 ml/min/1.73m 2 , P 〈 0.001), higher cardio-ankle vascular index (8.7 vs. 7.5, P 〈 0.001), lower peak VO 2 (14.9 vs. 17.9 ml/kg/min, P 〈 0.001) and higher VE/VCO 2 slope (34.9 vs. 31.9, P=0.02) compared with non-hyperuricemia group. In the follow up period (mean of 897 days), cardiac and all-cause mortalities were significantly higher in those with hyperuricemia (P=0.006 and P=0.004, respectively). In the multivariable Cox proportional hazard analyses after adjusting for confounding factors including chronic kidney disease and use of diuretics, hyperuricemia was an independent predictor of all-cause mortality (hazard ratio 1.98, P=0.039). Conclusion: Hyperuricemia is associated with arterial stiffness, impaired exercise capacity, and high mortality in HFpEF.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.12221
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 10
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    Urinary Angiotensinogen as a Marker of Intrarenal Angiotensin II Activity Associated with Deterioration of Renal Function in Patients with Chronic Kidney Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Journal of the American Society of Nephrology Vol. 18, No. 5 ( 2007-05), p. 1558-1565
    Details
    In: Journal of the American Society of Nephrology, Ovid Technologies (Wolters Kluwer Health), Vol. 18, No. 5 ( 2007-05), p. 1558-1565
    Type of Medium: Online Resource
    ISSN: 1046-6673
    URL: Article
    DOI: 10.1681/ASN.2006060554
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
    detail.hit.zdb_id: 2029124-3
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