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Doi T, Langsted A, Nordestgaard BG. Mass changes in remnant cholesterol and LDL cholesterol explain part of the results of gemfibrozil and non-gemfibrozil fibrate trials. J Intern Med 2024; 295:707-710. [PMID: 38343109 DOI: 10.1111/joim.13771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Langsted
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark
- Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Doi T, Langsted A, Nordestgaard BG. Remnant cholesterol, LDL cholesterol, and apoB absolute mass changes explain results of the PROMINENT trial. Atherosclerosis 2024; 393:117556. [PMID: 38678642 DOI: 10.1016/j.atherosclerosis.2024.117556] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND AND AIMS The PROMINENT trial, a cardiovascular outcome trial of the triglyceride- and remnant cholesterol-lowering agent pemafibrate, has shown neutral results despite reduction in plasma triglycerides and remnant cholesterol. We tested the hypothesis that absolute mass changes in remnant cholesterol, LDL cholesterol, and apolipoprotein B explain the results of the PROMINENT trial. METHODS Among 108,431 individuals from the Copenhagen General Population Study (CGPS), those who met the key inclusion criteria of the PROMINENT trial were analyzed to mimic the trial design. Endpoint atherosclerotic cardiovascular disease (ASCVD) was cardiovascular death, myocardial infarction, ischemic stroke, and coronary revascularization as defined in PROMINENT. RESULTS In the PROMINENT trial, treatment with pemafibrate resulted in -7 mg/dL (-0.18 mmol/L; -18 %) change in remnant cholesterol, +10 mg/dL (+0.26 mmol/L; +12 %) LDL cholesterol, and +5 mg/dL (+0.05 g/L; +5 %) apolipoprotein B. In the CGPS mimicking PROMINENT, the estimated hazard ratios for ASCVD were 0.97 (95 % confidence interval: 0.94-0.99) for a -7 mg/dL (-0.18 mmol/L) change in remnant cholesterol, 1.04 (1.01-1.07) for a +10 mg/dL (+0.26 mmol/L) change in LDL cholesterol, and 1.02 (1.01-1.03) for a +5 mg/dL (+0.05 g/L) change in apolipoprotein B. When combining absolute changes in remnant cholesterol, LDL cholesterol, and apolipoprotein B, the estimated hazard ratio for ASCVD was 1.05 (0.96-1.14) in the CGPS mimicking PROMINENT compared to 1.03 (0.91-1.15) in the PROMINENT trial. CONCLUSIONS Absolute mass changes in remnant cholesterol, LDL cholesterol, and apolipoprotein B can explain results of the PROMINENT trial. The 3 mg/dL (0.08 mmol/L) higher total atherogenic cholesterol together with 5 mg/dL (0.05 g/L) higher apolipoprotein B seem to explain the trend toward more ASCVD in the pemafibrate arm.
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Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Langsted
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Elías-López D, Doi T, Nordestgaard BG, Kobylecki CJ. Remnant cholesterol and low-grade inflammation jointly in atherosclerotic cardiovascular disease: implications for clinical trials. Curr Opin Clin Nutr Metab Care 2024; 27:125-135. [PMID: 38320159 DOI: 10.1097/mco.0000000000000999] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
PURPOSE OF REVIEW Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death despite the development of effective treatments. Recently, elevated remnant cholesterol and low-grade inflammation have emerged as factors explaining part of the residual ASCVD risk. Interestingly, the coexistence of both high remnant cholesterol and low-grade inflammation can further increase the risk of ASCVD. The aim of this review is to describe the role of elevated remnant cholesterol and low-grade inflammation, separately and combined, in ASCVD. RECENT FINDINGS Results from recently published studies, including observational and genetic Mendelian randomization studies, support a causal relationship between elevated remnant cholesterol and low-grade inflammation on risk of ASCVD in both primary and secondary prevention settings. In addition, current evidence from observational studies suggests that the coexistence of elevated remnant cholesterol and low-grade inflammation further increases the risk of ASCVD. SUMMARY Recent observational studies suggest that high remnant cholesterol combined with low-grade inflammation may confer a particular high risk for ASCVD. Attention on the dual threat from high remnant cholesterol and low-grade inflammation is necessary, and further research in this field is warranted. The effect of remnant cholesterol-lowering drugs and anti-inflammatory drugs on ASCVD risk alone and combined remains to be elucidated. VIDEO ABSTRACT http://links.lww.com/COCN/A20.
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Affiliation(s)
- Daniel Elías-López
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev Gentofte
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev Gentofte, Herlev, Denmark
- Department of Endocrinology and Metabolism and Research Center of Metabolic Diseases, National Institute of Medical Sciences and Nutrition Salvador Zubirán, México City, México
| | - Takahito Doi
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev Gentofte
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev Gentofte, Herlev, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev Gentofte
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev Gentofte, Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Camilla J Kobylecki
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev Gentofte
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev Gentofte, Herlev, Denmark
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Nakao K, Noguchi T, Miura H, Asaumi Y, Morita Y, Takeuchi S, Matama H, Sawada K, Doi T, Hosoda H, Nakashima T, Honda S, Fujino M, Yoneda S, Kawakami S, Nagai T, Nishihira K, Kanaya T, Otsuka F, Nakanishi M, Kataoka Y, Tahara Y, Goto Y, Kusano K, Yamamoto H, Omae K, Ogawa H, Yasuda S. Effect of Eicosapentaenoic Acid/Docosahexaenoic Acid on Coronary High-Intensity Plaques Detected Using Noncontrast T1-weighted Imaging: The AQUAMARINE EPA/DHA Randomized Study. J Atheroscler Thromb 2024; 31:122-134. [PMID: 37704431 PMCID: PMC10857838 DOI: 10.5551/jat.64063] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/09/2023] [Indexed: 09/15/2023] Open
Abstract
AIM Omega-3 fatty acids have emerged as a new option for controlling the residual risk for coronary artery disease (CAD) in the statin era. Eicosapentaenoic acid (EPA) is associated with reduced CAD risk in the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention trial, whereas the Statin Residual Risk with Epanova in High Cardiovascular Risk Patients with Hypertriglyceridemia trial that used the combination EPA/docosahexaenoic acid (DHA) has failed to derive any clinical benefit. These contradictory results raise important questions about whether investigating the antiatherosclerotic effect of omega-3 fatty acids could help to understand their significance for CAD-risk reduction. METHODS The Attempts at Plaque Vulnerability Quantification with Magnetic Resonance Imaging Using Noncontrast T1-weighted Technic EPA/DHA study is a single-center, triple-arm, randomized, controlled, open-label trial used to investigate the effect of EPA/DHA on high-risk coronary plaques after 12 months of treatment, detected using cardiac magnetic resonance (CMR) in patients with CAD receiving statin therapy. Eligible patients were randomly assigned to no-treatment, 2-g/day, and 4-g/day EPA/DHA groups. The primary endpoint was the change in the plaque-to-myocardium signal intensity ratio (PMR) of coronary high-intensity plaques detected by CMR. Coronary plaque assessment using computed tomography angiography (CTA) was also investigated. RESULTS Overall, 84 patients (mean age: 68.2 years, male: 85%) who achieved low-density lipoprotein cholesterol levels of <100 mg/dL were enrolled. The PMR was reduced in each group over 12 months. There were no significant differences in PMR changes among the three groups in the primary analysis or analysis including total lesions. The changes in CTA parameters, including indexes for detecting high-risk features, also did not differ. CONCLUSION The EPA/DHA therapy of 2 or 4 g/day did not significantly improve the high-risk features of coronary atherosclerotic plaques evaluated using CMR under statin therapy.
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Affiliation(s)
- Kazuhiro Nakao
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yoshiaki Morita
- Department of Radiology, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Satoshi Takeuchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
- Department of Advanced Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Keniciro Sawada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Hayato Hosoda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Takahiro Nakashima
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Masashi Fujino
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Shuichi Yoneda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Shoji Kawakami
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Kensaku Nishihira
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Michio Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yoichi Goto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Haruko Yamamoto
- Centre for Advancing Clinical and Translational Science, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Katsuhiro Omae
- Department of Data Science, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Doi T, Tsutsumimoto K, Makino K, Nakakubo S, Sakimoto F, Matsuda S, Shimada H. Combined Social Frailty and Life-Space Activities Associated with Risk of Disability: A Prospective Cohort Study. J Frailty Aging 2024; 13:184-188. [PMID: 38616376 DOI: 10.14283/jfa.2024.17] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVES To examine the association between social frailty and life-space activities, and determine whether a combined status of life-space activities and social frailty is associated with risk of disability among older adults. DESIGN A prospective cohort study. SETTING AND PARTICIPANTS The participants were 8,301 older adults (mean age 72.9 ± 5.6 years, women [53.3%]) from a community setting. METHODS Life-space activities were evaluated using the Active Mobility Index (AMI) to assess activities in each life-space (distance from the respondent's home: up to 1 km, 1-10 km, or greater than 10 km) during the past 1 month. Activities were also assessed according to physical or social activity. Social frailty and characteristics were measured at the baseline. Incident disability was assessed according to long term care insurance. RESULTS The lowest scoring group was based on the quartile in each of the AMI scores (Q1), with reference to the highest scoring group, which had a higher odds ratios for social frailty (AMI total score Q1: OR 4.32, 95% CI 3.43-5.45, AMI physical score Q1: 2.19, 95% CI 1.79-2.69, AMI social score Q1: 5.04, 95% CI 3.94-6.44). During the follow-up (mean 23.5 months), 330 participants had incident disability. Incident disability was associated with social frailty. Combined status of social frailty and low AMI increased the risk of disability (HR 2.15, 95% CI 1.52-3.03), with reference to non-frailty and higher AMI scores. CONCLUSIONS AND IMPLICATIONS Social frailty or reduced activity in life-space assessment were identified as risk factors for incident disability. To decrease the risk of disability, the development of an intervention program to enhance activities and cope with social frailty is required.
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Affiliation(s)
- T Doi
- Takehiko Doi, Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi 474-8511 Japan, TEL and FAX: +81-562-44-5651, E-mail:
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Kubota Y, Kawazoe A, Mishima S, Nakamura Y, Kotani D, Kuboki Y, Bando H, Kojima T, Doi T, Yoshino T, Kuwata T, Shitara K. Corrigendum to "Comprehensive clinical and molecular characterization of claudin 18.2 expression in advanced gastric or gastroesophageal junction cancer": [ESMO Open 8 (2023) 100762]. ESMO Open 2024; 9:102232. [PMID: 38194883 PMCID: PMC10820305 DOI: 10.1016/j.esmoop.2023.102232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Affiliation(s)
- Y Kubota
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba; Department of Clinical Oncology, St. Marianna, University School of Medicine, Kanagawa
| | - A Kawazoe
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - S Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - Y Nakamura
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - D Kotani
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - Y Kuboki
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - H Bando
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - T Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - T Doi
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - T Kuwata
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Chiba, Japan; Department of Genetics and Clinical Laboratories, National Cancer Center Hospital East, Chiba, Japan
| | - K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba.
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Doi T, Langsted A, Nordestgaard BG. Lipoproteins, Cholesterol, and Atherosclerotic Cardiovascular Disease in East Asians and Europeans. J Atheroscler Thromb 2023; 30:1525-1546. [PMID: 37704428 PMCID: PMC10627775 DOI: 10.5551/jat.rv22013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/03/2023] [Indexed: 09/15/2023] Open
Abstract
One fifth of the world population live in East Asia comprising Japan, Korea, and China where ischemic heart disease, a major component of atherosclerotic cardiovascular disease (ASCVD), is the second most frequent cause of death. Each of low-density lipoproteins (LDL), remnant lipoproteins, and lipoprotein(a), summarized as non-high-density lipoproteins (non-HDL) or apolipoprotein B (apoB) containing lipoproteins, causes ASCVD. However, a significant proportion of the evidence on lipoproteins and lipoprotein cholesterol with risk of ASCVD came from White people mainly living in Europe and North America and not from people living in East Asia or of East Asian descent. With a unique biological, geohistorical, and social background in this world region, East Asians have distinctive characteristics that might have potential impact on the association of lipoproteins and lipoprotein cholesterol with risk of ASCVD. Considering the movement across national borders in the World, understanding of lipoprotein and lipoprotein cholesterol evidence on ASCVD in East Asia is important for both East Asian and non-East Asian populations wherever they live in the World.In this review, we introduce the biological features of lipoproteins and lipoprotein cholesterol and the evidence for their association with risk of ASCVD in East Asian and European populations. We also provide an overview of guideline recommendations for prevention of ASCVD in these two different world regions. Finally, specific preventive strategies and future perspectives are touched upon.
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Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Copenhagen University Hospital . Herlev Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital . Herlev Gentofte, Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Langsted
- Department of Clinical Biochemistry, Copenhagen University Hospital . Herlev Gentofte, Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Børge G. Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital . Herlev Gentofte, Herlev, Denmark
- The Copenhagen General Population Study, Copenhagen University Hospital . Herlev Gentofte, Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Doi T, Langsted A, Nordestgaard BG. Dual elevated remnant cholesterol and C-reactive protein in myocardial infarction, atherosclerotic cardiovascular disease, and mortality. Atherosclerosis 2023; 379:117141. [PMID: 37217436 DOI: 10.1016/j.atherosclerosis.2023.05.010] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND AIMS Elevated remnant cholesterol and low-grade inflammation each cause atherosclerotic cardiovascular disease (ASCVD); however, it is unknown whether joint elevation of both factors confers the highest risk. We tested the hypothesis that dual elevated remnant cholesterol and low-grade inflammation marked by elevated C-reactive protein is associated with the highest risk of myocardial infarction, ASCVD, and all-cause mortality. METHODS The Copenhagen General Population Study randomly recruited white Danish individuals aged 20-100 years in 2003-2015 and followed them for a median 9.5 years. ASCVD was cardiovascular mortality, myocardial infarction, stroke, and coronary revascularization. RESULTS In 103,221 individuals, we observed 2,454 (2.4%) myocardial infarctions, 5,437 (5.3%) ASCVD events, and 10,521 (10.2%) deaths. The hazard ratios increased with each of stepwise higher remnant cholesterol and stepwise higher C-reactive protein. In individuals with the highest tertile of both remnant cholesterol and C-reactive protein compared to individuals with the lowest tertile of both, the multivariable adjusted hazard ratios were 2.2 (95%CI:1.9-2.7) for myocardial infarction, 1.9 (1.7-2.2) for ASCVD, and 1.4 (1.3-1.5) for all-cause mortality. Corresponding values for only the highest tertile of remnant cholesterol were 1.6 (1.5-1.8), 1.4 (1.3-1.5), and 1.1 (1.0-1.1), and those for only the highest tertile of C-reactive protein were 1.7 (1.5-1.8), 1.6 (1.5-1.7), and 1.3 (1.3-1.4), respectively. There was no statistical evidence for interaction between elevated remnant cholesterol and elevated C-reactive protein on risk of myocardial infarction (p = 0.10), ASCVD (p = 0.40), or all-cause mortality (p = 0.74). CONCLUSIONS Dual elevated remnant cholesterol and C-reactive protein confers the highest risk of myocardial infarction, ASCVD, and all-cause mortality, that is, compared to either of these two factors individually.
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Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 73, 2730, Herlev, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, 2730, Herlev, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Anne Langsted
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 73, 2730, Herlev, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, 2730, Herlev, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte, Borgmester Ib Juuls Vej 73, 2730, Herlev, Denmark; The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, 2730, Herlev, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
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Doi T, Nordestgaard BG, Langsted A. Can remnant cholesterol (triglyceride-rich lipoproteins) reclassify estimated risk of atherosclerotic cardiovascular disease? Curr Opin Endocrinol Diabetes Obes 2023; 30:128-135. [PMID: 36722437 DOI: 10.1097/med.0000000000000799] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW To summarize recent studies analyzing reclassification of estimated risk of myocardial infarction (MI) and ischemic heart disease (IHD) by inclusion of remnant cholesterol (= cholesterol content in triglyceride-rich lipoproteins) in primary and secondary prevention settings. RECENT FINDINGS For individuals in a primary prevention setting with remnant cholesterol levels at least 95th percentile (≥1.6 mmol/l, 61 mg/dl), 23% of MI and 21% of IHD events developed later were reclassified correctly from below to above 5% for 10-year occurrence when remnant cholesterol levels were added to models based on conventional risk factors, whereas no events were reclassified incorrectly. Overall improved reclassification of MI was also observed for remnant cholesterol levels as low as at least 50th percentile (≥0.6 mmol/l, 25 mg/dl); however, the addition of remnant cholesterol over the entire concentration range yielded insignificant improvements of NRI for MI but slightly improved reclassification of NRI for IHD. In a secondary prevention setting, addition of remnant cholesterol over the entire concentration range to a conventional risk model improved reclassification. SUMMARY Elevated remnant cholesterol levels considerably improves reclassification of individuals who later develop MI and IHD, in primary as well as in secondary prevention settings.
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Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte
- The Copenhagen General Population Study
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte
- The Copenhagen General Population Study
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Langsted
- Department of Clinical Biochemistry, Copenhagen University Hospital-Herlev and Gentofte
- The Copenhagen General Population Study
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Kubota Y, Kawazoe A, Mishima S, Nakamura Y, Kotani D, Kuboki Y, Bando H, Kojima T, Doi T, Yoshino T, Kuwata T, Shitara K. Comprehensive clinical and molecular characterization of claudin 18.2 expression in advanced gastric or gastroesophageal junction cancer. ESMO Open 2023; 8:100762. [PMID: 36610262 PMCID: PMC10024138 DOI: 10.1016/j.esmoop.2022.100762] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND We conducted comprehensive clinical and molecular characterization of claudin 18.2 expression (CLDN18.2) in advanced gastric or gastroesophageal junction cancer (GC/GEJC). PATIENTS AND METHODS Patients with advanced GC/GEJC who received systemic chemotherapy from October 2015 to December 2019 with available tumor specimens were analyzed. We evaluated clinicopathological features of CLDN18.2 expression with four molecular subtypes: mismatch repair deficient, Epstein-Barr virus-positive, human epidermal growth factor receptor 2-positive, and others. In addition, programmed death-ligand 1 (PD-L1) combined positive score (CPS), genomic alterations, and the expression of immune cell markers were assessed. Clinical outcomes of standard first- or second-line chemotherapy and subsequent anti-programmed cell death protein 1 (anti-PD-1) therapy were also investigated according to CLDN18.2 expression. RESULTS Among 408 patients, CLDN18.2-positive (moderate-to-strong expression in ≥75%) was identified in 98 patients (24.0%) with almost equal distribution in the four molecular subtypes or CPS subgroups. CLDN18.2-positive was associated with Borrmann type 4, KRAS amplification, low CD16, and high CD68 expression. Overall survival with first-line chemotherapy was not significantly different between CLDN18.2-positive and -negative groups [median 18.4 versus 20.1 months; hazard ratio 1.26 (95% confidence interval 0.89-1.78); P = 0.191] regardless of stratification by PD-L1 CPS ≥5. Progression-free survival and objective response rates of first- and second-line chemotherapy, and anti-PD-1 therapy also showed no significant differences according to CLDN18.2 status. CONCLUSIONS CLDN18.2 expression in advanced GC/GEJC was associated with some clinical and molecular features but had no impact on treatment outcomes with chemotherapy or checkpoint inhibition. CLDN18.2-positive also had no impact on overall survival. This information could be useful to interpret the results from currently ongoing clinical trials of CLDN18.2-targeted therapies for advanced GC/GEJC and to consider a treatment strategy for CLDN18.2-positive GC/GEJC.
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Affiliation(s)
- Y Kubota
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba; Department of Clinical Oncology, St. Marianna University School of Medicine, Kanagawa
| | - A Kawazoe
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - S Mishima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - Y Nakamura
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - D Kotani
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - Y Kuboki
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - H Bando
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - T Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - T Doi
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba
| | - T Kuwata
- Departments of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Chiba, Japan; Genetics and Clinical Laboratories, National Cancer Center Hospital East, Chiba, Japan
| | - K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba.
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11
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Shimada H, Doi T, Tsutsumimoto K, Makino K, Harada K, Tomida K, Arai H. Predictive Validity of Different Walking Measures to Identify the Incident Long-Term Care Needs in Older Adults. J Nutr Health Aging 2023; 27:759-766. [PMID: 37754216 DOI: 10.1007/s12603-023-1978-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/26/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES A comfortable walking speed is a suitable measurement of functional status in older adults. In addition to assessing their comfortable walking speed, two complex walking tests were administered to a cohort of older people, assuming that these tests would be a more sensitive predictor of the incident long-term care needs than comfortable walking speed. DESIGN A prospective observational study was conducted to collect data. SETTING AND PARTICIPANTS Among the initial 5,563 community-dwelling independent older adults (aged ≥ 65 years), 935 were excluded and the data of 4,628 (mean age, 73.9 ± 5.5 years, 65-94 years; 2,052 men, 2,576 women) older adults were finally analyzed. METHODS Three walking tasks were administered: comfortable, complicated balance, and Go-stop walking. Complicated balance walking was measured under comfortable walking conditions, with participants having to walk with their hands crossed at the shoulder joint at 90°. For the Go-stop walking test, the time taken to walk 2 meters was measured using a stopwatch. For two years following baseline assessments, participants received monthly follow-ups for incident certification of the need for care under the long-term care insurance (LTCI) system. RESULTS Low performance in comfortable, complicated balance, and Go-stop walking were 29.8%, 37.7%, and 35.1%, respectively. During the 24-month follow-up period, 246 participants (5.3%) required LTCI certification. The Youden Index was used to determine the cut-points of the incident long-term care needs in the comfortable, complicated balance, and Go-stop walking conditions, which were 1.055 m/s, 0.936 m/s, and 3.205 seconds, respectively. Participants classified as exhibiting low performance included 1,381 (29.8%) under comfortable walking, 1,746 (37.7%) under complicated balance walking, and 1,623 (35.1%) under the Go-stop walking tests. The C-indices of the comfortable, complicated balance, and Go-stop walking tests were 0.72 (95% confidence interval (CI) 0.69-0.76), 0.71 (95% CI 0.67-0.74), and 0.65 (95% CI 0.61-0.69), respectively. Cox proportional hazards regression model revealed significant relationships between the incident long-term care needs and the comfortable (hazard ratio (HR) 2.14, 95% CI 1.62-2.84), complicated balance (1.81, 1.36-2.41), and Go-stop (1.46, 1.12-1.91) walking conditions. CONCLUSIONS AND IMPLICATIONS The findings suggest that slow walking speed has a considerably greater impact on the incident long-term care needs in older adults. However, the complex walking task did not improve the predictive performance. Comfortable walking speed tests, which can easily be measured to predict the future incident long-term care needs, are effective tools in community health promotion and primary care.
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Affiliation(s)
- H Shimada
- Hiroyuki Shimada, Department of Preventive Gerontology, Centre for Gerontology and Social Science, Research Institute, National Centre for Geriatrics and Gerontology 7-430 Morioka-cho, Obu, Aichi 474-8511, Japan, Tel: +81-562-44-5651 (ext. 5611) E-mail:
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12
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Van Cutsem E, Hochster H, Shitara K, Mayer R, Ohtsu A, Falcone A, Yoshino T, Doi T, Ilson D, Arkenau HT, George B, Benhadji K, Makris L, Tabernero J. Pooled safety analysis from phase III studies of trifluridine/tipiracil in patients with metastatic gastric or gastroesophageal junction cancer and metastatic colorectal cancer. ESMO Open 2022; 7:100633. [PMID: 36455504 PMCID: PMC9808443 DOI: 10.1016/j.esmoop.2022.100633] [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] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Trifluridine/tipiracil (FTD/TPI) showed clinical benefit, including improved survival and manageable safety in previously treated patients with metastatic colorectal (mCRC) or gastric/gastroesophageal junction (mGC/GEJC) cancer in the phase III RECOURSE and TAGS trials, respectively. A pooled analysis was conducted to further characterize FTD/TPI safety, including management of haematologic toxicities and use in patients with renal or hepatic impairment. PATIENTS AND METHODS Adults with ≥2 prior regimens for advanced mGC/GEJC or mCRC were randomized (2 : 1) to FTD/TPI [35 mg/m2 twice daily days 1-5 and 8-12 (28-day cycle); same dosage in both trials] or placebo plus best supportive care. Adverse events (AEs) were summarized in the safety population (patients who received ≥1 dose) and analysed by renal/hepatic function. RESULTS TAGS and RECOURSE included 335 and 533 FTD/TPI-treated and 168 and 265 placebo-treated patients, respectively. Overall safety of FTD/TPI was similar in TAGS and RECOURSE. Haematologic (neutropenia, anaemia) and gastrointestinal (nausea, diarrhoea) AEs were most commonly observed. Laboratory-assessed grade 3-4 neutropenia occurred in 37% (TAGS)/38% (RECOURSE) of FTD/TPI-treated patients (median onset: 29 days/55 days), and 96% (TAGS)/97% (RECOURSE) of cases resolved regardless of renal/hepatic function. Supportive medications for neutropenia were received by 17% (TAGS) and 9% (RECOURSE); febrile neutropenia was reported in 2% and 4%, respectively. Overall grade ≥3 AEs were more frequent in patients with moderate renal impairment [81% (TAGS); 85% (RECOURSE)] versus normal renal function (74%; 67%); anaemia and neutropenia were more common in patients with renal impairment. FTD/TPI safety (including haematologic AEs) was consistent across patients with normal and mildly impaired hepatic function. CONCLUSIONS These results support FTD/TPI as a well-tolerated treatment in patients with mGC/GEJC or mCRC, with a consistent safety profile. Safety was largely similar in patients with normal or mildly impaired renal/hepatic function; however, patients with renal impairment should be monitored for haematologic toxicities.
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Affiliation(s)
- E. Van Cutsem
- University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium,Correspondence to: Prof. Eric Van Cutsem, Gastroenterology/Digestive Oncology, University Hospitals Gasthuisberg/Leuven & KU Leuven, Herestraat 49, 3000 Leuven, Belgium. Tel: +32-16-34-42-18; Fax: +32-16-34-44-19
| | - H. Hochster
- Rutgers Cancer Institute, New Brunswick, USA
| | - K. Shitara
- National Cancer Center Hospital East, Chiba, Japan
| | - R. Mayer
- Dana-Farber Cancer Institute, Boston, USA
| | - A. Ohtsu
- National Cancer Center Hospital East, Chiba, Japan
| | - A. Falcone
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - T. Yoshino
- National Cancer Center Hospital East, Chiba, Japan
| | - T. Doi
- National Cancer Center Hospital East, Chiba, Japan
| | - D.H. Ilson
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - H.-T. Arkenau
- Sarah Cannon Research Institute, Cancer Institute, University College London, London, UK
| | - B. George
- Medical College of Wisconsin, Milwaukee, USA
| | | | | | - J. Tabernero
- Vall d’Hebron Hospital Campus and Vall d’Hebron Institute of Oncology (VHIO), UVic-UCC, IOB-Quiron, Barcelona, Spain
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Funabashi S, Kataoka Y, Hori M, Ogura M, Doi T, Noguchi T, Shiba M. The effect of achieving LDL-C <1.8 mmol/L to prevent the first atherosclerotic cardiovascular events in the primary prevention settings of severe heterozygous familial hypercholesterolemia. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2344] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The International Atherosclerosis Society (IAS) has proposed “severe familial hypercholesterolemia” (FH) as a phenotype with the highest cardiovascular risk. LDL-C <2.5 mmol/l is a recommended therapeutic goal for the primary prevention settings of severe FH. However, given that ESC guidelines recommends LDL-C <1.8 mmol/l in FH patients, this stricter goal may be better to prevent the first atherosclerotic cardiovascular disease (ASCVD) in severe FH patients.
Purpose
To determine whether achieving LDL-C<1.8 mg/dl is more beneficial to reduce the first ASCVD events.
Methods
A total of 148 severe FH subjects without any history of ASCVD were analyzed. Severe FH was defined as untreated LDL-C >10.3 mmol/l, LDL-C >8.0 mmol/l+ 1 high-risk feature, LDL-C >4.9 mmol/l + 2 high-risk features according to IAS proposed statement. The occurrence of ASCVD (all-cause death, CAD, ischemic stroke and lower extremity artery disease (LEAD)) were compared in those with on-treatment LDL-C < and ≥1.8 mmol/L.
Results
10.1% (=15/148) of study subjects achieved on-treatment LDL-C <1.8 mmol/l. They were more likely to receive PCSK9 inhibitor (15.0 vs. 66.7%, p<0.01), whereas there was no significant difference in FH-related physical characteristics (tendon xanthomas: 72.2 vs. 93.3%, p=0.12) and causative genotypes (LDLR: 68.4 vs. 66.7%, p=1.00, PCSK9: 8.3 vs. 6.7%, p=1.00, LDLR/PCSK9: 3.8 vs. 6.7%, p=0.48), untreated LDL-C (7.3±1.7 vs. 7.9±1.8 mmol/l, p=0.22) and lipoprotein(a) (23 [11–42] vs. 25 [15–70] mg/dl, p=0.41) levels between two groups. During the observational period (median=7.0 years), severe FH achieving on-treatment LDL-C <1.8 mmol/l was associated with a lower likelihood of experiencing ASCVD events (Figure 1). Of note, any cardiovascular events did not occur in severe FH who achieved on-treatment LDL-C <1.8 mmol/l. In those with on-treatment LDL ≥1.8 mmol/L, CAD (76.5%=26/34) was more dominant component of ASCVD, followed by ischemic stroke (17.6%=6/34) and LEAD (5.9%=2/34).
Conclusions
A significantly lower frequency of ASCVD was observed in severe FH who achieved LDL-C <1.8 mmol/L in the primary prevention settings. Given that only 10.1% of severe FH patients achieved LDL-C <1.8 mmol/l, more actions are required to motivate physicians for further intensified management of LDL-C in severe FH patients in the primary prevention settings.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Funabashi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine , Osaka , Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine , Osaka , Japan
| | - M Hori
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology , Osaka , Japan
| | - M Ogura
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology , Osaka , Japan
| | - T Doi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine , Osaka , Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine , Osaka , Japan
| | - M Shiba
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology , Osaka , Japan
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Doi T, Patel M, Falchook G, Koyama T, Friedman C, Piha-Paul S, Gutierrez M, Abdul-Karim R, Awad M, Adkins D, Takahashi S, Kadowaki S, Cheng B, Ikeda N, Laadem A, Yoshizuka N, Qian M, Dosunmu O, Arkenau HT, Johnson M. 453O DS-7300 (B7-H3 DXd antibody-drug conjugate [ADC]) shows durable antitumor activity in advanced solid tumors: Extended follow-up of a phase I/II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.582] [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] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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15
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Funabashi S, Kataoka Y, Hori M, Ogura M, Doi T, Noguchi T, Harada‐Shiba M. Characterization of Polyvascular Disease in Heterozygous Familial Hypercholesterolemia: Its Association With Circulating Lipoprotein(a) Levels. J Am Heart Assoc 2022; 11:e025232. [PMID: 35929461 PMCID: PMC9496307 DOI: 10.1161/jaha.121.025232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 11/16/2022]
Abstract
Background Heterozygous familial hypercholesterolemia (HeFH) more likely exhibits extensive atherosclerotic disease at multiple vascular beds. Lipoprotein(a) (Lp(a)) is an atherogenic lipoprotein that elevates HeFH-related atherosclerotic cardiovascular disease risks. Whether circulating Lp(a) level associates with polyvascular propagation of atherosclerosis in subjects with HeFH remains uncertain. Methods and Results The current study analyzed 370 subjects with clinically diagnosed HeFH who received evaluation of systemic arteries. Polyvascular disease (polyVD) was defined as more than 2 coexisting atherosclerosis conditions including coronary artery disease, carotid stenosis, or peripheral artery disease. Clinical characteristics and lipid features were analyzed in subjects with HeFH and polyVD; 5.7% of patients with HeFH (21/370) had polyVD. They were more likely to have a clustering of risk factors, tendon (P<0.001) and skin xanthomas (P=0.004), and corneal arcus (P=0.026). Furthermore, an elevated Lp(a) level (P=0.006) and a greater frequency of Lp(a) level ≥50 mg/dL (P<0.001) were observed in subjects with HeFH and polyVD. On multivariable analysis adjusting risk factors and lipid-lowering agents, Lp(a) ≥50 mg/dL (odds ratio [OR], 5.66 [95% CI, 1.68-19.0], P=0.005), age, and family history of premature coronary artery disease independently predicted polyVD in subjects with HeFH. Of note, the prevalence of polyVD rose to 33.3% in patients with HeFH and age >58 years old, family history of premature coronary artery disease, and Lp(a) ≥50 mg/dL (OR, 10.3 [95% CI, 3.12-33.4], P<0.001). Conclusions An increased level of circulating Lp(a) levels predicted concomitance of polyVD in patients with HeFH. The current findings suggest subjects with HeFH and Lp(a) ≥50 mg/dL as a high-risk category who require meticulous screening of systemic vascular beds.
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Affiliation(s)
- Sayaka Funabashi
- Department of Cardiovascular MedicineNational Cerebral & Cardiovascular CentreSuitaOsaka
| | - Yu Kataoka
- Department of Cardiovascular MedicineNational Cerebral & Cardiovascular CentreSuitaOsaka
| | - Mika Hori
- Department of Molecular Innovation in LipidologyNational Cerebral & Cardiovascular CenterResearch InstituteSuitaOsaka
- Department of Endocrinology Research Institute of Environmental MedicineNagoya UniversityNagoyaAichi
| | - Masatsune Ogura
- Department of Molecular Innovation in LipidologyNational Cerebral & Cardiovascular CenterResearch InstituteSuitaOsaka
| | - Takahito Doi
- Department of Cardiovascular MedicineNational Cerebral & Cardiovascular CentreSuitaOsaka
| | - Teruo Noguchi
- Department of Cardiovascular MedicineNational Cerebral & Cardiovascular CentreSuitaOsaka
| | - Mariko Harada‐Shiba
- Department of Molecular Innovation in LipidologyNational Cerebral & Cardiovascular CenterResearch InstituteSuitaOsaka
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Doi T, Langsted A, Nordestgaard B. Elevated remnant cholesterol appropriately reclassifies individuals who develop myocardial infarction. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.218] [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: 11/02/2022]
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Doi T, Langsted A, Nordestgaard BG. Elevated Remnant Cholesterol Reclassifies Risk of Ischemic Heart Disease and Myocardial Infarction. J Am Coll Cardiol 2022; 79:2383-2397. [PMID: 35710189 DOI: 10.1016/j.jacc.2022.03.384] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/18/2022] [Accepted: 03/29/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Elevated remnant cholesterol causes ischemic heart disease. OBJECTIVES We tested the hypothesis that the inclusion of elevated remnant cholesterol will lead to appropriate reclassification of individuals who later experience myocardial infarction and ischemic heart disease. METHODS For >10 years we followed up 41,928 white Danish individuals from the Copenhagen General Population Study without a history of ischemic cardiovascular disease, diabetes, and statin use. Using predefined cut points for elevated remnant cholesterol, we calculated net reclassification index (NRI) from below to above 5%, 7.5%, and/or 10% 10-year occurrence of myocardial infarction and ischemic heart disease defined as a composite of death from ischemic heart disease, myocardial infarction, and coronary revascularization. RESULTS For individuals with remnant cholesterol levels ≥95th percentile (≥1.6 mmol/L, 61 mg/dL), 23% (P < 0.001) of myocardial infarction and 21% (P < 0.001) of ischemic heart disease were reclassified correctly from below to above 5% for 10-year occurrence when remnant cholesterol levels were added to models based on conventional risk factors, whereas no events were reclassified incorrectly. Consequently, the addition of remnant cholesterol levels yielded NRI of 10% (95% CI: 1%-20%) for myocardial infarction and 5% (95% CI: -3% to 13%) for ischemic heart disease. Correspondingly, when reclassifications were combined from below to above 5%, 7.5%, and 10% risk of events, 42% (P < 0.001) of individuals with myocardial infarction and 41% (P < 0.001) with ischemic heart disease were reclassified appropriately, leading to NRI of respectively 20% (95% CI: 9%-31%) and 11% (95% CI: 2%-21%). CONCLUSIONS Elevated remnant cholesterol levels considerably improve myocardial infarction and ischemic heart disease risk prediction.
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Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Anne Langsted
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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18
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Kurokawa Y, Honma Y, Sawaki A, Naito Y, Iwagami S, Komatsu Y, Takahashi T, Nishida T, Doi T. Pimitespib in patients with advanced gastrointestinal stromal tumor (CHAPTER-GIST-301): a randomized, double-blind, placebo-controlled phase 3 trial. Ann Oncol 2022; 33:959-967. [PMID: 35688358 DOI: 10.1016/j.annonc.2022.05.518] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [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: 01/15/2022] [Revised: 04/06/2022] [Accepted: 05/29/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Prognosis of advanced gastrointestinal stromal tumors (GIST) refractory to tyrosine kinase inhibitors (TKIs) is poor. This randomized, placebo-controlled, phase 3 trial evaluated the efficacy and safety of pimitespib, a novel heat shock protein 90 inhibitor, in advanced GIST refractory to standard TKIs. PATIENTS AND METHODS Patients with histologically confirmed GIST refractory to imatinib, sunitinib, and regorafenib were randomized 2:1 to oral pimitespib 160 mg/day or placebo for five consecutive days per week in 21-day cycles. Following disease progression by blinded central radiological review (BCRR), crossover to open-label pimitespib was permitted. The primary endpoint was progression-free survival (PFS) by BCRR in the full analysis set. Secondary endpoints included overall survival (OS) adjusted using the rank preserving structural failure time method to reduce the expected confounding impact of crossover. RESULTS From Oct 31, 2018 to Apr 30, 2020, 86 patients were randomized to pimitespib (n=58) or placebo (n=28). Median PFS was 2.8 months (95% CI 1.6-2.9) with pimitespib versus 1.4 months (0.9-1.8) with placebo (hazard ratio [HR] 0.51 [95% CI 0.30-0.87]; one-sided p=0.006). Pimitespib showed an improvement in crossover-adjusted OS compared with placebo (HR 0.42 [0.21-0.85], one-sided p=0.007). Seventeen (60.7%) patients receiving placebo crossed-over to pimitespib; median PFS after crossover was 2.7 (95% CI 0.7-4.1) months. The most common (≥30%) treatment-related adverse events (AEs) with pimitespib were diarrhea (74.1%) and decreased appetite (31.0%); the most common (≥10%) grade ≥3 treatment-related AE was diarrhea (13.8%). Treatment-related AEs leading to pimitespib discontinuation occurred in 3 (5.2%) patients. CONCLUSION Pimitespib significantly improved PFS and crossover-adjusted OS compared with placebo and had an acceptable safety profile in patients with advanced GIST refractory to standard TKIs.
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Affiliation(s)
- Y Kurokawa
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan;.
| | - Y Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - A Sawaki
- Department of Medical Oncology, Fujita Health University Hospital, Aichi, Japan
| | - Y Naito
- Department of General Internal Medicine/Medical Oncology/Experimental Therapeutics, National Cancer Center Hospital East, Kashiwa, Japan
| | - S Iwagami
- Department of Gastroenterological Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Y Komatsu
- Department of Cancer Center, Hokkaido University Hospital, Sapporo, Japan
| | - T Takahashi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - T Nishida
- Department of Surgery, National Cancer Center Hospital, Tokyo, Japan;; Department of Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Japan
| | - T Doi
- Department of Experimental Therapeutics, National Cancer Center Hospital Kashiwa, Japan
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Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Anne Langsted
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Abstract
Heterozygous familial hypercholesterolemia (HeFH) is a genetic disorder that elevates low-density lipoprotein cholesterol and increases the risk of premature atherosclerotic cardiovascular disease (ASCVD). However, despite their atherogenic lipid profiles, the cardiovascular risk of HeFH varies in each individual. Their variety of phenotypic features suggests the need for better risk stratification to optimize their therapeutic management. The current review summarizes three potential approaches, including (1) definition of familial hypercholesterolemia (FH)-related risk scores, (2) genetic analysis, and (3) biomarkers. The International Atherosclerosis Society has recently proposed a definition of severe FH to identify very high-risk HeFH subjects according to their clinical characteristics. Furthermore, published studies have shown the association of FH-related genetic phenotypes with ASCVD, which indicates the genetic analysis’s potential to evaluate individual cardiovascular risks. Biomarkers reflecting disease activity have been considered to predict the formation of atherosclerosis and the occurrence of ASCVD in HeFH subjects. Incorporating these risk stratifications will be expected to allocate adequate intensity of lipid-lowering therapies in HeFH subjects, which ultimately improves cardiovascular outcomes.
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Affiliation(s)
- Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Centre
| | | | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Centre.,Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte.,Department of Clinical Medicine, University of Copenhagen
| | - Mariko Harada-Shiba
- Department of Molecular Innovation in Lipidology, National Cerebral & Cardiovascular Centre
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21
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Cao Y, Qin S, Luo S, Li Z, Cheng Y, Fan Y, Sun Y, Yin X, Yuan X, Li W, Liu T, Hsu CH, Lin X, Kim SB, Kojima T, Zhang J, Lee SH, Bai Y, Muro K, Doi T, Bai C, Gu K, Pan HM, Bai L, Yang JW, Cui Y, Lu W, Chen J. Pembrolizumab versus chemotherapy for patients with esophageal squamous cell carcinoma enrolled in the randomized KEYNOTE-181 trial in Asia. ESMO Open 2021; 7:100341. [PMID: 34973513 DOI: 10.1016/j.esmoop.2021.100341] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 08/25/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND In the randomized phase III KEYNOTE-181 study, pembrolizumab prolonged overall survival (OS) compared with chemotherapy as second-line therapy in patients with advanced esophageal cancer and programmed death-ligand 1 (PD-L1) combined positive score (CPS) ≥10. We report a post hoc subgroup analysis of patients with esophageal squamous cell carcinoma (ESCC) enrolled in KEYNOTE-181 in Asia, including patients from the KEYNOTE-181 China extension study. PATIENTS AND METHODS Three hundred and forty Asian patients with advanced/metastatic ESCC were enrolled in KEYNOTE-181, including the China cohort. Patients were randomly assigned 1 : 1 to receive pembrolizumab 200 mg every 3 weeks for ≤2 years or investigator's choice of paclitaxel, docetaxel, or irinotecan. OS, progression-free survival, response, and safety were analyzed without formal comparisons. OS was evaluated based on PD-L1 CPS expression level. RESULTS In Asian patients with ESCC, median OS was 10.0 months with pembrolizumab and 6.5 months with chemotherapy [hazard ratio (HR), 0.63; 95% CI 0.50-0.80; nominal P < 0.0001]. Median progression-free survival was 2.3 months with pembrolizumab and 3.1 months with chemotherapy (HR, 0.79; 95% CI 0.63-0.99; nominal P = 0.020). Objective response rate was 17.1% with pembrolizumab and 7.1% with chemotherapy; median duration of response was 10.5 months and 7.7 months, respectively. In patients with PD-L1 CPS <1 tumors (pembrolizumab versus chemotherapy), the HR was 0.99 (95% CI 0.56-1.72); the HR (95% CI) for death was better for patients with PD-L1 CPS cut-offs >1 [CPS ≥1, 0.57 (0.44-0.75); CPS ≥5, 0.56 (0.41-0.76); CPS ≥10, 0.53 (0.37-0.75)]. Treatment-related adverse events were reported in 71.8% of patients in the pembrolizumab group and 89.8% in the chemotherapy group; grade 3-5 events were reported in 20.0% and 44.6%, respectively. CONCLUSIONS Pembrolizumab monotherapy demonstrated promising efficacy in Asian patients with ESCC, with fewer treatment-related adverse events than chemotherapy. PD-L1 CPS ≥1 is an appropriate cut-off and a predictive marker of pembrolizumab efficacy in Asian patients with ESCC.
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Affiliation(s)
- Y Cao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China.
| | - S Qin
- PLA Cancer Centre of Nanjing Bayi Hospital, Nanjing, China
| | - S Luo
- The Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Z Li
- Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Y Cheng
- Jilin Cancer Hospital, Jilin, China
| | - Y Fan
- Cancer Hospital of University of Chinese Academy of Sciences, Institute of Cancer and Basic Medicine of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Y Sun
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, and The Affiliated Hospital of Anhui Medical University, Hefei, China
| | - X Yin
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - X Yuan
- Tongji Hospital, Wuhan, China
| | - W Li
- Hubei Cancer Hospital, Wuhan, China
| | - T Liu
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - C-H Hsu
- National Taiwan University Hospital, Taipei, Taiwan
| | - X Lin
- Fujian Medical University Union Hospital, Fuzhou, China
| | - S-B Kim
- Asan Medical Center, Seoul, South Korea
| | - T Kojima
- National Cancer Center Hospital East, Kashiwa, Japan
| | - J Zhang
- Ruijin Hospital, Shanghai, China
| | - S-H Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y Bai
- Harbin Medical University Cancer Hospital, Harbin, China
| | - K Muro
- Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Doi
- National Cancer Center Hospital East, Kashiwa, Japan
| | - C Bai
- Peking Union Medical College Hospital, Beijing, China
| | - K Gu
- The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China
| | - H-M Pan
- Sir Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - L Bai
- Chinese PLA General Hospital, Beijing, China
| | - J-W Yang
- Fujian Province Cancer Hospital, Fuzhou, China
| | - Y Cui
- MSD China, Shanghai, China
| | - W Lu
- MSD China, Shanghai, China
| | - J Chen
- Jiangsu Cancer Hospital, Nanjing, China
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22
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Doi T, Langsted A, Nordestgaard BG. Mineral oil and icosapent ethyl may jointly explain the between arm difference of cardiovascular risk in REDUCE-IT. Eur Heart J 2021; 42:4867-4868. [PMID: 34734260 DOI: 10.1093/eurheartj/ehab764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/14/2022] Open
Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
| | - Anne Langsted
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
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23
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Ueo H, Ueo H, Minoura I, Gamachi A, Doi T, Yamaguchi M, Yamashita T, Tsuda H, Moriya T, Yamaguchi R, Kozuka Y, Sasaki T, Masuda T, Kai Y, Kubota Y, Urano Y, Mori M, Mimori K. Clinical usefulness of a novel fluorescence technique for the intraoperative diagnosis of surgical margins in patients with breast cancer. Br J Surg 2021; 108:e340-e342. [PMID: 34428279 DOI: 10.1093/bjs/znab265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/02/2021] [Accepted: 06/22/2021] [Indexed: 11/12/2022]
Abstract
In both 5- and 15-min data, FI was significantly higher in malignant tissues than in benign tissues. The diagnostic accuracy was similar at 5 and 15 min. Therefore, the 5-min FI was enough applying in the further analyses.
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Affiliation(s)
- H Ueo
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Ueo Breast Cancer Hospital, Oita, Japan
| | - H Ueo
- Ueo Breast Cancer Hospital, Oita, Japan
| | - I Minoura
- Goryo Chemical, Inc., Sapporo, Japan
| | - A Gamachi
- Department of Pathology, Almeida Memorial Hospital, Oita, Japan
| | - T Doi
- Breast Cancer Centre, Shonan Memorial Hospital, Kamakura, Japan
| | - M Yamaguchi
- Department of Breast Surgery, JCHO Kurume General Hospital, Kurume, Japan
| | - T Yamashita
- Department of Breast and Endocrine Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - H Tsuda
- Department of Basic Pathology, National Defence Medical College, Tokorozawa, Japan
| | - T Moriya
- Department of Pathology, Kawasaki Medical School, Kurashiki, Japan
| | - R Yamaguchi
- Department of Pathology and Laboratory Medicine, Kurume University Medical Centre, Kurume, Japan
| | - Y Kozuka
- Department of Pathology, Mie University Hospital, Tsu, Japan
| | - T Sasaki
- Department of Next-Generation Pathology Information and Networking, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - T Masuda
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Y Kai
- Ueo Breast Cancer Hospital, Oita, Japan
| | - Y Kubota
- Ueo Breast Cancer Hospital, Oita, Japan
| | - Y Urano
- Graduate School of Medicine and Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - M Mori
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Mimori
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
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24
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Sugimoto T, Sakurai T, Akatsu H, Doi T, Fujiwara Y, Hirakawa A, Kinoshita F, Kuzuya M, Lee S, Matsuo K, Michikawa M, Ogawa S, Otsuka R, Sato K, Shimada H, Suzuki H, Suzuki H, Takechi H, Takeda S, Umegaki H, Wakayama S, Arai H. The Japan-Multimodal Intervention Trial for Prevention of Dementia (J-MINT): The Study Protocol for an 18-Month, Multicenter, Randomized, Controlled Trial. J Prev Alzheimers Dis 2021; 8:465-476. [PMID: 34585222 PMCID: PMC8187136 DOI: 10.14283/jpad.2021.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background/Objectives The Japan-multimodal intervention trial for prevention of dementia (J-MINT) is intended to verify the effectiveness of multi-domain interventions and to clarify the mechanism of cognitive improvement and deterioration by carrying out assessment of dementia-related biomarkers, omics analysis and brain imaging analysis among older adults at high risk of dementia. Moreover, the J-MINT trial collaborates with partnering private enterprises in the implementation of relevant interventional measures. This manuscript describes the study protocol. Design/Setting Eighteen-month, multi-centered, randomized controlled trial. Participants We plan to recruit 500 older adults aged 65–85 years with mild cognitive impairment. Subjects will be centrally randomized into intervention and control groups at a 1:1 allocation ratio using the dynamic allocation method with all subjects stratified by age, sex, and cognition. Intervention The multi-domain intervention program includes: (1) management of vascular risk factors; (2) group-based physical exercise and self-monitoring of physical activity; (3) nutritional counseling; and (4) cognitive training. Health-related information will be provided to the control group every two months. Measurements The primary and secondary outcomes will be assessed at baseline, 6-, 12-, and 18-month follow-up. The primary outcome is the change from baseline to 18 months in a global composite score combining several neuropsychological domains. Secondary outcomes include: cognitive change in each neuropsychological test, incident dementia, changes in blood and dementia-related biomarkers, changes in geriatric assessment including activities of daily living, frailty status and neuroimaging, and number of medications taken. Conclusions This trial that enlist the support of private enterprises will lead to the creation of new services for dementia prevention as well as to verify the effectiveness of multi-domain interventions for dementia prevention. Electronic Supplementary Material Supplementary material is available for this article at 10.14283/jpad.2021.29 and is accessible for authorized users.
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Affiliation(s)
- T Sugimoto
- Takashi Sakurai, 7-430 Morioka, Obu, Aichi, 474-8511, Japan, Tel: +81-562-46-2311, E-mail:
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25
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Funabashi S, Kataoka Y, Hori M, Ogura M, Nakaoku Y, Nishimura K, Doi T, Nishikawa R, Tsuda K, Noguchi T, Harada-Shiba M. Substantially Elevated Atherosclerotic Risks in Japanese Severe Familial Hypercholesterolemia Defined by the International Atherosclerosis Society. JACC Asia 2021; 1:245-255. [PMID: 36338164 PMCID: PMC9627852 DOI: 10.1016/j.jacasi.2021.07.004] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND The International Atherosclerosis Society (IAS) has proposed "severe familial hypercholesterolemia" (FH) as a phenotype with the highest cardiovascular risk. However, whether this criteria could appropriately stratify a high-risk Japanese patient with FH remains unknown. OBJECTIVES This study sought to characterize atherosclerotic cardiovascular diseases in IAS-defined Japanese subjects with severe FH. METHODS This study analyzed 380 clinically diagnosed subjects with heterozygous FH without any history of atherosclerotic cardiovascular diseases. Severe FH was defined as untreated low-density lipoprotein cholesterol >400 mg/dL, >310 mg/dL plus 1 high-risk feature, or >190 mg/dL plus 2 high-risk features according to IAS-proposed statement. The occurrence of first and subsequent composite outcomes (cardiac [cardiac death + coronary artery disease + coronary revascularization] and noncardiac events [stroke + peripheral artery disease] was compared between subjects with severe (n = 135) and non-severe (n = 227) FH. RESULTS Severe FH was identified in 40.3% of study population. They had higher low-density lipoprotein cholesterol (P < 0.001) and lipoprotein(a) (P = 0.03) levels. Moreover, they more frequently received high-intensity statin (P < 0.001), PCSK9 inhibitor (P < 0.001), and lipoprotein apheresis (P = 0.01) than nonsevere FH subjects did, which resulted in a lower on-treatment low-density lipoprotein cholesterol level of subjects with severe FH (113 ± 47.2 vs 130 ± 53.9 mg/dL; P = 0.007). However, during the 7.4-year observational period, subjects with severe FH exhibited a 9.3-, 15.4-, and 5.9-fold greater risk for first composite (P < 0.001), cardiac (P < 0.001), and noncardiac outcomes (P = 0.02), respectively. Multivariate Cox proportional hazard model consistently revealed the 7.8- and 7.9-fold elevated risks of first (P < 0.001) and of subsequent (P < 0.001) composite outcomes in subjects with severe FH. CONCLUSIONS Japanese subjects with severe FH present profound risks of both first and subsequent atherosclerotic cardiovascular diseases in the primary prevention settings. These findings support the clinical applicability of IAS-defined severe FH in Japanese patients, which identifies those who require further stringent antiatherosclerotic management.
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Affiliation(s)
- Sayaka Funabashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Mika Hori
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center, Research Institute, Suita, Osaka, Japan
| | - Masatsune Ogura
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center, Research Institute, Suita, Osaka, Japan
| | - Yuriko Nakaoku
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Ryo Nishikawa
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Kosuke Tsuda
- Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Mariko Harada-Shiba
- Department of Molecular Innovation in Lipidology, National Cerebral and Cardiovascular Center, Research Institute, Suita, Osaka, Japan
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26
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Kuboki Y, Shitara K, Morizane C, Kojima T, Yoh K, Sakai D, Tahara M, Hirai H, Kurokawa Y, Kato T, Doi T. 1383P Phase I study of the irreversible FGFR inhibitor futibatinib in Japanese patients with advanced solid tumors: Updated dose expansion results and activity in gastric cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1492] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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27
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Hollebecque A, Bridgewater J, Meric-Bernstam F, Goyal L, Arkenau HT, Yamamiya I, Yamashita F, Li K, Wacheck V, Doi T. 52P Assessment of futibatinib exposure–response (E–R) relationships in patients with advanced solid tumors, including cholangiocarcinoma (CCA). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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28
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Johnson M, Doi T, Piha-Paul S, Sen S, Shimizu T, Cheng B, Yoshizuka N, Okamoto N, Okuda Y, Qian X, Serbest G, Hammett T, Brady W, Patel M, Bendell J. 513O A phase I/II multicenter, first-in-human study of DS-7300 (B7-H3 DXd-ADC) in patients (pts) with advanced solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1035] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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29
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Tanabe S, Kojima T, Tazawa H, Noma K, Katsui K, Hori K, Nakamura N, Urata Y, Doi T, Kanazawa S, Shirakawa Y, Fujiwara T, Okada H. 554P Phase I clinical trial of OBP-301, a novel telomerase-specific oncolytic virus, in combination with radiotherapy in esophageal cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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30
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Doi T, Langsted A, Nordestgaard BG. A possible explanation for the contrasting results of REDUCE-IT vs. STRENGTH: cohort study mimicking trial designs. Eur Heart J 2021; 42:4807-4817. [PMID: 34455435 DOI: 10.1093/eurheartj/ehab555] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [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] [Received: 04/22/2021] [Revised: 06/23/2021] [Accepted: 08/09/2021] [Indexed: 01/11/2023] Open
Abstract
AIMS We tested the hypothesis that the contrasting results for the effect of high-dose, purified omega-3 fatty acids on the prevention of atherosclerotic cardiovascular disease (ASCVD) in two randomized trials, Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) vs. Long-Term Outcomes Study to Assess Statin Residual Risk with Epanova in High Cardiovascular Risk Patients with Hypertriglyceridaemia (STRENGTH), can be explained by differences in the effect of active and comparator oils on lipid traits and C-reactive protein. METHODS AND RESULTS In the Copenhagen General Population Study (CGPS) with 106 088 individuals, to mimic trial designs we analysed those who met key inclusion criteria in REDUCE-IT (n = 5684; ASCVD = 852) and STRENGTH (n = 6862; ASCVD = 697). Atherosclerotic cardiovascular disease incidence was followed for the median durations of REDUCE-IT and STRENGTH (4.9 and 3.5 years), respectively. When combining changes in plasma triglycerides, low-density lipoprotein cholesterol, and C-reactive protein observed in the active oil groups of the original studies, estimated hazard ratios for ASCVD in the CGPS were 0.96 [95% confidence interval 0.93-0.99] mimicking REDUCE-IT and 0.94 (0.91-0.98) mimicking STRENGTH. In the comparator oil groups, corresponding hazard ratios were 1.07 (1.04-1.10) and 0.99 (0.98-0.99). Combining these results, the active oil vs. comparator oil hazard ratio was 0.88 (0.84-0.93) in the CGPS mimicking REDUCE-IT compared to 0.75 (0.68-0.83) in the REDUCE-IT. The corresponding hazard ratio was 0.96 (0.93-0.99) in the CGPS mimicking STRENGTH compared to 0.99 (0.90-1.09) in STRENGTH. CONCLUSION The contrasting results of REDUCE-IT vs. STRENGTH can partly be explained by a difference in the effect of comparator oils (mineral vs. corn), but not of active oils [eicosapentaenoic acid (EPA) vs. EPA + docosahexaenoic acid], on lipid traits and C-reactive protein. The unexplained additional 13% risk reduction in REDUCE-IT likely is through other effects of EPA or mineral oil.
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Affiliation(s)
- Takahito Doi
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,The Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
| | - Anne Langsted
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,The Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,The Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 73, Herlev 2730, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen 2200, Denmark
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31
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Tabernero J, Shitara K, Zaanan A, Doi T, Lorenzen S, Van Cutsem E, Fornaro L, Catenacci DVT, Fougeray R, Moreno SR, Azcue P, Arkenau HT, Alsina M, Ilson DH. Trifluridine/tipiracil versus placebo for third or later lines of treatment in metastatic gastric cancer: an exploratory subgroup analysis from the TAGS study. ESMO Open 2021; 6:100200. [PMID: 34175675 PMCID: PMC8253956 DOI: 10.1016/j.esmoop.2021.100200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Metastatic gastric cancer and cancer of the esophagogastric junction (GC/EGJ) is an aggressive disease with poor prognosis. In the TAGS study, trifluridine/tipiracil (FTD/TPI) improved overall survival (OS) compared with placebo in heavily pre-treated patients. This unplanned, exploratory subgroup analysis of the TAGS study aimed to clarify outcomes when FTD/TPI was used as third-line (3L) treatment and fourth- or later-line (4L+) treatment. PATIENTS AND METHODS Patients were divided into a 3L group (126 and 64 in FTD/TPI and placebo arms, respectively) and 4L+ group (211 and 106 in FTD/TPI and placebo arms, respectively). Endpoints included OS, progression-free survival (PFS), time to Eastern Cooperative Oncology Group performance status (ECOG PS) deterioration to ≥2, and safety. RESULTS Baseline characteristics were generally well balanced between FTD/TPI and placebo for 3L and 4L+ treatment. Median OS (mOS) for FTD/TPI versus placebo was: 6.8 versus 3.2 months {hazard ratio (HR) [95% confidence interval (CI)] = 0.68 (0.47-0.97), P = 0.0318} in the 3L group; and 5.2 versus 3.7 months [0.73 (0.55-0.95), P = 0.0192] in the 4L+ group. Median PFS for FTD/TPI versus placebo was 3.1 versus 1.9 months [0.54 (0.38-0.77), P = 0.0004] in the 3L group; and 1.9 versus 1.8 months [0.57 (0.44-0.74), P < 0.0001] in the 4L+ group. Time to deterioration of ECOG PS to ≥2 for FTD/TPI versus placebo was 4.8 versus 2.0 months [HR (95% CI) = 0.60 (0.42-0.86), P = 0.0049] in the 3L group; and 4.0 versus 2.5 months [0.75 (0.57-0.98), P = 0.0329] in the 4L+ group. The safety of FTD/TPI was consistent in all subgroups. CONCLUSIONS This analysis confirms the efficacy and safety of FTD/TPI in patients with GC/EGJ in third and later lines with a survival benefit that seems slightly superior in 3L treatment. When FTD/TPI is taken in 3L as recommended in the international guidelines, physicians can expect to provide patients with an mOS of 6.8 months.
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Affiliation(s)
- J Tabernero
- Department of Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain.
| | - K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - A Zaanan
- Department of Gastrointestinal Oncology, European Georges Pompidou Hospital, AP-HP Centre, University of Paris, Paris, France
| | - T Doi
- Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - S Lorenzen
- Third Department of Internal Medicine (Hematology/Medical Oncology), Klinikum Rechts der Isar, Technische Universitaet München, München, Germany
| | - E Van Cutsem
- Department of Gastroenterology and Digestive Oncology, University Hospital Gasthuisberg and University of Leuven, Leuven, Belgium
| | - L Fornaro
- Division of Oncology, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - D V T Catenacci
- Gastrointestinal Oncology Program, University of Chicago Medical Center, Chicago, USA
| | - R Fougeray
- Centre of EXcellence Methodology and Valorization of Data (CentEX MVD), Institut de Recherches Internationales Servier, Suresnes, France
| | - S R Moreno
- Global Medical and Patient Affairs, Les Laboratoires Servier SAS, Suresnes, France
| | - P Azcue
- Global Medical and Patient Affairs, Les Laboratoires Servier SAS, Suresnes, France
| | - H-T Arkenau
- Drug Development Unit, Sarah Cannon Research Institute UK Limited, London, UK
| | - M Alsina
- Department of Medical Oncology, Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona, Spain
| | - D H Ilson
- Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, USA
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Nakajima K, Nakata T, Doi T, Tada H, Saito S, Maruyama K. Creation of mortality risk calculator using a I-123 mIBG-based machine learning model: differential prediction of arrhythmic death and heart-failure death. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.055] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Although I-123 meta-iodobenzylguanidine (mIBG) has been applied to patients with chronic heart failure (CHF), a diagnostic tool for differential prediction of fatal arrhythmic events (ArE) and heart-failure death (HFD) has been pursued.
Purpose
The aim of this study was to create a calculator of mortality risk for differentiating mode of cardiac death using a machine learning (ML) method, and to test the accuracy in a new cohort of patients with CHF.
Methods
A total of 529 patients with CHF was used as the training database for ML. The ArE group consisted of patients with arrhythmic death, sudden cardiac death and appropriate therapy by implantable cardioverter defibrillator. A heart-to-mediastinum ratio (H/M) standardized to the medium-energy collimator condition was calculated with a planar anterior mIBG scintigram. The best classifier models for predicting HFD and ArE were determined by four-fold cross validation. Input variables included age, sex, New York Heart Association (NYHA) functional class, left ventricular ejection fraction, ischemic etiology, mIBG H/M and washout rate, and b-type natriuretic peptide (BNP) or NT Pro BNP, estimated glomerular filtration rate, hemoglobin, and complications such as diabetes and hypertension. After creating the ML-based model, the constructed classifier functions for ArE, HFD, and survival were exported for subsequent use. A new cohort of patients (n = 312, age 67 ± 13 years, 2015 or later) was used to test the ML-based model.
Results
The training database included 141 events (27%) with ArE (7%) and HFD (20%). Receiver-operating characteristic analysis by four-fold validation showed area under the curve value of 0.90 for HFD and 0.73 for ArE. Among various ML methods, the logistic regression method demonstrated the most stable calculation of the probability of ArE followed by random forest and gradient boosted tree methods. Therefore, the logistic-regression method was used for calculating both HFD and ArE probabilities. In the test cohort, patients with a high HFD probability >8% resulted in 6.3-fold higher HFD than those with low probability (≤ 8%). Patients with high ArE probability >8% showed 2.5-fold higher ArE than those with low probability (≤ 8%).
Conclusion
The ML-based mortality risk calculator could be used for stratifying patients at high and low risks, which might be useful for estimating appropriate treatment strategy.
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Affiliation(s)
- K Nakajima
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - T Nakata
- Hakodate Goryoukaku Hospital, Hakodate, Japan
| | - T Doi
- Teine Keijinkai Hospital, Sapporo, Japan
| | - H Tada
- Kanazawa University Hospital, Kanazawa, Japan
| | - S Saito
- Kanazawa University Hospital, Kanazawa, Japan
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Yoshihara F, Hosoda H, Doi T, Yoshida M, Kitamura K, Yamamoto H, Asaumi Y, Ishibashi-Ueda H, Kishida M, Arisato T, Matsuo M, Miyazato M, Yasuda S. Combined evaluation of plasma B-type natriuretic peptide and urinary liver-type fatty acid-binding protein/creatinine ratio is related to worsening renal function in patients undergoing elective percutaneous coronary intervention. Clin Exp Nephrol 2021; 25:1319-1328. [PMID: 34255252 DOI: 10.1007/s10157-021-02113-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND There are few reports on the significance for the combined evaluation of blood humoral factors and urinary biomarkers in terms of worsening renal function (WRF) after coronary angiography (CAG)/percutaneous coronary arterial intervention (PCI). METHOD AND RESULTS Urinary liver type-fatty acid-binding protein (L-FABP), neutrophil gelatinase associated lipocalin (NGAL), and adrenomedullin (AM) were measured less than 24 h before and 3 h, 6 h, 1 day, and 2 days after CAG/PCI. WRF was defined as a > 20% decrease in the estimated GFR. WRF occurred in seven of 100 patients and the increase in L-FABP/creatinine (Cr) at 1 day after CAG/PCI was significantly higher in the WRF group than in the non-WRF group. Plasma B-type natriuretic peptide (BNP) before CAG/PCI and L-FABP/Cr at 1 day after CAG/PCI were independent predictors for WRF. The areas under the receiver-operating characteristic curves were as follows: 0.760 for BNP before CAG/PCI, 0.731 for L-FABP/Cr at 1 day after CAG/PCI, and 0.892 for BNP and L-FABP/Cr. Urinary AM levels after PCI/CAG were negatively correlated only to serum potassium levels. Gene expressions of AM and AM-receptor were detectable in renal tubule epithelial cells. AM increased intracellular second messenger levels in a dose-dependent manner. CONCLUSIONS Our results suggest that combined evaluation of plasma BNP and urinary L-FABP/Cr is useful as a predictor of renal dysfunction in CAG/PCI patients.
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Affiliation(s)
- Fumiki Yoshihara
- Division of Nephrology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan.
| | - Hiroshi Hosoda
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Morikatsu Yoshida
- Department of Biochemistry, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmmachi, Suita, Osaka, 564-8565, Japan
| | - Kazuo Kitamura
- Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Haruko Yamamoto
- Center for Advancing Clinical and Translational Sciences, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Hatsue Ishibashi-Ueda
- Department of Pathology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Masatsugu Kishida
- Division of Nephrology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Tetsuya Arisato
- Division of Nephrology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Miki Matsuo
- Division of Nephrology, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
| | - Mikiya Miyazato
- Department of Biochemistry, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmmachi, Suita, Osaka, 564-8565, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan
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Maio M, Amonkar M, Norquist J, Ascierto P, Manzyuk L, Motola-Kuba D, Penel N, Cassier P, Bariani G, De Jesus Acosta A, Doi T, Muñoz F, Miller W, Oh D, Gottfried M, Wang R, Norwood K, Marabelle A. SO-8 Health-related quality of life in patients treated with pembrolizumab for microsatellite instability-high/mismatch repair deficient advanced solid tumors: Results from the KEYNOTE-158 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.032] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Murai K, Kataoka Y, Nakaoku Y, Nishimura K, Kitahara S, Iwai T, Nakamura H, Hosoda H, Hirayama A, Matama H, Doi T, Nakashima T, Honda S, Fujino M, Nakao K, Yoneda S, Nishihira K, Kanaya T, Otsuka F, Asaumi Y, Tsujita K, Noguchi T, Yasuda S. The association between the extent of lipidic burden and delta-fractional flow reserve: analysis from coronary physiological and near-infrared spectroscopic measures. Cardiovasc Diagn Ther 2021; 11:362-372. [PMID: 33968615 DOI: 10.21037/cdt-20-1024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Vulnerable plaque features including lipidic plaque have been shown to affect fractional flow reserve (FFR). Given that formation and propagation of lipid plaque is accompanied by endothelial dysfunction which impairs vascular tone, the degree of lipidic burden may affect vasoreactivity during hyperemia, potentially leading to reduced FFR. Our aim is to elucidate the relationship of the extent of lipidic plaque burden with coronary physiological vasoreactivity measure. Methods We analyzed 89 subjects requeuing PCI due to angiographically intermediate coronary stenosis with FFR ≤0.80. Near-infrared spectroscopy (NIRS) and intravascular ultrasound were used to evaluate lipid-core burden index (LCBI) and atheroma volume at both target lesion (maxLCBI4mm; maximum value of LCBI within any 4 mm segments) and entire target vessel (LCBIvessel: LCBI within entire vessel). In addition to FFR, delta-FFR was measured by difference of distal coronary artery pressure/aortic pressure (Pd/Pa) between baseline and hyperemic state. Results The averaged FFR and delta-FFR was 0.74 (0.69-0.77), and 0.17±0.05, respectively. On target lesion-based analysis, maxLCBI4mm was negatively correlated to FFR (ρ=-0.213, P=0.040), and it was positively correlated to delta-FFR (ρ=0.313, P=0.002). Furthermore, target vessel-based analysis demonstrated similar relationship of LCBIvessel with FFR (ρ=-0.302, P=0.003) and delta-FFR (ρ=0.369, P<0.001). Even after adjusting clinical characteristics and lesion/vessel features, delta-FFR (by 0.10 increase) was independently associated with maxLCBI4mm (β=57.2, P=0.027) and LCBIvessel (β=24.8, P=0.007) by mixed linear model analyses. Conclusions A greater amount of lipidic plaque burden at not only "target lesion" alone but "entire target vessel" was associated with a greater delta-FFR. The accumulation of lipidic plaque materials at both local site and entire vessel may impair hyperemia-induced vasoreactivity, which causes a reduced FFR.
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Affiliation(s)
- Kota Murai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan.,Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan.,Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuriko Nakaoku
- Department of Preventative Cardiology, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventative Cardiology, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Satoshi Kitahara
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan.,Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamasa Iwai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Hayato Nakamura
- Division of Internal Medicine, Okinawa Prefectural Yaeyama Hospital, Okinawa, Japan
| | - Hayato Hosoda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Atsushi Hirayama
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan.,Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Takahiro Nakashima
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Masashi Fujino
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kazuhiro Nakao
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Shuichi Yoneda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kensaku Nishihira
- Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan.,Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan.,Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Kitahara S, Kataoka Y, Miura H, Nishii T, Nishimura K, Murai K, Iwai T, Nakamura H, Hosoda H, Matama H, Doi T, Nakashima T, Honda S, Fujino M, Nakao K, Yoneda S, Nishihira K, Kanaya T, Otsuka F, Asaumi Y, Tsujita K, Noguchi T, Yasuda S. The feasibility and limitation of coronary computed tomographic angiography imaging to identify coronary lipid-rich atheroma in vivo: Findings from near-infrared spectroscopy analysis. Atherosclerosis 2021; 322:1-7. [PMID: 33706078 DOI: 10.1016/j.atherosclerosis.2021.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 10/22/2020] [Revised: 02/04/2021] [Accepted: 02/18/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Coronary computed tomography angiography (CCTA) non-invasively visualizes lipid-rich plaque. However, this ability is not fully validated in vivo. The current study aimed to elucidate the association of CCTA features with near-infrared spectroscopy-derived lipidic plaque measure in patients with coronary artery disease. METHODS 95 coronary lesions (culprit/non-culprit = 51/44) in 35 CAD subjects were evaluated by CCTA and NIRS imaging. CT density, positive remodeling, spotty calcification, napkin-ring sign and NIRS-derived maximum 4-mm lipid-core burden index (maxLCBI4mm) were analyzed by two independent physicians. The association of CCTA-derived plaque features with maxLCBI4mm ≥ 400 was evaluated. RESULTS The median CT density and maxLCBI4mm were 57.7 Hounsfield units (HU) and 304, respectively. CT density (r = -0.75, p < 0.001) and remodeling index (RI) (r = 0.58, p < 0.001) were significantly associated with maxLCBI4mm, respectively. Although napkin-ring sign (p < 0.001) showed higher prevalence of maxLCBI4mm ≥ 400 than those without it, spotty calcification did not (p = 0.13). On multivariable analysis, CT density [odds ratio (OR) = 0.95, 95% confidence interval (CI) = 0.93-0.97; p < 0.001] and positive remodeling [OR = 7.71, 95%CI = 1.37-43.41, p = 0.02] independently predicted maxLCBI4mm ≥ 400. Receiver operating characteristic curve analysis demonstrated CT density <32.9 HU (AUC = 0.92, sensitivity = 85.7%, specificity = 91.7%) and RI ≥ 1.08 (AUC = 0.83, sensitivity = 74.3%, specificity = 85.0%) as optimal cut-off values of maxLCBI4mm ≥ 400. Of note, only 52.6% at lesions with one of these plaque features exhibited maxLCBI4mm ≥ 400, whereas the frequency of maxLCBI4mm ≥ 400 was highest at those with both features (88.5%, p < 0.001 for trend). CONCLUSIONS CT density <32.9 HU and RI ≥ 1.08 were associated with lipid-rich plaque on NIRS imaging. Our findings underscore the synergistic value of CT density and positive remodeling to detect lipid-rich plaque by CCTA.
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Affiliation(s)
- Satoshi Kitahara
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan.
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Tatsuya Nishii
- Department of Radiology, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kota Murai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takamasa Iwai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Hayato Nakamura
- Division of Internal Medicine, Okinawa Prefectural Yaeyama Hospotal, Ishigaki, Okinawa, Japan
| | - Hayato Hosoda
- Department of Cardiology, Chikamori Hospital, Kochi, Japan
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Takahiro Nakashima
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Masashi Fujino
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kazuhiro Nakao
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Shuichi Yoneda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kensaku Nishihira
- Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, Dokkyo Medical University Hospital, Mibu, Tochigi, Japan
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan; Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan; Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Soga F, Tanaka H, Tatsumi K, Mochizuki Y, Sano H, Toki H, Matsumoto K, Shite J, Takaoka H, Doi T, Hirata K. impact of dapagliflozin on left ventricular diastolic function in diabetic patients with heart failure complicating cardiovascular risk factors. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Type 2 diabetes mellitus (T2DM) is a well-known risk factor for heart failure (HF), even in patients without a structural heart disease or a symptom of HF. Diabetes-related cardiomyopathy is presented as an left ventricular (LV) diastolic dysfunction, which, like cardiovascular disease, is a contributor of the development of HF in both patients with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). Furthermore, comorbid factors other than T2DM also have been identified as high risk factors for of progression to HF. Dapagliflozin is a sodium glucose cotransporter type 2 (SGLT2) inhibitor, and represents a new class of anti-hyperglycemic agents for T2DM. A result from a recent large clinical trial showed that dapagliflozin reduced risk of worsening HF or death from cardiovascular causes for patients with HFrEF compared to those who received a placebo, regardless of the presence or absence of T2DM. However, the effect of SGLT2 inhibitors on LV diastolic function in T2DM patients with HF who had cardiovascular risk factors other than T2DM remains uncertain.
Purpose
Our purpose was to investigate the impact of dapagliflozin on LV diastolic function in T2DM patients with stable HF complicating cardiovascular risk factors.
Methods
We analyzed data from our previous prospective multicenter study, which investigate the effect of dapagliflozin on LV diastolic function of 53 T2DM patients with stable HF at five institutions in Japan. Patients who had been taking at least one antidiabetic drugs other than SGLT2 inhibitor started the administration of dapagliflozin. Cardiovascular risk factors other than T2DM was determined as age, gender, hypertension, dyslipidemia, history of cardiovascular events and overweight.
Results
E/e′ significantly decreased from 9.3 to 8.5 cm/s 6 months after administration of dapagliflozin (p = 0.020) as previously described. Multivariate logistic regression analysis showed that dyslipidemia was the only independent determinant of an improvement of E/e’ among cardiovascular risk factors. Furthermore, relative changes in E/e’ from baseline to 6 months after administration of dapagliflozin seen in HFpEF patients with dyslipidemia were significantly larger than those in HFpEF patients without dyslipidemia (-15.2% vs. 29.6%, p = 0.014), but such a difference was not observed in non-HFpEF patients. In addition, relative changes in high-density lipoprotein cholesterol (HDL-C) from baseline to 6 months after administration of dapagliflozin had significant correlation with those in E/e’ (r=-0.300, p = 0.038). However, such correlations were not observed in low-density lipoprotein cholesterol (LDL-C) and triglyceride (r = 0.05, p = 0.72 and r = 0.05, p = 0.73). Conclusion: Dapagliflozin was more beneficial effect on LV diastolic function for T2DM patients with stable HF, especially those with complicating dyslipidemia. Our findings may thus offer a new insight into the management of T2DM patients with HF.
Abstract Figure.
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Affiliation(s)
- F Soga
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Tanaka
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Tatsumi
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Mochizuki
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Sano
- Takatsuki General Hospital, Cardiology, Takatsuki, Japan
| | - H Toki
- Kobe Red Cross Hospital, Cardiology, Kobe, Japan
| | - K Matsumoto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - J Shite
- Osaka Saiseikai Nakatsu Hospital, Cardiology, Osaka, Japan
| | - H Takaoka
- Takatsuki General Hospital, Cardiology, Takatsuki, Japan
| | - T Doi
- Kobe Red Cross Hospital, Cardiology, Kobe, Japan
| | - K Hirata
- Kobe University Graduate School of Medicine, Kobe, Japan
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Doi T, Hori M, Harada-Shiba M, Kataoka Y, Onozuka D, Nishimura K, Nishikawa R, Tsuda K, Ogura M, Son C, Miyamoto Y, Noguchi T, Shimokawa H, Yasuda S. Patients With LDLR and PCSK9 Gene Variants Experienced Higher Incidence of Cardiovascular Outcomes in Heterozygous Familial Hypercholesterolemia. J Am Heart Assoc 2021; 10:e018263. [PMID: 33533259 PMCID: PMC7955325 DOI: 10.1161/jaha.120.018263] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Indexed: 12/17/2022]
Abstract
Background Patients with familial hypercholesterolemia who harbored both low‐density lipoprotein receptor (LDLR) and PCSK9 (proprotein convertase subtilisin/kexin type 9) gene variants exhibit severe phenotype associated with substantially high levels of low‐density lipoprotein cholesterol. In this study, we investigated the cardiovascular outcomes in patients with both LDLR and PCSK9 gene variants. Methods and Results A total of 232 unrelated patients with LDLR and/or PCSK9 gene variants were stratified as follows: patients with LDLR and PCSK9 (LDLR/PCSK9) gene variants, patients with LDLR gene variant, and patients with PCSK9 gene variant. Clinical demographics and the occurrence of primary outcome (nonfatal myocardial infarction) were compared. The observation period of primary outcome started at the time of birth and ended at the time of the first cardiac event or the last visit. Patients with LDLR/PCSK9 gene variants were identified in 6% of study patients. They had higher levels of low‐density lipoprotein cholesterol (P=0.04) than those with LDLR gene variants. On multivariate Cox regression model, they experienced a higher incidence of nonfatal myocardial infarction (hazard ratio, 4.62; 95% CI, 1.66–11.0; P=0.003 versus patients with LDLR gene variant). Of note, risk for nonfatal myocardial infarction was greatest in male patients with LDLR/PCSK9 gene variants compared with those with LDLR gene variant (86% versus 24%; P<0.001). Conclusions Patients with LDLR/PCSK9 gene variants were high‐risk genotype associated with atherogenic lipid profiles and worse cardiovascular outcomes. These findings underscore the importance of genetic testing to identify patients with LDLR/PCSK9 gene variants, who require more stringent antiatherosclerotic management.
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Affiliation(s)
- Takahito Doi
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan.,Department of Advanced Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Miyagi Japan.,Department of Clinical Biochemistry, Herlev and Gentofte Hospital Copenhagen University Hospital Herlev Denmark
| | - Mika Hori
- Department of Molecular Innovation in Lipidology National Cerebral and Cardiovascular Center Suita Osaka Japan.,Department of Endocrinology Research Institute of Environmental Medicine, Nagoya University Nagoya Aichi Japan
| | - Mariko Harada-Shiba
- Department of Molecular Innovation in Lipidology National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Daisuke Onozuka
- Department of Statistics and Data Analysis Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Kunihiro Nishimura
- Department of Statistics and Data Analysis Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Ryo Nishikawa
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Kosuke Tsuda
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Masatsune Ogura
- Department of Molecular Innovation in Lipidology National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Cheol Son
- Division of Endocrinology and Metabolism National Cerebral and Cardiovascular Center Suita Osaka Japan.,Omics Research Center National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Yoshihiro Miyamoto
- Preventive Medicine and Epidemiologic Informatics, Center for Cerebral and Cardiovascular Disease Information National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan
| | - Hiroaki Shimokawa
- Department of Medicine International University of Health and Welfare Graduate School of Medicine Narita Chiba Japan.,Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Miyagi Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Osaka Japan.,Department of Cardiovascular Medicine Tohoku University Graduate School of Medicine Sendai Miyagi Japan
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Doi T, Tsutsumimoto K, Ishii H, Nakakubo S, Kurita S, Shimada H. Association between Sarcopenia, Its Defining Indices, and Driving Cessation in Older Adults. J Nutr Health Aging 2021; 25:462-466. [PMID: 33786563 DOI: 10.1007/s12603-020-1554-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Driving a car is essential for older adults to support their activities of daily living and maintain their quality of life. However, physical function - which often declines with age - is a key factor to determine whether older adults can continue driving safely. As such, we sought to examine the association between sarcopenia and driving cessation in older adults. DESIGN A prospective study. SETTING A community setting. PARTICIPANTS We conducted a study including 2,874 older adult participants from the community (mean age: 71.0 ± 4.7 years [range: 65-93 years], women: 36.3%). MEASUREMENTS We assessed whether they were still driving at baseline examination as well as their degree of sarcopenia. Sarcopenia was assessed according to the clinical definition provided by the EWGSOP2 by measuring muscle mass, muscle strength, and physical performance represented by gait speed. Driving cessation was determined based on driving status at the initial visit and at a follow-up examination approximately 15 months later. RESULTS At the baseline assessment, there were 62 participants (2.2%) with confirmed sarcopenia and 23 participants (0.8%) with severe sarcopenia. Participants were classified into either the ongoing driving (n = 2816) or driving cessation (n = 58) group. Low muscle strength and low muscle mass were associated with driving cessation (low muscle strength: odds ratio [OR] 2.09, 95% confidence interval [CI] 1.13-3.87; low muscle mass: OR 2.00, 95% CI 1.04-3.85). Slow gait was not associated with driving cessation (OR 1.35, 95% CI 0.68-2.69). Significantly, sarcopenia was associated with driving cessation (confirmed sarcopenia: OR 4.48, 95% CI 1.63-12.29; severe sarcopenia: OR 4.46, 95% CI 1.21-16.41). CONCLUSIONS Sarcopenia is associated with an increased likelihood of driving cessation in community-dwelling older adults. Evaluation of physical function related to sarcopenia would be useful for judgment of the ability to drive safely among older adults.
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Affiliation(s)
- T Doi
- Takehiko Doi, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511, Japan, Tel: +81-562-44-5651, E-mail:
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Sugane H, Kataoka Y, Otsuka F, Nakaoku Y, Nishimura K, Nakano H, Murai K, Honda S, Hosoda H, Matama H, Doi T, Nakashima T, Fujino M, Nakao K, Yoneda S, Tahara Y, Asaumi Y, Noguchi T, Kawai K, Yasuda S. Cardiac outcomes in patients with acute coronary syndrome attributable to calcified nodule. Atherosclerosis 2020; 318:70-75. [PMID: 33243488 DOI: 10.1016/j.atherosclerosis.2020.11.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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] [Received: 08/11/2020] [Revised: 10/14/2020] [Accepted: 11/05/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIMS Calcified nodule (CN) is an eruptive calcified mass causing acute coronary syndrome (ACS). Since coronary calcification is associated with an elevated cardiac event's risk, ACS attributable to CN may exhibit worse clinical outcome following percutaneous coronary intervention (PCI). METHODS We retrospectively analyzed 657 ACS patients receiving PCI with newer-generation drug-eluting stent (DES) implantation under intravascular ultrasound (IVUS) guidance. CN was defined as (1) protruding calcification with its irregular surface and (2) the presence of calcification at adjacent proximal and distal segments. The primary endpoint was a composite of major adverse cardiac event [MACE = cardiac death + ACS recurrence + target lesion revascularization (TLR)]. RESULTS CN was identified in 5.3% (=35/657) of the study subjects. CN patients were more likely to have coronary risk factors including hypertension (p = 0.005), chronic kidney disease (p < 0.001), maintenance hemodialysis (p < 0.001) and a history of PCI (p < 0.001). During the observational period (median = 1304 days), CN was associated with an increased risk of MACE (HR = 7.68, 95%CI = 4.61-12.80, p < 0.001), ACS recurrence (HR = 12.32, 95%CI = 6.05-25.11, p < 0.001) and TLR (HR = 10.48, 95%CI = 5.80-18.94, p < 0.001). These cardiac risks related to CN were consistently observed by Cox proportional hazards model (MACE: p < 0.001, ACS recurrence: p < 0.001, TLR: p < 0.001) and a propensity score-matched cohort analysis (MACE: p = 0.002, ACS recurrence: p = 0.01, TLR: p = 0.005). Of note, over 80% of TLR at the CN lesion was driven by its re-appearance within the implanted DES. CONCLUSIONS ACS patients attributable to CN have an increased risk of ACS recurrence and TLR, mainly driven by the continuous growth and protrusion of the calcified mass.
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Affiliation(s)
- Hiroki Sugane
- Department of Cardiology, Chikamori Hospital, Kochi, Japan; Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine and Tohoku University Hospital, Sendai, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan.
| | - Fumiyuki Otsuka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Yuriko Nakaoku
- Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroki Nakano
- Department of Cardiology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Kota Murai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Hayato Hosoda
- Department of Cardiology, Chikamori Hospital, Kochi, Japan
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Takahiro Nakashima
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Masashi Fujino
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kazuhiro Nakao
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Shuichi Yoneda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Kazuya Kawai
- Department of Cardiology, Chikamori Hospital, Kochi, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine and Tohoku University Hospital, Sendai, Japan
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Funabashi S, Kataoka Y, Hori M, Ogura M, Matsuki K, Doi T, Noguchi T, Harada-Shiba M. Lp (a) >50 mg/dl predicts atherosclerotic cardiovascular events in patients with heterozygous familial hypercholesterolemia who achieved LDL-C <2.6 mmol/l. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2991] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Lipoprotein (a) [Lp (a)] is a plasma lipoprotein which exhibits atherogenic properties. Lp(a) ≥50 mg/dl has been recently shown to associate with a risk of atherosclerotic cardiovascular diseases (ASCVD) in patients with heterozygous familial hypercholesterolemia (HeFH). While current guideline recommends lowering LDL-C as a first-line therapeutic approach in HeFH subjects, it remains to be fully determined whether an elevated level of Lp(a) confers additional ASCVD risks in HeFH patients who achieved a lower LDL-C level.
Purpose
To investigate cardiovascular outcomes in HeFH subjects with a lower LDL-C but an elevated Lp(a) levels.
Methods
182 HeFH patients with on-treatment LDL-C <2.6 mmol/l under lipid-lowering therapies were analyzed. Clinical characteristics and MACE (= a composite of all-cause death, ACS, stroke, PAD and coronary revascularization) were compared in HeFH subjects with Lp(a) ≥ vs. <50 mg/dl.
Results
The averaged LDL-C and Lp (a) levels were 1.9 mmol/l and 26.8 mg/dl, respectively. 19.2% of study subjects exhibited Lp(a)≥50 mg/dl. HeFH patients with Lp(a) ≥50 mg/dl were more likely to be older and have a history of hypertension, but these comparisons did not meet statistical significance. There was no significant difference in on-treatment LDL-C, HDL-C and Triglyceride level (Table). However, during the observational period (median=4.7 years), there was a 2.7-fold (95% CI, 1.41–5.02; p=0.004) greater likelihood of experiencing MACE in subjects with Lp(a) ≥50 mg/dl (picture). Even after adjusting clinical demographics, Lp(a) ≥50 mg/dl remained an independent predictor for the occurrence of MACE (hazard ratio=2.53, 95% CI: 1.29–4.82, p<0.001).
Conclusions
Despite achieving on-treatment LDL-C <2.6 mmol/l, an elevated risk of MACE was observed in HeFH patients with Lp(a) ≥50 mg/dl. Our findings suggest an increased level of Lp(a) as a risk stratification marker and a potential therapeutic target in patients with HeFH.
Clinical outcome
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Funabashi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - M Hori
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - M Ogura
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - K Matsuki
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - T Doi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - M Harada-Shiba
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
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Funabashi S, Kataoka Y, Hori M, Ogura M, Matsuki K, Doi T, Noguchi T, Harada-Shiba M. Prevalence, clinical characteristics and prognosis of intracranial artery atherosclerosis in heterozygous familial hypercholesterolemia: insights from magnetic resonance angiography imaging analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2364] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Heterozygous familial hypercholesterolemia (HeFH) exhibits substantially atherogenic substrate which involves coronary and peripheral arteries. Whether atherosclerosis in HeFH propagates to intracranial arteries causing stroke remains to be determined.
Purpose
To characterize intracranial artery stenosis (IAS) in subjects with HeFH.
Methods
148 HeFH subjects who underwent MRI/MRA imaging to evaluate intracranial arteries were analyzed. IAS was defined as the presence of stenosis with its % diameter stenosis ≥25%. Clinical demographics and cardiovascular events (all-cause death, ACS, stroke and PAD) were compared in those with and without IAS.
Results
IAS was observed in 24.3% (=36/148) of study subjects. It was more frequently located at middle cerebral artery (30.6%=11/36), followed by internal carotid artery (25.0%=9/36). 47.2% of IAS exhibited % diameter stenosis ≥75%. Furthermore, 58.3% of HeFH patients with IAS exhibited concomitance of CAD, PAD or carotid stenosis. They were more likely to be older (Table). While there was no significant difference in LDL-C level, an elevated triglyceride level was observed in those with IAS (Table). Of note, during the observational period (median=14.1 years), IAS was associated with a greater likelihood of experiencing not only stroke but other cardiovascular events (all-cause death + ACS + PAD) (picture). Multivariate analysis demonstrated triglyceride level ≥1.7mmol/l as an independent predictor of IAS in HeFH patients (HR=5.53, 95% CI: 1.85–16.5, p=0.002).
Conclusions
Around one-fourth of HeFH patients harboured IAS, which was associated with concomitance of atherosclerosis in other vascular beds and the occurrence of stroke and other cardiovascular events. Given the relationship of IAS with hypertriglyceridemia, this lipid feature may be an important contributor to atherosclerotic formation which involves intracranial artery in HeFH patients.
Clinical outcome
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Funabashi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - M Hori
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - M Ogura
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - K Matsuki
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - T Doi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - M Harada-Shiba
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
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Tanaka H, Soga F, Tatsumi K, Mochizuki Y, Sano H, Toki H, Matsumoto K, Shite J, Takaoka H, Doi T, Hirata K. Positive effect of dapagliflozin on left ventricular longitudinal function for type 2 diabetic mellitus patients with chronic heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Type 2 diabetes mellitus (T2DM) has come to be considered an independent predictor of mortality, and also a contributor to the development of heart failure (HF) with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). Left ventricular (LV) longitudinal myocardial dysfunction as assessed in terms of lower global longitudinal strain (GLS), has been identified even in T2DM patients with preserved LV ejection fraction (LVEF), and should be considered the first marker of a preclinical form of DM-related cardiac dysfunction, leading to HFpEF. Sodium glucose cotransporter type 2 (SGLT2) inhibitors represent a new class of anti-hyperglycemic agents for T2DM, but the effect of SGLT2 inhibitors on LV longitudinal myocardial function in T2DM patients with HF remains uncertain. To examine this effect, as well as the association of LV longitudinal myocardial function with LV diastolic function after administration of SGLT2 inhibitor in T2DM patients with stable HF, we analyzed data from our previous prospective multicenter study, in which we investigated the effect of SGLT2 inhibitor on LV diastolic functional parameters of T2DM patients with stable HF at five institutions in Japan.
Methods
Our previous trial was a prospective multicenter study of 58 T2DM patients with stable HF at five institutions in Japan. Patients who had been taking at least one antidiabetic drugs other than SGLT2 inhibitors started the administration of 5 mg/day of dapagliflozin. Echocardiography was performed at baseline and 6 months after administration of dapagliflozin. LV diastolic function was defined as the ratio of mitral inflow E to mitral e' annular velocities (E/e'). LV longitudinal myocardial function was assessed as GLS based on the current guidelines.
Results
E/e' significantly decreased from 9.3 to 8.5 cm/s 6 months after administration of dapagliflozin (p=0.020) as previously described, while GLS showed significant improvement from 15.5±3.5% to 16.9±4.1% (p<0.01) 6 months after administration of dapagliflozin. Furthermore, improvement of GLS in HFpEF patients was more significant from 17.0±1.9% to 18.7±2.0% (p<0.001), compared to that in HFrEF patients from 11.3±3.8% to 11.8±4.6% (p=0.13). It was noteworthy that multiple regression analysis showed that the change in GLS after administration of dapagliflozin was the only independent determinant parameter for the change in E/e' after administration of dapagliflozin.
Conclusion
Dapagliflozin was found to be associated with improvement of LV longitudinal myocardial function, which led to further improvement of LV diastolic function of T2DM patients with stable HF. GLS-guided management may thus lead to improved management of T2DM patients with stable HF.
Representative case
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - F Soga
- Kobe University, Kobe, Japan
| | | | - Y Mochizuki
- Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - H Sano
- Aijinkai Takatsuki Hospital, Takatsuki, Japan
| | - H Toki
- Kobe Red Cross Hospital, Kobe, Japan
| | | | - J Shite
- Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - H Takaoka
- Aijinkai Takatsuki Hospital, Takatsuki, Japan
| | - T Doi
- Kobe Red Cross Hospital, Kobe, Japan
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Adjei A, Beg M, Melear J, Thompson J, Tsai FC, Baranda J, Bastos B, Spira A, Lou Y, Seetharam M, Uemura M, Camidge D, Yamamoto N, Cowey C, Doi T, Anthony S, Janat-Amsbury M, Wade M, Bearss D, Sarantopoulos J. 536MO A phase I, first-in-human, safety, pharmacokinetic, and pharmacodynamic study of oral dubermatinib (TP-0903) in patients with advanced solid tumours. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.650] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Morizane C, Kojima T, Kuboki Y, Bando H, Matsubara N, Shitara K, Yoh K, Hirai H, Kato T, Doi T. 544P Phase I study of the irreversible FGFR inhibitor (i) futibatinib (FBN; TAS-120) in Japanese patients (pts) with advanced (adv) solid tumours. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.658] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kato K, Sun JM, Shah M, Enzinger P, Adenis A, Doi T, Kojima T, Metges JP, Li Z, Kim SB, Cho BC, Mansoor W, Li SH, Sunpaweravong P, Maqueda M, Goekkurt E, Liu Q, Shah S, Bhagia P, Shen L. LBA8_PR Pembrolizumab plus chemotherapy versus chemotherapy as first-line therapy in patients with advanced esophageal cancer: The phase 3 KEYNOTE-590 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2298] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Schuler M, Tabernero J, Massard C, Iyer GV, Witt O, Doi T, Qin S, Lu-Emerson C, Hargrave D, Garcia-Corbacho J, Little S, Xia Q, Santiago-Walker A, Moy C, Hammond C, Lau Y, Sweiti H, Pant S. 603TiP Phase II, open-label study of erdafitinib in adult and adolescent patients (pts) with advanced solid tumours harboring fibroblast growth factor receptor (FGFR) gene alterations. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.717] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Takahashi S, Shimizu T, Doi T, Lopez-Vilarino J, Martin RN, Kahatt C, Teruel CF, Sasamoto H, Zeaiter A. 551P Phase I study of lurbinectedin in Japanese patients with pretreated advanced tumours: Final results. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.665] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kataoka Y, Doi T. Coronary artery ectasia: Importance of its risk stratification and management. Int J Cardiol 2020; 322:43-44. [PMID: 32841618 DOI: 10.1016/j.ijcard.2020.08.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/06/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan.
| | - Takahito Doi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, Suita, Osaka, Japan
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Tsuda K, Kataoka Y, Ogata S, Nishimura K, Nishikawa R, Doi T, Nakashima T, Hosoda H, Honda S, Kawakami S, Fujino M, Nakao K, Yoneda S, Nishihira K, Otsuka F, Tahara Y, Asaumi Y, Hoshiga M, Noguchi T, Yasuda S. Diminished response to statins predicts the occurrence of heart failure after acute myocardial infarction. Cardiovasc Diagn Ther 2020; 10:705-716. [DOI: 10.21037/cdt-20-415] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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