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Yamaguchi S, Maeda M, Oba K, Maimaituxun G, Arasaki O, Yagi S, Kusunose K, Soeki T, Yamada H, Fukuda D, Masuzaki H, Sata M, Shimabukuro M. Sex differences in the association between epicardial adipose tissue volume and left atrial volume index. BMC Cardiovasc Disord 2024; 24:46. [PMID: 38218772 PMCID: PMC10788019 DOI: 10.1186/s12872-023-03569-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/19/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Sex disparities in the association between epicardial adipose tissue volume (EATV) and cardiovascular disease have been reported. The sex-dependent effects of EATV on left atrial (LA) size have not been elucidated. METHODS Consecutive 247 subjects (median 65 [interquartile range 57, 75] years; 67% of men) who underwent multi-detector computed tomography without significant coronary artery disease or moderate to severe valvular disease were divided into two groups: patients with sinus rhythm (SR) or atrial fibrillation (AF). Sex differences in the association between the EATV index (EATVI) (mL/m2) and LA volume index (LAVI) in 63 SR (28 men and 35 women) and 184 AF (137 men and 47 women) patients were evaluated using univariate and multivariate regression analyses. RESULTS In overall that includes both men and women, the relationship between EATVI and LAVI was not significantly correlated for patients with SR and AF. The relationship between EATVI and LAVI differed between men and women in both SR and AF groups. In SR patients, there was a positive relationship between EATVI and LAVI in men, but not in women. In contrast, in patients with AF, a negative relationship was found between EATVI and LAVI in women, whereas no association was found in men. CONCLUSIONS We evaluated sex differences in the association between EATVI and LAVI in patients with either SR or AF, and found a positive relationship in men with SR and a negative relationship in women with AF. This is the first report to evaluate sex differences in the relationship between EATVI and LAVI, suggesting that EAT may play a role, at least in part, in sex differences in the etiology of AF.
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Affiliation(s)
- Satoshi Yamaguchi
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1247, Japan
- Department of Cardiology, Nakagami Hospital, 610 Noborikawa, Okinawa, 904-2195, Japan
| | - Minetaka Maeda
- Department of Cardiology, Yuuai Medical Center, 50-5 Yone, Tomishiro, 901-0224, Okinawa, Japan
| | - Kageyuki Oba
- Department of Cardiology, Yuuai Medical Center, 50-5 Yone, Tomishiro, 901-0224, Okinawa, Japan
| | - Gulinu Maimaituxun
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1247, Japan
| | - Osamu Arasaki
- Department of Cardiology, Yuuai Medical Center, 50-5 Yone, Tomishiro, 901-0224, Okinawa, Japan
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-0042, Japan
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine, University of the Ryukyus, 207 Nishihara-cho, Okinawa, 903-0215, Japan
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-0042, Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-0042, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, 207 Nishihara-cho, Okinawa, 903-0215, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-0042, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1247, Japan.
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2
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Hirata K, Kakazu M, Arakaki T, Kakazu A, Arasaki O. Serial Electrocardiographic Changes in Early Post-myocardial Infarction Pericarditis. Cureus 2022; 14:e26795. [PMID: 35971359 PMCID: PMC9372382 DOI: 10.7759/cureus.26795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/17/2022] Open
Abstract
A 72-year-old man developed fever and chest pain, accompanied by an increase in C-reactive protein, four days after successful emergency catheter intervention for an acute wide anterior myocardial infarction (MI). A twelve-lead electrocardiogram (ECG) showed marked ST elevation in leads V1-6, I, and aVL, with reciprocal ST depression in leads II, III, and aVF. Although these ECG changes improved by day three, he developed fever and chest pain on day four, and an ECG at this timepoint showed ST elevation in leads II, III, aVF, and mild worsening of the ST elevation in the anterolateral leads, indicating diffuse ST-segment elevation consistent with acute pericarditis. Despite the presence of a typical friction rub, there was no pericardial effusion on an echocardiogram. No elevation of cardiac enzymes was noted. A diagnosis of early post-infarction pericarditis was made, and the patient was successfully treated with acetaminophen and colchicine. Early post-infarction pericarditis (EPIP), albeit rare in the era of emergency catheter treatment, is important because it may indicate a large transmural infarction and must be differentiated from re-infarction. Fever, chest pain, friction rub, ST elevation in the leads distant from the infarct area, recurrence of ST-segment elevation in the infarct area, and increase in inflammatory markers but not cardiac enzymes were crucial for establishing a diagnosis of EPIP.
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3
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Teragawa H, Morimoto T, Fujii Y, Ueda T, Sakuma M, Shimabukuro M, Arasaki O, Node K, Nomiyama T, Ueda S. Effect of Anagliptin versus Sitagliptin on Renal Function: Subanalyzes from the REASON Trial. Diabetes Metab Syndr Obes 2022; 15:685-694. [PMID: 35264863 PMCID: PMC8901417 DOI: 10.2147/dmso.s350518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/17/2022] [Indexed: 04/20/2023] Open
Abstract
PURPOSE The effects of two types of dipeptidyl peptidase-4 (DPP-4) inhibitors on renal function remain unclear. Thus, we investigated the effect of anagliptin (ANA) and sitagliptin (SITA) on renal function in patients with type 2 diabetes who participated in the randomized evaluation of ANA versus SITA on low-density lipoprotein-cholesterol (LDL-C) in diabetes (REASON) trial. PATIENTS AND METHODS We measured the estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR) before and after the REASON trial. ANA 200 mg/day was administered to 177 patients for 52 weeks, while SITA 50 mg/day was given to 176 patients. We investigated the relationship between differences in renal function and differences in hemoglobin A1c (HbA1c) levels, LDL-C levels, and blood pressure (BP). RESULTS No significant differences were found in baseline eGFR and UACR between the two groups. The eGFR levels were significantly decreased in both groups; however, the UACR level was unchanged in the ANA group but elevated in the SITA group, although the difference did not reach significance between the two groups. The difference in eGFR was affected by the differences in HbA1c level and BP, and the difference in the UACR was affected by the differences in LDL-C level and BP, which were reduced only in the ANA group. CONCLUSION These findings imply that the effects of DPP-4 inhibitors on renal function, especially on UACR, may be different between the types of DPP-4 inhibitors.
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Affiliation(s)
- Hiroki Teragawa
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yuichi Fujii
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
| | - Tomohiro Ueda
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Michio Shimabukuro
- Deparment of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Osamu Arasaki
- Department of Cardiology, Yuuai Medical Center, Tomigusuku, Okinawa, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Takashi Nomiyama
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Okinawa, Japan
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Furuhashi M, Sakuma I, Morimoto T, Higashiura Y, Sakai A, Matsumoto M, Sakuma M, Shimabukuro M, Nomiyama T, Arasaki O, Node K, Ueda S. Differential Effects of DPP-4 Inhibitors, Anagliptin and Sitagliptin, on PCSK9 Levels in Patients with Type 2 Diabetes Mellitus who are Receiving Statin Therapy. J Atheroscler Thromb 2022; 29:24-37. [PMID: 33342939 PMCID: PMC8737073 DOI: 10.5551/jat.58396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Aim:
Proprotein convertase subtilisin/kexin type 9 (PCSK9) degrades the low-density lipoprotein (LDL) receptor, leading to hypercholesterolemia and cardiovascular risk. Treatment with a statin leads to a compensatory increase in circulating PCSK9 level. Anagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, was shown to decrease LDL cholesterol (LDL-C) levels to a greater extent than that by sitagliptin, another DPP-4 inhibitor, in the Randomized Evaluation of Anagliptin versus Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) trial. We investigated PCSK9 concentration in type 2 diabetes mellitus (T2DM) and the impact of treatment with anagliptin or sitagliptin on PCSK9 level as a sub-analysis of the REASON trial.
Methods:
PCSK9 concentration was measured at baseline and after 52 weeks of treatment with anagliptin (
n
=122) or sitagliptin (
n
=128) in patients with T2DM who were receiving statin therapy. All of the included patients had been treated with a DPP-4 inhibitor prior to randomization.
Results:
Baseline PCSK9 level was positively, but not significantly, correlated with LDL-C and was independently associated with platelet count and level of triglycerides. Concomitant with reduction of LDL-C, but not hemoglobin A1c (HbA1c), by anagliptin, PCSK9 level was significantly increased by treatment with sitagliptin (218±98 vs. 242±115 ng/mL,
P
=0.01), but not anagliptin (233±97 vs. 250±106 ng/mL,
P
=0.07).
Conclusions:
PCSK9 level is independently associated with platelet count and level of triglycerides, but not LDL-C, in patients with T2DM. Anagliptin reduces LDL-C level independent of HbA1c control in patients with T2DM who are on statin therapy possibly by suppressing excess statin-mediated PCSK9 induction and subsequent degradation of the LDL receptor.
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Affiliation(s)
- Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | | | | | - Yukimura Higashiura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Akiko Sakai
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Megumi Matsumoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo College of Medicine
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University
| | - Takashi Nomiyama
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare Ichikawa Hospital
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Shinichiro Ueda
- Department of Pharmacology and Therapeutics, University of the Ryukyus
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Inoue T, Shinjo T, Matsuoka M, Tamashiro M, Oba K, Arasaki O, Moromizato T, Arima H. The association between frailty and chronic kidney disease; cross-sectional analysis of the Nambu Cohort Study. Clin Exp Nephrol 2021; 25:1311-1318. [PMID: 34244892 DOI: 10.1007/s10157-021-02110-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Both frailty and chronic kidney disease (CKD) increase with age and share many similarities. Many studies have demonstrated an association between frailty and chronic kidney disease (CKD), but an association with dipstick proteinuria is limited. METHODS This is the cross-sectional analysis of the Nambu Cohort Study at the beginning of observation. Frailty was diagnosed using Kihon Checklist. Logistic analysis was used to evaluate the association between frailty and CKD or dipstick proteinuria. RESULTS Among a total of 630 outpatients [age, 78 (70-84) years, men, 50%], the prevalence of patients with pre-frailty and frailty was 32% and 40%, respectively. The proportion of patients with pre-frailty and frailty increased with decreasing estimated glomerular filtration rate (eGFR) and increasing dipstick proteinuria levels. The odds ratios (95% confidence intervals) for CKD stage of 60 < eGFR ≤ 45 ml/min/1.73 m2, and 45 ml/min/1.73 m2 < eGFR for frailty was 0.87 (0.56-1.35) and 2.54 (1.46-4.53), respectively, compared with non-CKD as a reference. Furthermore, the odds ratios for the frailty of dipstick proteinuria with ± and + or over were 1.36 (0.88-2.09) and 1.78 (1.00-3.17), respectively, when dipstick proteinuria-was used as a reference. Moreover, the combination of eGFR and dipstick proteinuria levels increased the odds ratio for pre-frailty and frailty. CONCLUSION Elderly patients with CKD had a higher prevalence of pre-frailty and frailty. By adding urinary protein information to eGFR, the link between CKD and frailty becomes even more robust.
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Affiliation(s)
- Taku Inoue
- Cardiovascular Medicine, Tomishiro Central Hospital, Taku Inoue: 25 Ueta, Tomigusuku City, Okinawa, 901-0243, Japan. .,Department of Preventive Medicine and Public Health, School of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Tetsuji Shinjo
- Cardiovascular Medicine, Tomishiro Central Hospital, Taku Inoue: 25 Ueta, Tomigusuku City, Okinawa, 901-0243, Japan
| | | | | | - Kageyuki Oba
- Cardiovascular Medicine, Yuai Medical Center, Tomigusuku, Japan
| | - Osamu Arasaki
- Cardiovascular Medicine, Yuai Medical Center, Tomigusuku, Japan
| | | | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, School of Medicine, Fukuoka University, Fukuoka, Japan
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6
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Morimoto T, Sakuma I, Sakuma M, Tokushige A, Natsuaki M, Asahi T, Shimabukuro M, Nomiyama T, Arasaki O, Node K, Ueda S. Author Correction: Randomized Evaluation of Anagliptin vs Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) Trial: A 52-week, open-label, randomized clinical trial. Sci Rep 2020; 10:3548. [PMID: 32080316 PMCID: PMC7033276 DOI: 10.1038/s41598-020-60644-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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7
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Oba K, Shinjo T, Tamashiro M, Matsuoka M, Arasaki O, Arima H, Inoue T. Cause of Death and Associated Factors in Elderly Patients With Atrial Fibrillation - Long-Term Retrospective Study. Circ Rep 2020; 2:490-498. [PMID: 33693274 PMCID: PMC7819663 DOI: 10.1253/circrep.cr-20-0079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background:
Oral anticoagulant (OAC) therapy reduces the risk of stroke in patients with atrial fibrillation (AF). This study elucidated the causes of death and related factors in elderly Japanese AF patients. Methods and Results:
Over a median (interquartile range [IQR]) follow-up period of 46 (20–76) months, there were 171 all-cause deaths (28% cardiovascular, 46% non-cardiovascular, and 26% unknown causes) among 389 AF patients (median [IQR] age 80 [74–85] years; CHAD2DS2-VASc score 5 [4–6]). Cox regression analysis indicated that diabetes was associated with an increase in all-cause death (hazard ratio [HR] 1.48; 95% confidence interval [CI] 1.02–2.13), whereas hypercholesterolemia (HR 0.53; 95% CI 0.35–0.79), pre-existing heart failure (HR 0.67; 95% CI 0.48–0.95), and OAC use (HR 0.62; 95% CI 0.44–0.88) were associated with reductions in all-cause death. Pre-existing heart failure was associated with both cardiovascular (HR 3.03; 95% CI 1.33–8.20) and non-cardiovascular (HR 0.44; 95% CI 0.30–0.65) deaths, in opposite directions. OAC use was associated with a reduction in cardiovascular death (HR 0.34, 95% CI 0.17–0.69). The predominance of non-cardiovascular death and death-related factors were equivalent regardless of when observations started (before 2009 or in 2009 and later). Conclusions:
The predominant cause of death in elderly Japanese AF patients was non-cardiovascular. Distinct clinical factors were associated with cardiovascular and non-cardiovascular death.
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Affiliation(s)
- Kageyuki Oba
- Cardiovascular Medicine, Tomishiro Central Hospital Okinawa Japan
| | | | | | | | - Osamu Arasaki
- Cardiovascular Medicine, Tomishiro Central Hospital Okinawa Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University Fukuoka Japan
| | - Taku Inoue
- Cardiovascular Medicine, Nambu Hospital Okinawa Japan.,Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University Fukuoka Japan
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Yamaguchi S, Abe M, Iseki K, Arakaki T, Arasaki O, Shimabukuro M, Ueda S. Prognostic Impact of Early Changes in Serum Chloride Concentrations Among Hospitalized Acute Heart Failure Patients - A Retrospective Cohort Study. Circ Rep 2020; 2:409-419. [PMID: 33693262 PMCID: PMC7819648 DOI: 10.1253/circrep.cr-20-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Serum electrolyte concentrations on admission and after the administration of loop diuretics may be associated with prognosis in patients hospitalized due to acute heart failure (AHF). This study investigated the prognostic impact of early changes in chloride (Cl) concentrations after diuretic administration, according to stratified Cl concentrations on admission, in AHF. Methods and Results: In all, 355 consecutive patients hospitalized due to AHF were included in this single-center retrospective cohort study. Patients were divided into 2 groups based on whether Cl decreased (n=196) or not (n=159) during the first 5 days in hospital. These 2 groups were further stratified according to Cl on admission into 4 groups: Group 1, decrease in Cl and no hypochloremia (n=127); Group 2, decrease in Cl and hypochloremia (n=69); Group 3, no decrease in Cl and no hypochloremia (n=50); and Group 4, no decrease in Cl and hypochloremia (n=109). The risk of death was significantly higher in the group without than with a decrease in Cl (all-cause death hazard ratio [HR] 1.79; 95% confidence interval [CI] 1.15-2.78; P=0.009). Group 4 had the worst prognosis and a significantly higher risk of death (all-cause death [vs. Group 1 as a reference], HR 2.51; 95% CI 1.45-4.32; P=0.001). Conclusions: The absence of an early decline in Cl was associated with poor prognosis in AHF, especially in patients with hypochloremia on admission.
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Affiliation(s)
- Satoshi Yamaguchi
- Department of Cardiology, Nakagami Hospital Okinawa Japan.,Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine, University of the Ryukyus Okinawa Japan
| | - Masami Abe
- Department of Cardiology, Tomishiro Central Hospital Okinawa Japan
| | - Kunitoshi Iseki
- Clinical Research Support Center, Tomishiro Central Hospital Okinawa Japan
| | - Tomohiro Arakaki
- Department of Cardiology, Tomishiro Central Hospital Okinawa Japan
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital Okinawa Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University Fukushima Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine, University of the Ryukyus Okinawa Japan
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9
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Furuhashi M, Sakuma I, Morimoto T, Higashiura Y, Sakai A, Matsumoto M, Sakuma M, Shimabukuro M, Nomiyama T, Arasaki O, Node K, Ueda S. Treatment with anagliptin, a DPP-4 inhibitor, decreases FABP4 concentration in patients with type 2 diabetes mellitus at a high risk for cardiovascular disease who are receiving statin therapy. Cardiovasc Diabetol 2020; 19:89. [PMID: 32539832 PMCID: PMC7296623 DOI: 10.1186/s12933-020-01061-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/08/2020] [Indexed: 12/16/2022] Open
Abstract
Background Fatty acid-binding protein 4 (FABP4) acts as a novel adipokine, and elevated FABP4 concentration is associated with obesity, insulin resistance and atherosclerosis. Dipeptidyl peptidase-4 (DPP-4) inhibitors, a class of antidiabetic drugs, have distinct structures among the drugs, possibly leading to a drug class effect and each drug effect. Sitagliptin, a DPP-4 inhibitor, has been reported to decrease FABP4 concentration in drug-naïve and sulfonylurea-treated patients with type 2 diabetes mellitus. Anagliptin, another DPP-4 inhibitor, was shown to decrease low-density lipoprotein cholesterol (LDL-C) level to a greater extent than that by sitagliptin in the Randomized Evaluation of Anagliptin vs. Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) trial. Aim and methods As a sub-analysis study using data obtained from the REASON trial, we investigated the effects of treatment with anagliptin (n = 148, male/female: 89/59) and treatment with sitagliptin (n = 159, male/female: 93/66) for 52 weeks on FABP4 concentration in patients with type 2 diabetes mellitus at a high risk for cardiovascular events who were receiving statin therapy. Results The DPP-4 inhibitor had been administered in 82% of the patients in the anagliptin group and 81% of the patients in sitagliptin group prior to randomization. Serum FABP4 level was significantly decreased by 7.9% by treatment with anagliptin (P = 0.049) and was not significantly decreased by treatment with sitagliptin (P = 0.660). Change in FABP4 level was independently associated with basal FABP4 level and changes in waist circumference and creatinine after adjustment of age, sex and the treatment group. Conclusion Anagliptin decreases serum FABP4 concentration independent of change in hemoglobin A1c or LDL-C in patients with type 2 diabetes mellitus and dyslipidemia who are on statin therapy. Trial registration ClinicalTrials.gov number NCT02330406. Registered January 5, 2015, https://clinicaltrials.gov/ct2/show/NCT02330406
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Affiliation(s)
- Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South 1, West 16, Sapporo, 060-8543, Japan.
| | - Ichiro Sakuma
- Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yukimura Higashiura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South 1, West 16, Sapporo, 060-8543, Japan
| | - Akiko Sakai
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South 1, West 16, Sapporo, 060-8543, Japan
| | - Megumi Matsumoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South 1, West 16, Sapporo, 060-8543, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Takashi Nomiyama
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital, Tomigusuku, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Shinichiro Ueda
- Department of Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Japan
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10
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Teragawa H, Morimoto T, Fujii Y, Ueda T, Sakuma M, Shimabukuro M, Arasaki O, Node K, Nomiyama T, Ueda S. Effect of Anagliptin versus Sitagliptin on Inflammatory Markers: Sub-Analysis from the REASON Trial. Diabetes Metab Syndr Obes 2020; 13:4993-5001. [PMID: 33364803 PMCID: PMC7751594 DOI: 10.2147/dmso.s282968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 11/23/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Experimental evidence has suggested that dipeptidyl peptidase-4 (DPP-4) inhibitors have an anti-inflammatory effect as well as a glucose-lowering effect, but this has yet to be confirmed in diabetic patients. Therefore, we examined the anti-inflammatory effects of two kinds of DPP-4 inhibitors in patients who participated in the randomized evaluation of anagliptin (ANA) vs sitagliptin (SITA) on low-density lipoprotein cholesterol in diabetes (REASON) Trial, which compared low-density lipoprotein-cholesterol lowering effects between (ANA) and SITA in patients with type 2 diabetes, dyslipidemia, and atherosclerotic vascular lesions. PATIENTS AND METHODS The studied patients consisted of 177 patients who received ANA 200 mg per day and 176 patients who received SITA 50 mg per day for 52 weeks. We measured high-sensitivity C-reactive protein (hs-CRP), white blood cells (WBC), and interleukin-6 (IL-6) before and after treatment for 52 weeks, and the changes in inflammatory markers were measured as the differences between baseline and 52 weeks. Furthermore, we checked the relationship between the change in hs-CRP and several clinical factors such as the baseline hs-CRP level, use of a moderate-intensity statin, presence of coronary artery disease (CAD) and taking a previous DDP-4 inhibitor. RESULTS The levels of the inflammatory markers hs-CRP, WBC, and IL-6 were determined to have not significantly changed from baseline to the final follow-up in each arm; furthermore, the changes in these markers were not significantly different between the two groups. The change in hs-CRP level was not affected by the baseline hs-CRP level, use of a moderate-intensity statin, presence of coronary artery disease, and absence of prior DPP-4 inhibitor use. CONCLUSION In this sub-analysis from the REASON Trial, taking a DPP-4 inhibitor, either ANA or SITA, for 52 weeks did not affect the levels of inflammatory markers.
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Affiliation(s)
- Hiroki Teragawa
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
- Correspondence: Hiroki Teragawa Department of Cardiovascular Medicine, JR Hiroshima Hospital, 3-1-36 Futabanosato, Higashi-ku, Hiroshima732-0052, JapanTel +81-82-262-1171Fax +81-82-262-1499 Email
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yuichi Fujii
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
| | - Tomohiro Ueda
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital, Tomigusuku, Okinawa, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Takashi Nomiyama
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University, Fukuoka, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Okinawa, Japan
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11
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Furuhashi M, Sakuma I, Morimoto T, Higashiura Y, Sakai A, Matsumoto M, Sakuma M, Shimabukuro M, Nomiyama T, Arasaki O, Node K, Ueda S. Independent and Distinct Associations of FABP4 and FABP5 With Metabolic Parameters in Type 2 Diabetes Mellitus. Front Endocrinol (Lausanne) 2020; 11:575557. [PMID: 33071982 PMCID: PMC7538548 DOI: 10.3389/fendo.2020.575557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/21/2020] [Indexed: 01/22/2023] Open
Abstract
Objective: Among fatty acid-binding proteins (FABPs), secreted forms of FABP4 and FABP5, which are expressed in adipocytes and macrophages, act as bioactive molecules. We investigated concentrations of FABP4 and FABP5 in patients with type 2 diabetes mellitus. Methods: As a sub-analysis study of the Randomized Evaluation of Anagliptin vs. Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) trial, 256 patients (male/female: 146/110, age: 68 ± 10 years) with type 2 diabetes mellitus and dyslipidemia who were receiving statin therapy were recruited. Patients who had been treated with a thiazolidinedione were excluded. Results: Several drugs which may modulate FABP4 levels including statins, dipeptidyl peptidase-4 inhibitors and angiotensin II receptor blockers had been administered in 100, 81, and 51% of the recruited patients, respectively. The level of FABP4, but not that of FABP5, was significantly higher in females than in males. Multivariable linear regression analysis demonstrated that waist circumference (β = 0.21), estimated glomerular filtration rate (β = -0.31), triglycerides (β = 0.16), and FABP5 (β = 0.39) were independent predictors of FABP4 level after adjusting age and sex. On the other hand, FABP5 level was independently associated with levels of FABP4 (β = 0.57) and high-density lipoprotein (HDL) cholesterol (β = -0.12). Conclusions: Concentrations of FABP4 and FABP5 are independent predictors of each other in patients with type 2 diabetes mellitus. There are distinct independent associations of FABP4 with renal dysfunction, adiposity and hypertriglyceridemia and there is a distinct independent association of FABP5 with a low HDL cholesterol level in type 2 diabetic patients with dyslipidemia at high risks for cardiovascular disease who are receiving statin therapy.
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Affiliation(s)
- Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- *Correspondence: Masato Furuhashi
| | - Ichiro Sakuma
- Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yukimura Higashiura
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Akiko Sakai
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Megumi Matsumoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Takashi Nomiyama
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital, Tomigusuku, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Shinichiro Ueda
- Department of Pharmacology and Therapeutics, University of the Ryukyus, Okinawa, Japan
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12
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Yamaguchi S, Shimabukuro M, Abe M, Arakaki T, Arasaki O, Ueda S. Comparison of the prognostic values of three calculation methods for echocardiographic relative wall thickness in acute decompensated heart failure. Cardiovasc Ultrasound 2019; 17:30. [PMID: 31796050 PMCID: PMC6891973 DOI: 10.1186/s12947-019-0179-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/15/2019] [Indexed: 01/19/2023] Open
Abstract
Purpose Left ventricular (LV) wall thickness can be measured at the posterior wall (PW) and the intraventricular septum (IVS) in a parasternal long axis view by transthoracic echocardiography. Thus, there are three methods to calculate relative wall thickness as follows: RWTPW = 2 × PWth/LVDd; RWTIVS + PW = (IVSth + PWth) /LVDd; and RWTIVS = 2 × IVSth/LVDd (IVSth = interventricular septum thickness; LVDd = LV internal dimension at end--diastole; PWth = posterior wall thickness). The aim was to compare the prognostic values of these RWTs in patients with acute decompensated heart failure (ADHF). Method This was a single-center, retrospective, observational study at a Japanese community hospital. A total of 389 hospitalized ADHF patients were divided into two groups based on the three median RWT values. The primary outcome was all-cause death. Survival analysis was performed, and Cox proportional hazard models unadjusted and adjusted by Get With The Guideline score were used. Results High-RWTPW had poor survival (log-rank, P = 0.009) and was a significant risk (unadjusted HR (95%CI), 1.72 (1.14–2.61), P = 0.01; adjusted HR, 1.95 (1.28–2.98), P = 0.02). High-RWTIVS + PW was not associated with poor survival on survival analysis or the unadjusted Cox model. Only the adjusted Cox model showed that High-RWTIVS + PW was associated with a significant risk of the primary outcome (unadjusted HR (95%CI), 1.45 (0.96–2.17), P = 0.07; adjusted HR, 1.53 (1.01–2.32), P = 0.045). High-RWTIVS did not have significant prognostic value. Conclusions When calculating RWT, RWTPW should be recommended for evaluating the mortality risk in ADHF.
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Affiliation(s)
- Satoshi Yamaguchi
- Department of Cardiology, Tomishiro Central Hospital, 25 Ueta, Okinawa, 901-0243, Japan.,Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine, University of the Ryukyus, 205 Uehara, Nishihara-cho, Okinawa, 901-0215, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology, and Metabolism, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Masami Abe
- Department of Cardiology, Tomishiro Central Hospital, 25 Ueta, Okinawa, 901-0243, Japan
| | - Tomohiro Arakaki
- Department of Cardiology, Tomishiro Central Hospital, 25 Ueta, Okinawa, 901-0243, Japan
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital, 25 Ueta, Okinawa, 901-0243, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine, University of the Ryukyus, 205 Uehara, Nishihara-cho, Okinawa, 901-0215, Japan.
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Chihara A, Tanaka A, Morimoto T, Sakuma M, Shimabukuro M, Nomiyama T, Arasaki O, Ueda S, Node K. Differences in lipid metabolism between anagliptin and sitagliptin in patients with type 2 diabetes on statin therapy: a secondary analysis of the REASON trial. Cardiovasc Diabetol 2019; 18:158. [PMID: 31733647 PMCID: PMC6858725 DOI: 10.1186/s12933-019-0965-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/10/2019] [Indexed: 12/14/2022] Open
Abstract
Background Anagliptin, a dipeptidyl peptidase-4 inhibitor, is reported to reduce the level of low-density lipoprotein cholesterol (LDL-C). The underlying mechanism of this effect and effect on lipid metabolism however remains uncertain. Aim and methods We therefore evaluate the effects of anagliptin on lipid metabolism-related markers compared with those of sitagliptin. The study was a secondary analysis using data obtained from the Randomized Evaluation of Anagliptin versus Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) trial. This trial in patients with type 2 diabetes at a high risk of cardiovascular events and on statin therapy showed that anagliptin reduced LDL-C levels to a greater extent than sitagliptin. Cholesterol absorption (campesterol and sitosterol) and synthesis (lathosterol) markers were measured at baseline and 52 weeks in the study cohort (n = 353). Results There was no significant difference in the changes of campesterol or sitosterol between the two treatment groups (p = 0.85 and 0.55, respectively). Lathosterol concentration was increased significantly at 52 weeks with sitagliptin treatment (baseline, 1.2 ± 0.7 μg/mL vs. 52 weeks, 1.4 ± 1.0 μg/mL, p = 0.02), whereas it did not change in the anagliptin group (baseline, 1.3 ± 0.8 μg/mL vs. 52 weeks, 1.3 ± 0.7 μg/mL, p = 0.99). The difference in absolute change between the two groups showed a borderline significance (p = 0.06). Conclusion These findings suggest that anagliptin reduces LDL-C level by suppressing excess cholesterol synthesis, even in combination with statin therapy. Trial registration ClinicalTrials.gov number NCT02330406. https://clinicaltrials.gov/ct2/show/NCT02330406; registered January 5, 2015.
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Affiliation(s)
- Atsuko Chihara
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Takashi Nomiyama
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University, Fukuoka, Japan
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital, Tomigusuku, Japan
| | - Shinichiro Ueda
- Department of Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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14
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Morimoto T, Sakuma I, Sakuma M, Tokushige A, Natsuaki M, Asahi T, Shimabukuro M, Nomiyama T, Arasaki O, Node K, Ueda S. Randomized Evaluation of Anagliptin vs Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) Trial: A 52-week, open-label, randomized clinical trial. Sci Rep 2019; 9:8537. [PMID: 31189978 PMCID: PMC6561974 DOI: 10.1038/s41598-019-44885-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/27/2019] [Indexed: 12/29/2022] Open
Abstract
Additional reductions in low-density lipoprotein-cholesterol (LDL-C) via antidiabetic therapies should be considered in statin-using patients with sub-optimal LDL-C levels. We compared the efficacy of anagliptin and sitagliptin, two antidiabetic therapies, in reducing LDL-C in type 2 diabetic patients. A randomized, open-label, parallel-group trial was conducted at 17 centres in Japan between April 2015 and January 2018. Adults (age ≥20 years) with type 2 diabetes, any atherosclerotic vascular lesions, and statin prescriptions were included. Anagliptin or sitagliptin were administered for 52 weeks. Primary and secondary endpoints were changes in LDL-C and haemoglobin A1C (HbA1c) levels, respectively. We assessed the superiority (primary endpoint) and non-inferiority (secondary endpoint) of anagliptin over sitagliptin. This study was registered at Clinicaltrials.gov (NCT02330406). Of 380 participants, 353 were eligible and randomized. Mean participant age was 68 years, and 61% were males. Baseline median LDL-C and HbA1c were 108 mg/dL and 6.9%, respectively. Changes in LDL-C were −3.7 mg/dL with anagliptin and +2.1 mg/dL with sitagliptin at 52 weeks, and the estimated treatment difference was a significant −4.5 mg/dL (P = 0.01 for superiority). Changes in HbA1c were +0.02% with anagliptin and +0.12% with sitagliptin (P < 0.0001 for non-inferiority). Overall, anagliptin was superior to sitagliptin in lowering LDL-C without deteriorating HbA1c.
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Affiliation(s)
- Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Ichiro Sakuma
- Caress Sapporo Hokko Memorial Clinic N-27, E-8, 1-15, Higashi, Sapporo, Hokkaido, 065-0027, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan
| | - Akihiro Tokushige
- Department of Pharmacology and Therapeutics, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
| | - Masahiro Natsuaki
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Tomohiro Asahi
- Department of Cardiology, Naha City Hospital, 2-31-1 Furujima, Naha, Okinawa, 902-8511, Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Takashi Nomiyama
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University, 7-45-1 Nanakuma, Jyonan, Fukuoka, 814-0180, Japan
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital, 25 Ueda, Tomigusuku, Okinawa, 901-0243, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Shinichiro Ueda
- Department of Pharmacology and Therapeutics, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
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15
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Yamaguchi S, Abe M, Arakaki T, Arasaki O, Shimabukuro M. Incremental Prognostic Value of Platelet Count in Patients With Acute Heart Failure ― A Retrospective Observational Study ―. Circ J 2019; 83:576-583. [DOI: 10.1253/circj.cj-18-0961] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Satoshi Yamaguchi
- Department of Cardiology, Tomishiro Central Hospital
- Department of Clinical Pharmacology and Therapeutics, Graduate School of Medicine, University of the Ryukyus
| | - Masami Abe
- Department of Cardiology, Tomishiro Central Hospital
| | | | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University
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16
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Maeda M, Oba K, Yamaguchi S, Arasaki O, Sata M, Masuzaki H, Shimabukuro M. Usefulness of Epicardial Adipose Tissue Volume to Predict Recurrent Atrial Fibrillation After Radiofrequency Catheter Ablation. Am J Cardiol 2018; 122:1694-1700. [PMID: 30244845 DOI: 10.1016/j.amjcard.2018.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 08/02/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
Abstract
Although increasing evidence suggests that epicardial adipose tissue volume (EATV) is associated with post-ablation atrial fibrillation (AF), ranges of EATV predictive of post-ablation recurrence of AF remain unclear. In this study, we evaluated: (1) relationships between EATV and characteristics of AF, (2) impact of EATV on recurrent AF after radiofrequency ablation; , and (3) cut-off point for recurrent AF using a receiver operating characteristic curve. In 218 consecutive symptomatic patients undergoing who underwent ablation for AF (143 paroxysmal AF; 78 persistent AF), the EATV index (EATVI: EATV/body surface area, mL/m2) was measured using 320-row multidetector computed tomography. The high EATV group showed specific cardiometabolic derangements as well as left atrial dilatation and left ventricular dysfunction. Multivariate regression analysis showed that the EATVI was an independent predictor of recurrent AF after catheter ablation. High EATV (EATVI ≥ 85 mL/m2) or EATVI cutoff ≥116 mL/m2 can predict recurrent AF after catheter ablation, independent of other risk factors. In conclusion, EATVI was an independent predictor of recurrent AF after catheter ablation; a high EATV tertile or EATVI cutoff may be useful for prediction of recurrent AF after catheter ablation. Future studies should determine the utility of the EATVI in the clinical setting of AF ablation.
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Oba K, Maeda M, Maimaituxun G, Yamaguchi S, Arasaki O, Fukuda D, Yagi S, Hirata Y, Nishio S, Iwase T, Takao S, Kusunose K, Yamada H, Soeki T, Wakatsuki T, Harada M, Masuzaki H, Sata M, Shimabukuro M. Effect of the Epicardial Adipose Tissue Volume on the Prevalence of Paroxysmal and Persistent Atrial Fibrillation. Circ J 2018; 82:1778-1787. [PMID: 29806623 DOI: 10.1253/circj.cj-18-0021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although increasing evidence suggests that epicardial adipose tissue volume (EATV) is associated with atrial fibrillation (AF), it is controversial whether there is a dose-response relationship of increasing EATV along the continuum of AF. We evaluated the effect of the EATV on the prevalence of paroxysmal AF (PAF) and persistent AF (PeAF) and the relationships with cardiac structure and functional remodeling.Methods and Results:Subjects who underwent multidetector computed tomography (MDCT) coronary angiography because of symptoms suggestive of coronary artery disease were divided into sinus rhythm (SR) (n=112), PAF (n=133), and PeAF (n=71) groups. The EATV index (EATV/body surface area, mL/m2) was strongly associated with the prevalence of PAF and PeAF on the model adjusted for known AF risk factors. The effect of the EATV index on the prevalence of PeAF, but not on that of PAF, was modified by the left atrial (LA) dimension, suggesting that extension of the LA dimension is related to EATV expansion in PeAF. The cutoff value of the EATV index for the prevalence was higher in PeAF than in PAF (64 vs. 55 mL/m2, P<0.01). CONCLUSIONS The EATV index is associated with the prevalence of PAF and PeAF, and its cutoff values are predictive for PAF and PeAF development independently of other AF risk factors.
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Affiliation(s)
- Kageyuki Oba
- Department of Cardiology, Tomishiro Central Hospital
| | | | - Gulinu Maimaituxun
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | | | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital
| | - Daiju Fukuda
- Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Yukina Hirata
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Susumu Nishio
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Takashi Iwase
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Shoichiro Takao
- Department of Diagnostic Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Kenya Kusunose
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Masafumi Harada
- Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School
| | - Michio Shimabukuro
- Department of Cardiology, Tomishiro Central Hospital.,Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School.,Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University
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Shimabukuro M, Tanaka A, Sata M, Dai K, Shibata Y, Inoue Y, Ikenaga H, Kishimoto S, Ogasawara K, Takashima A, Niki T, Arasaki O, Oshiro K, Mori Y, Ishihara M, Node K. α-Glucosidase inhibitor miglitol attenuates glucose fluctuation, heart rate variability and sympathetic activity in patients with type 2 diabetes and acute coronary syndrome: a multicenter randomized controlled (MACS) study. Cardiovasc Diabetol 2017; 16:86. [PMID: 28683829 PMCID: PMC5501494 DOI: 10.1186/s12933-017-0571-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/26/2017] [Indexed: 01/16/2023] Open
Abstract
Background Little is known about clinical associations between glucose fluctuations including hypoglycemia, heart rate variability (HRV), and the activity of the sympathetic nervous system (SNS) in patients with acute phase of acute coronary syndrome (ACS). This pilot study aimed to evaluate the short-term effects of glucose fluctuations on HRV and SNS activity in type 2 diabetes mellitus (T2DM) patients with recent ACS. We also examined the effect of suppressing glucose fluctuations with miglitol on these variables. Methods This prospective, randomized, open-label, blinded-endpoint, multicenter, parallel-group comparative study included 39 T2DM patients with recent ACS, who were randomly assigned to either a miglitol group (n = 19) or a control group (n = 20). After initial 24-h Holter electrocardiogram (ECG) (Day 1), miglitol was commenced and another 24-h Holter ECG (Day 2) was recorded. In addition, continuous glucose monitoring (CGM) was performed throughout the Holter ECG. Results Although frequent episodes of subclinical hypoglycemia (≤4.44 mmo/L) during CGM were observed on Day 1 in the both groups (35% of patients in the control group and 31% in the miglitol group), glucose fluctuations were decreased and the minimum glucose level was increased with substantial reduction in the episodes of subclinical hypoglycemia to 7.7% in the miglitol group on Day 2. Holter ECG showed that the mean and maximum heart rate and mean LF/HF were increased on Day 2 in the control group, and these increases were attenuated by miglitol. When divided 24-h time periods into day-time (0700–1800 h), night-time (1800–0000 h), and bed-time (0000–0700 h), we found increased SNS activity during day-time, increased maximum heart rate during night-time, and glucose fluctuations during bed-time, which were attenuated by miglitol treatment. Conclusions In T2DM patients with recent ACS, glucose fluctuations with subclinical hypoglycemia were associated with alterations of HRV and SNS activity, which were mitigated by miglitol, suggesting that these pathological relationships may be a residual therapeutic target in such patients. Trial registration Unique Trial Number, UMIN000005874 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000006929) Electronic supplementary material The online version of this article (doi:10.1186/s12933-017-0571-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michio Shimabukuro
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, Japan.,Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kazuoki Dai
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Yoshisato Shibata
- Miyazaki Medical Association Hospital, Cardiovascular Center, Miyazaki, Japan
| | - Yohei Inoue
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.,Miyazaki Medical Association Hospital, Cardiovascular Center, Miyazaki, Japan
| | - Hiroki Ikenaga
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Kozue Ogasawara
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Akira Takashima
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Toshiyuki Niki
- Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Osamu Arasaki
- Department of Cardiology, Tomishiro Central Hospital, Okinawa, Japan
| | - Koichi Oshiro
- Department of Cardiology, Ohama Dai-ichi Hospital, Okinawa, Japan
| | - Yutaka Mori
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Masaharu Ishihara
- Division of Coronary Heart Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan.
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19
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Takahashi Y, Yamauchi A, Tabuchi M, Toritsuka D, Arasaki O, Tamashiro M, Kakazu M, Iju K, Kume M, Sakihama S, Matayoshi Y. [Cardiac Rehabilitation in Minimally Invasive Cardiac Surgery Coronary Artery Bypass Grafting]. Kyobu Geka 2017; 70:483-487. [PMID: 28698412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES A purpose is to compare the in-hospital rehabilitation progress after minimally invasive cardiac surgery coronary artery bypass grafting (MICS CABG) with that after off pump coronary artery bypass grafting( OPCAB). METHODS We analyzed 60 patients who underwent coronary artery bypass grafting surgery from January 2015 to December 2016. Fourteen patients underwent MICS CABG (MICS CABG group) and 46 patients underwent OPCAB (OPCAB group). The post-operative days to start standing position and independent walking, and hospitalization duration were analyzed between the 2 groups. RESULTS There were no significant differences between the groups:standing position(1.2 vs 1.2 days) and independent walking(4.8 vs 4.9 days). Hospitalization duration was shorter in MICS CABG group(14.3 vs 17.5 days). CONCLUSION MICS CABG may shorten hospitalization length compared with OPCAB, however, further research will be needed.
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Affiliation(s)
- Yo Takahashi
- Department of Rehabilitation, Tomishiro Central Hospital, Tomishiro, Japan
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20
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Ooshiro D, Yamaguchi S, Kakazu M, Arasaki O. Effectiveness of continuous low-dose fasudil on refractory coronary vasospasm subsequent to cardiopulmonary arrest. Clin Case Rep 2017; 5:1207-1209. [PMID: 28781824 PMCID: PMC5538208 DOI: 10.1002/ccr3.830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/09/2016] [Accepted: 11/27/2016] [Indexed: 11/25/2022] Open
Abstract
Refractory coronary vasospasm subsequent to reperfusion, such as cardiopulmonary resuscitation or revascularization, for myocardial infarction may respond to fasudil in the superacute phase. Continuous low‐dose fasudil administration should be an option for refractory coronary vasospastic angina (VSA).
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Affiliation(s)
- Daisuke Ooshiro
- Department of Cardiology Tomishiro Central Hospital Okinawa Japan
| | | | - Masanori Kakazu
- Department of Cardiology Tomishiro Central Hospital Okinawa Japan
| | - Osamu Arasaki
- Department of Cardiology Tomishiro Central Hospital Okinawa Japan
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21
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Yamaguchi S, Arasaki O. Abstract 236: Identifying Factors Influencing Low Density Lipoprotein Lowering Effect of Ezetimibe in Japanese Subject. Arterioscler Thromb Vasc Biol 2016. [DOI: 10.1161/atvb.36.suppl_1.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Ezetimibe inhibits cholesterol absorption at the small intestine brush border. Ezetimibe lowers low-density lipoprotein (LDL) level. In acute coronary syndrome patients, ezetimibe reduces risk of myocardial infarction and stroke as a secondary prevention. Japanese food has lower fat content than American and European foods. In Japanese individuals, whether ezetimibe has an effect on lowering LDL levels is not well understood. In a clinical setting, the LDL-lowering effect varies slightly. To prevent cardiac events, patients with high sensitivity to ezetimibe need to be identified. The factors influencing the LDL-lowering effect of ezetimibe have not been identified. We investigated the factors that affect ezetimibe sensitivity in Japanese patients.
Methods:
Our study design was a single center retrospective observational study. The inclusion criteria were ezetimibe naive subjects and patients being administered ezetimibe. Primary outcome was the decrease in the rate of LDL at the 365 days, as calculated by the reduced LDL level divided by the baseline level. The secondary outcome was multi-linear regression for the decreasing rate of LDL.
Results:
Fifty-two patients were analyzed. The primary outcome, the decreasing rate of LDL, was -18±17%. LDL decreased significantly analyzed by Wilcoxon signed test (P <0.0001)(Figure1). The positive predictive factors were age, statin level, and baseline LDL level. Diabetes mellitus does not influence the LDL-lowering effect of ezetimibe.
Conclusion:
Ezetimibe lowers LDL level in Japanese patients. Elderly individuals and subjects with higher LDL levels are sensitive to ezetimibe.
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Affiliation(s)
| | - Osamu Arasaki
- Dept of Cardiology, Tomishiro Central Hosp, Tomishiro-shi, Japan
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22
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Inoue T, Arasaki O, Kawamitsu K, Kajiwara K, Shinzato Y, Ishikawa N, Yamamoto A, Sunagawa O, Katsumata Y, Ueda S. Impact of beta-blockers and resting heart rate in diabetic patients with stable coronary artery disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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