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Sakata Y, Saito G, Sakata S, Oya Y, Tamiya M, Suzuki H, Shibaki R, Okada A, Yokoyama T, Matsumoto H, Otsuki T, Sato Y, Junji U, Tsukita Y, Inaba M, Ikeda H, Arai D, Maruyama H, Hara S, Tsumura S, Morinaga J, Sakagami T. Corrigendum to "Osimertinib as first-line treatment for elderly patients with advanced EGFR mutation-positive non-small-cell lung cancer in a real-world setting (OSI-FACT-EP)" [Lung Cancer 186 (2023) 107426]. Lung Cancer 2024; 188:107450. [PMID: 38160082 DOI: 10.1016/j.lungcan.2023.107450] [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: 01/03/2024]
Affiliation(s)
- Yoshihiko Sakata
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Minami-ku, Kumamoto 861-4193, Japan.
| | - Go Saito
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan
| | - Shinya Sakata
- Department of Respiratory Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yuko Oya
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan; Department of Respiratory Medicine, Fujita Health University School of Medicine, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino, Osaka 583-8588, Japan
| | - Ryota Shibaki
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama 641-8509, Japan
| | - Asuka Okada
- Department of Medical Oncology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka 531-0021, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa, Amagasaki, Hyogo 660-8550, Japan
| | - Taiichiro Otsuki
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, School of Medicine 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Uchida Junji
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, Osaka 560-8552, Japan
| | - Yoko Tsukita
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Megumi Inaba
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto 862-0965, Japan
| | - Hideki Ikeda
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan; Department of Respiratory Medicine, Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu, Chiba 292-8535, Japan
| | - Daisuke Arai
- Department of Internal Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashi, Utsunomiya, Tochigi 321-0974, Japan
| | - Hirotaka Maruyama
- Department of Respiratory Medicine, Japan Organization of Occupational Health and Safety, Kumamoto Rosai Hospital, 1670 Takehara, Yatsushiro, Kumamoto 866-8533, Japan
| | - Satoshi Hara
- Department of Respiratory Medicine, Itami City Hospital, 1-100 Koyaike, Itami, Hyogo 664-8540, Japan
| | - Shinsuke Tsumura
- Department of Respiratory Medicine, Kumamoto Regional Medical Center, 5-16-10 Honjyo, Chuo-ku, Kumamoto 860-0811, Japan
| | - Jun Morinaga
- Department of Clinical Investigation (Biostatistics), Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takuro Sakagami
- Department of Respiratory Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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Sakata Y, Saito G, Sakata S, Oya Y, Tamiya M, Suzuki H, Shibaki R, Okada A, Yokoyama T, Matsumoto H, Otsuki T, Sato Y, Junji U, Tsukita Y, Inaba M, Ikeda H, Arai D, Maruyama H, Hara S, Tsumura S, Morinaga J, Sakagami T. Osimertinib as first-line treatment for elderly patients with advanced EGFR mutation-positive non-small cell lung cancer in a real-world setting (OSI-FACT-EP). Lung Cancer 2023; 186:107426. [PMID: 37992594 DOI: 10.1016/j.lungcan.2023.107426] [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: 09/09/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES Osimertinib is the primary treatment for patients with epidermal growth factor receptor (EGFR) mutation-positive advanced non-small cell lung cancer. However, evidence of the outcomes of osimertinib treatment in patients over 75 years of age in the real-world setting is limited. MATERIALS AND METHODS This retrospective study analyzed the data of 538 patients (203 elderly and 335 non-elderly) with EGFR mutation-positive lung cancer in whom osimertinib was initiated as first-line treatment between August 2018 and December 2019. Patients over 75 years of age were classified as elderly. The data cut-off date was February 28, 2022. RESULTS The progression-free survival (PFS) did not significantly differ between the elderly and non-elderly groups [elderly group: median PFS, 16.9 months (95 % confidence interval (CI), 14.3-20.2); non-elderly group: median PFS, 22.1 months (95 % CI: 19.5-26.3); hazard ratio (HR) for the elderly against the non-elderly: 1.21 (95 % CI: 0.98-1.50), p = 0.079]. However, the time to treatment failure (TTF) was significantly shorter in the elderly than in the non-elderly [elderly group: median TTF, 14.0 months (95 % CI: 0.98-1.50); non-elderly group: median TTF, 21.8 months (95 % CI: 18.2-24.6); HR for the elderly against the non-elderly: 1.46 (95 % CI: 1.20-1.77), p < 0.001]. Furthermore, the rate of treatment discontinuation because of adverse events was 28.6 % in the elderly and 14.9 % in the non-elderly (p < 0.001). Among patients who discontinued treatment, the conversion rate to second-line treatment was 39.6 % in the elderly and 72.8 % in the non-elderly. In addition, the median overall survival was 30 months (95 % CI: 25.8-37.7) in the elderly and not reached (NR) (95 % CI: NR-NR) in the non-elderly (p < 0.001). CONCLUSION In a real-world clinical setting, elderly patients receiving osimertinib as first-line treatment should be aware of the frequent inability to transition to second-line treatment due to adverse events.
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Affiliation(s)
- Yoshihiko Sakata
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Minami-ku, Kumamoto 861-4193, Japan.
| | - Go Saito
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan
| | - Shinya Sakata
- Department of Respiratory Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yuko Oya
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan; Department of Respiratory Medicine, Fujita Health University School of Medicine, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, Osaka 541-8567, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, 3-7-1 Habikino, Habikino, Osaka 583-8588, Japan
| | - Ryota Shibaki
- Internal Medicine III, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama 641-8509, Japan
| | - Asuka Okada
- Department of Medical Oncology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka 531-0021, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, 2-17-77 Higashinaniwa, Amagasaki, Hyogo 660-8550, Japan
| | - Taiichiro Otsuki
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, School of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminami, Chuo-ku, Kobe, Hyogo 650-0047, Japan
| | - Uchida Junji
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, 5-1-1 Toneyama, Toyonaka, Osaka, Osaka 560-8552, Japan
| | - Yoko Tsukita
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Megumi Inaba
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto 862-0965, Japan
| | - Hideki Ikeda
- Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan; Department of Respiratory Medicine, Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu, Chiba 292-8535, Japan
| | - Daisuke Arai
- Department of Internal Medicine, Saiseikai Utsunomiya Hospital, 911-1 Takebayashi, Utsunomiya, Tochigi 321-0974, Japan
| | - Hirotaka Maruyama
- Department of Respiratory Medicine, Japan Organization of Occupational Health and Safety, Kumamoto Rosai Hospital, 1670 Takehara, Yatsushiro, Kumamoto 866-8533, Japan
| | - Satoshi Hara
- Department of Respiratory Medicine, Itami City Hospital, 1-100 Koyaike, Itami, Hyogo 664-8540, Japan
| | - Shinsuke Tsumura
- Department of Respiratory Medicine, Kumamoto Regional Medical Center, 5-16-10 Honjyo, Chuo-ku, Kumamoto 860-0811, Japan
| | - Jun Morinaga
- Department of Clinical Investigation (Biostatistics), Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Takuro Sakagami
- Department of Respiratory Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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3
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Robinson ML, Hahn PG, Inouye BD, Underwood N, Whitehead SR, Abbott KC, Bruna EM, Cacho NI, Dyer LA, Abdala-Roberts L, Allen WJ, Andrade JF, Angulo DF, Anjos D, Anstett DN, Bagchi R, Bagchi S, Barbosa M, Barrett S, Baskett CA, Ben-Simchon E, Bloodworth KJ, Bronstein JL, Buckley YM, Burghardt KT, Bustos-Segura C, Calixto ES, Carvalho RL, Castagneyrol B, Chiuffo MC, Cinoğlu D, Cinto Mejía E, Cock MC, Cogni R, Cope OL, Cornelissen T, Cortez DR, Crowder DW, Dallstream C, Dáttilo W, Davis JK, Dimarco RD, Dole HE, Egbon IN, Eisenring M, Ejomah A, Elderd BD, Endara MJ, Eubanks MD, Everingham SE, Farah KN, Farias RP, Fernandes AP, Fernandes GW, Ferrante M, Finn A, Florjancic GA, Forister ML, Fox QN, Frago E, França FM, Getman-Pickering AS, Getman-Pickering Z, Gianoli E, Gooden B, Gossner MM, Greig KA, Gripenberg S, Groenteman R, Grof-Tisza P, Haack N, Hahn L, Haq SM, Helms AM, Hennecke J, Hermann SL, Holeski LM, Holm S, Hutchinson MC, Jackson EE, Kagiya S, Kalske A, Kalwajtys M, Karban R, Kariyat R, Keasar T, Kersch-Becker MF, Kharouba HM, Kim TN, Kimuyu DM, Kluse J, Koerner SE, Komatsu KJ, Krishnan S, Laihonen M, Lamelas-López L, LaScaleia MC, Lecomte N, Lehn CR, Li X, Lindroth RL, LoPresti EF, Losada M, Louthan AM, Luizzi VJ, Lynch SC, Lynn JS, Lyon NJ, Maia LF, Maia RA, Mannall TL, Martin BS, Massad TJ, McCall AC, McGurrin K, Merwin AC, Mijango-Ramos Z, Mills CH, Moles AT, Moore CM, Moreira X, Morrison CR, Moshobane MC, Muola A, Nakadai R, Nakajima K, Novais S, Ogbebor CO, Ohsaki H, Pan VS, Pardikes NA, Pareja M, Parthasarathy N, Pawar RR, Paynter Q, Pearse IS, Penczykowski RM, Pepi AA, Pereira CC, Phartyal SS, Piper FI, Poveda K, Pringle EG, Puy J, Quijano T, Quintero C, Rasmann S, Rosche C, Rosenheim LY, Rosenheim JA, Runyon JB, Sadeh A, Sakata Y, Salcido DM, Salgado-Luarte C, Santos BA, Sapir Y, Sasal Y, Sato Y, Sawant M, Schroeder H, Schumann I, Segoli M, Segre H, Shelef O, Shinohara N, Singh RP, Smith DS, Sobral M, Stotz GC, Tack AJM, Tayal M, Tooker JF, Torrico-Bazoberry D, Tougeron K, Trowbridge AM, Utsumi S, Uyi O, Vaca-Uribe JL, Valtonen A, van Dijk LJA, Vandvik V, Villellas J, Waller LP, Weber MG, Yamawo A, Yim S, Zarnetske PL, Zehr LN, Zhong Z, Wetzel WC. Plant size, latitude, and phylogeny explain within-population variability in herbivory. Science 2023; 382:679-683. [PMID: 37943897 DOI: 10.1126/science.adh8830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/27/2023] [Indexed: 11/12/2023]
Abstract
Interactions between plants and herbivores are central in most ecosystems, but their strength is highly variable. The amount of variability within a system is thought to influence most aspects of plant-herbivore biology, from ecological stability to plant defense evolution. Our understanding of what influences variability, however, is limited by sparse data. We collected standardized surveys of herbivory for 503 plant species at 790 sites across 116° of latitude. With these data, we show that within-population variability in herbivory increases with latitude, decreases with plant size, and is phylogenetically structured. Differences in the magnitude of variability are thus central to how plant-herbivore biology varies across macroscale gradients. We argue that increased focus on interaction variability will advance understanding of patterns of life on Earth.
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Affiliation(s)
- M L Robinson
- Department of Entomology, Michigan State University, East Lansing, MI, USA
- Department of Biology, Utah State University, Logan, UT, USA
| | - P G Hahn
- Entomology and Nematology Department, University of Florida, Gainesville, FL, USA
| | - B D Inouye
- Department of Biological Science, Florida State University, Tallahassee, FL, USA
| | - N Underwood
- Department of Biological Science, Florida State University, Tallahassee, FL, USA
| | - S R Whitehead
- Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - K C Abbott
- Department of Biology, Case Western Reserve University, Cleveland, OH, USA
| | - E M Bruna
- Center for Latin American Studies, University of Florida, Gainesville, FL, USA
- Department of Wildlife Ecology and Conservation, University of Florida, Gainesville, FL, USA
| | - N I Cacho
- Instituto de Biología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - L A Dyer
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - L Abdala-Roberts
- Departamento de Ecología Tropical, Universidad Autónoma de Yucatán, Mérida, Yucatán, México
| | - W J Allen
- Bio-Protection Research Centre, University of Canterbury, Christchurch, New Zealand
| | - J F Andrade
- Departamento de Sistemática e Ecologia Universidade Federal da Paraíba, João Pessoa, Brazil
| | - D F Angulo
- Centro de Investigación Científica de Yucatán, Departamento de Recursos Naturales, Mérida, Yucatán, México
| | - D Anjos
- Instituto de Biologia, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - D N Anstett
- Department of Entomology, Michigan State University, East Lansing, MI, USA
- Plant Resilience Institute, Michigan State University, East Lansing, MI, USA
- Department of Plant Biology, Michigan State University, East Lansing, MI, USA
| | - R Bagchi
- Department of Ecology and Evolutionary Biology, University of Connecticut, Storrs, CT, USA
| | - S Bagchi
- Centre for Ecological Sciences, Indian Institute of Science, Bangalore, Karnataka, India
| | - M Barbosa
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - S Barrett
- Department of Biodiversity Conservation & Attractions Western Australia, Albany, Western Australia, Australia
| | - C A Baskett
- Institute of Science and Technology Austria, Klosterneuburg, Austria
| | - E Ben-Simchon
- Department of Natural Resources, Institute of Plant Sciences, Agricultural Research Organization - Volcani Institute, Rishon Le Tzion, Israel
- Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - K J Bloodworth
- Department of Biology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - J L Bronstein
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, USA
| | - Y M Buckley
- School of Natural Sciences, Zoology, Trinity College Dublin, Dublin, Ireland
| | - K T Burghardt
- Department of Entomology, University of Maryland, College Park, MD, USA
| | - C Bustos-Segura
- Institute of Biology, University of Neuchatel, Neuchatel, Switzerland
| | - E S Calixto
- Entomology and Nematology Department, University of Florida, Gainesville, FL, USA
| | - R L Carvalho
- Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil
| | | | - M C Chiuffo
- Grupo de Ecología de Invasiones, INIBIOMA, Universidad Nacional del Comahue, CONICET, San Carlos de Bariloche, Río Negro, Argentina
| | - D Cinoğlu
- Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
| | - E Cinto Mejía
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - M C Cock
- Facultad de Ciencias Exactas y Naturales, Instituto de Ciencias de la Tierra y Ambientales de La Pampa, Santa Rosa, La Pampa, Argentina
| | - R Cogni
- Department of Ecology, University of São Paulo, São Paulo, Brazil
| | - O L Cope
- Department of Entomology, Michigan State University, East Lansing, MI, USA
- Department of Biology, Whitworth University, Spokane, WA, USA
| | - T Cornelissen
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - D R Cortez
- Department of Biology, California State University San Bernardino, San Bernardino, CA, USA
| | - D W Crowder
- Department of Entomology, Washington State University, Pullman, WA, USA
| | - C Dallstream
- Department of Biology, McGill University, Montreal, Quebec, Canada
| | - W Dáttilo
- Red de Ecoetología, Instituto de Ecología AC, Xalapa, Veracruz, Mexico
| | - J K Davis
- Department of Entomology, Cornell University, Ithaca, NY, USA
| | - R D Dimarco
- Department of Biology and Biochemistry, University of Houston, Houston, TX, USA
- Grupo de Ecología de Poblaciones de Insectos, IFAB, San Carlos de Bariloche, Río Negro, Argentina
| | - H E Dole
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - I N Egbon
- Department of Animal and Environmental Biology, University of Benin, Benin City, Nigeria
| | - M Eisenring
- Forest Entomology, Swiss Federal Research Institute WSL, Birmensdorf, Switzerland
| | - A Ejomah
- Department of Animal and Environmental Biology, University of Benin, Benin City, Nigeria
| | - B D Elderd
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - M-J Endara
- Grupo de Investigación en Ecología y Evolución en los Trópicos-EETROP, Universidad de las Américas, Quito, Ecuador
| | - M D Eubanks
- Department of Entomology, Texas A&M University, College Station, TX, USA
| | - S E Everingham
- Institute of Plant Sciences, University of Bern, Bern, Switzerland
- Evolution & Ecology Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - K N Farah
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - R P Farias
- Instituto de Biologia, Universidade Federal da Bahia, Salvador, Bahia, Brasil
| | - A P Fernandes
- Department of Botany, Ganpat Parsekar College of Education Harmal, Pernem, Goa, India
| | - G W Fernandes
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Knowledge Center for Biodiversity, Brazil
| | - M Ferrante
- Faculty of Agricultural Sciences and Environment, University of the Azores, Ponta Delgada, Portugal
- Department of Crop Sciences, University of Göttingen, Göttingen, Germany
| | - A Finn
- School of Natural Sciences, Zoology, Trinity College Dublin, Dublin, Ireland
| | - G A Florjancic
- Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - M L Forister
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - Q N Fox
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - E Frago
- CIRAD, UMR CBGP, INRAE, Institut Agro, IRD, Université Montpellier, Montpellier, France
| | - F M França
- School of Biological Sciences, University of Bristol, Bristol, UK
- Programa de Pós-Graduação em Ecologia, Universidade Federal do Pará, Belém, Pará, Brasil
| | | | - Z Getman-Pickering
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | - E Gianoli
- Departamento de Biología, Universidad de La Serena, La Serena, Chile
| | - B Gooden
- CSIRO Black Mountain Laboratories, CSIRO Health and Biosecurity, Canberra, Australia
| | - M M Gossner
- Forest Entomology, Swiss Federal Research Institute WSL, Birmensdorf, Switzerland
- Institute of Terrestrial Ecosystems, Department of Environmental Systems Science, ETH Zurich, Zurich, Switzerland
| | - K A Greig
- Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
| | - S Gripenberg
- School of Biological Sciences, University of Reading, Reading, UK
| | - R Groenteman
- Manaaki Whenua - Landcare Research, Lincoln, New Zealand
| | - P Grof-Tisza
- Institute of Biology, University of Neuchatel, Neuchatel, Switzerland
| | - N Haack
- Independent Institute for Environmental Issues, Halle, Germany
| | - L Hahn
- Molecular Evolution and Systematics of Animals, University of Leipzig, Leipzig, Germany
| | - S M Haq
- Wildlife Crime Control Division, Wildlife Trust of India, Noida, Uttar Pradesh, India
| | - A M Helms
- Department of Entomology, Texas A&M University, College Station, TX, USA
| | - J Hennecke
- Systematic Botany and Functional Biodiversity, Leipzig University, Leipzig, Germany
- German Centre for Integrative Biodiversity Research (iDiv), Leipzig, Germany
| | - S L Hermann
- Department of Entomology, The Pennsylvania State University, University Park, PA, USA
| | - L M Holeski
- Department of Biological Sciences and Center for Adaptive Western Landscapes, Northern Arizona University, Flagstaff, AZ, USA
| | - S Holm
- Department of Environmental and Biological Sciences, University of Eastern Finland, Joensuu, Finland
- Department of Zoology, University of Tartu, Tartu, Estonia
| | - M C Hutchinson
- Department of Life and Environmental Sciences, University of California, Merced, Merced, CA, USA
| | - E E Jackson
- School of Biological Sciences, University of Reading, Reading, UK
| | - S Kagiya
- Field Science Center for Northern Biosphere, Hokkaido University, Sapporo, Hokkaido, Japan
| | - A Kalske
- Department of Biology, University of Turku, Turku, Finland
| | - M Kalwajtys
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - R Karban
- Department of Entomology and Nematology, University of California Davis, Davis, CA, USA
| | - R Kariyat
- Department of Entomology and Plant Pathology, University of Arkansas, Fayetteville, AR, USA
| | - T Keasar
- Department of Biology and the Environment, University of Haifa - Oranim, Oranim, Tivon, Israel
| | - M F Kersch-Becker
- Department of Entomology, The Pennsylvania State University, University Park, PA, USA
| | - H M Kharouba
- Department of Biology, University of Ottawa, Ottawa, Ontario, Canada
| | - T N Kim
- Department of Entomology, Kansas State University, Manhattan, KS, USA
| | - D M Kimuyu
- Department of Natural Resources, Karatina University, Karatina, Kenya
| | - J Kluse
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - S E Koerner
- Department of Biology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - K J Komatsu
- Department of Biology, University of North Carolina Greensboro, Greensboro, NC, USA
- Smithsonian Environmental Research Center, Edgewater, MD, USA
| | - S Krishnan
- Center for Sustainable Future, Amrita University and EIACP RP, Amrita Viswa Vidyapeetham, Coimbatore, India
| | - M Laihonen
- Biodiversity Unit, University of Turku, Turku, Finland
| | - L Lamelas-López
- Faculty of Agricultural Sciences and Environment, University of the Azores, Ponta Delgada, Portugal
| | - M C LaScaleia
- Department of Ecology and Evolutionary Biology, University of Connecticut, Storrs, CT, USA
| | - N Lecomte
- Canada Research Chair in Polar and Boreal Ecology, Department of Biology and Centre d'Études Nordiques, Université de Moncton, Moncton, Canada
| | - C R Lehn
- Biological Sciences Course, Instituto Federal Farroupilha, Panambi, RS, Brazil
| | - X Li
- College of Resources and Environmental sciences, Jilin Agricultural University, Changchun, China
| | - R L Lindroth
- Department of Entomology, University of Wisconsin-Madison, Madison, WI, USA
| | - E F LoPresti
- Department of Biological Sciences, University of South Carolina, Columbia, SC, USA
| | - M Losada
- Department of Soil Science and Agricultural Chemistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - A M Louthan
- Division of Biology, Kansas State University, Manhattan, KS, USA
| | - V J Luizzi
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, USA
| | - S C Lynch
- Division of Biology, Kansas State University, Manhattan, KS, USA
| | - J S Lynn
- Department of Biological Sciences, University of Bergen, Bergen, Norway
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - N J Lyon
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - L F Maia
- Bio-Protection Research Centre, University of Canterbury, Christchurch, New Zealand
- School of Biological Sciences, University of Bristol, Bristol, UK
| | - R A Maia
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - T L Mannall
- Institute of Plant Sciences, University of Bern, Bern, Switzerland
| | - B S Martin
- Department of Plant Biology, Michigan State University, East Lansing, MI, USA
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
| | - T J Massad
- Department of Scientific Services, Gorongosa National Park, Sofala, Mozambique
| | - A C McCall
- Biology Department, Denison University, Granville, OH, USA
| | - K McGurrin
- Department of Entomology, University of Maryland, College Park, MD, USA
| | - A C Merwin
- Department of Biology and Geology, Baldwin Wallace University, Berea, OH, USA
| | - Z Mijango-Ramos
- Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
| | - C H Mills
- Evolution & Ecology Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - A T Moles
- Evolution & Ecology Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - C M Moore
- Department of Biology, Colby College, Waterville, ME, USA
| | - X Moreira
- Misión Biológica de Galicia, Consejo Superior de Investigaciones Científicas, Pontevedra, Galicia, Spain
| | - C R Morrison
- Department of Integrative Biology, The University of Texas at Austin, Austin, TX, USA
| | - M C Moshobane
- South African National Biodiversity Institute, Pretoria National Botanical Garden, Brummeria, Silverton, South Africa
- Centre for Functional Biodiversity, University of KwaZulu-Natal, Scottsville, Pietermaritzburg, South Africa
| | - A Muola
- Division of Biotechnology and Plant Health, Norwegian Institute of Bioeconomy Research, Tromsø, Norway
| | - R Nakadai
- Faculty of Environment and Information Sciences, Yokohama National University, Yokohama, Kanagawa, Japan
| | - K Nakajima
- Insitute of Science and Engineering, Chuo University, Tokyo, Japan
- Institute of Cave Research, Shimohei-guun, Iwate Prefecture, Japan
| | - S Novais
- Red de Interacciones Multitróficas, Instituto de Ecología A.C., Xalapa, Veracruz, Mexico
| | - C O Ogbebor
- Nigerian Institute for Oil Palm Research, Benin City, Edo State, Nigeria
| | - H Ohsaki
- Department of Biological Sciences, Hirosaki University, Hirosaki, Aomori, Japan
| | - V S Pan
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
- Department of Integrative Biology, Michigan State University, East Lansing, MI, USA
| | - N A Pardikes
- Department of Biology, Utah State University, Logan, UT, USA
| | - M Pareja
- Departamento de Biologia Animal, Universidade Estadual de Campinas, Campinas, Brazil
| | - N Parthasarathy
- Department of Ecology and Evironmental Sciences, Pondicherry University, Puducherry, India
| | | | - Q Paynter
- Manaaki Whenua - Landcare Research, Auckland, New Zealand
| | - I S Pearse
- U.S. Geological Survey, Fort Collins Science Center, Fort Collins, CO, USA
| | - R M Penczykowski
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - A A Pepi
- Department of Biology, Tufts University, Medford, MA, USA
| | - C C Pereira
- Department of Genetics, Ecology and Evolution, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - S S Phartyal
- School of Ecology & Environment Studies, Nalanda University, Rajgir, India
| | - F I Piper
- Millennium Nucleus of Patagonian Limit of Life and Instituto de Ciencias Biológicas, Universidad de Talca, Talca, Chile
- Institute of Ecology and Biodiversity, Ñuñoa, Santiago
| | - K Poveda
- Department of Entomology, Cornell University, Ithaca, NY, USA
| | - E G Pringle
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - J Puy
- School of Natural Sciences, Zoology, Trinity College Dublin, Dublin, Ireland
- Estación Biológica de Doñana, Consejo Superior de Investigaciones Científicas, Sevilla, Spain
| | - T Quijano
- Departamento de Ecología Tropical, Universidad Autónoma de Yucatán, Mérida, Yucatán, México
| | - C Quintero
- INIBIOMA, CONICET - Universidad Nacional del Comahue, San Carlos de Bariloche, Río Negro, Argentina
| | - S Rasmann
- Institute of Biology, University of Neuchatel, Neuchatel, Switzerland
| | - C Rosche
- German Centre for Integrative Biodiversity Research (iDiv), Leipzig, Germany
- Institute of Geobotany and Botanical Garden, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - L Y Rosenheim
- Department of Entomology and Nematology, University of California Davis, Davis, CA, USA
| | - J A Rosenheim
- Department of Entomology and Nematology, University of California Davis, Davis, CA, USA
| | - J B Runyon
- Rocky Mountain Research Station, USDA Forest Service, Bozeman, MT, USA
| | - A Sadeh
- Department of Natural Resources, Newe Ya'ar Research Center, Volcani Institute, Ramat Yishay, Israel
| | - Y Sakata
- Department of Biological Environment, Akita Prefectural University, Shimoshinjyo-Nakano, Akita, Japan
| | - D M Salcido
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - C Salgado-Luarte
- Instituto de Investigación Multidisciplinario en Ciencia y Tecnología, Universidad de La Serena, La Serena, Chile
| | - B A Santos
- Departamento de Sistemática e Ecologia Universidade Federal da Paraíba, João Pessoa, Brazil
| | - Y Sapir
- The Botanic Garden, School of Plant Sciences and Food Security, Faculty of Life Science, Tel Aviv University, Tel Aviv, Israel
| | - Y Sasal
- INIBIOMA, CONICET - Universidad Nacional del Comahue, San Carlos de Bariloche, Río Negro, Argentina
| | - Y Sato
- Department of Evolutionary Biology and Environmental Studies, University of Zurich, Zurich, Switzerland
| | - M Sawant
- Department of Ecology, University of Pune, Maharashtra, India
| | - H Schroeder
- Department of Entomology, Cornell University, Ithaca, NY, USA
| | - I Schumann
- Department of Human Genetics, University of Leipzig, Leipzig, Germany
| | - M Segoli
- Mitrani Department of Desert Ecology, Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Midreshet Ben-Gurion, Israel
| | - H Segre
- Department of Natural Resources, Institute of Plant Sciences, Agricultural Research Organization - Volcani Institute, Rishon Le Tzion, Israel
- Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
- Department of Natural Resources, Newe Ya'ar Research Center, Volcani Institute, Ramat Yishay, Israel
| | - O Shelef
- Department of Natural Resources, Institute of Plant Sciences, Agricultural Research Organization - Volcani Institute, Rishon Le Tzion, Israel
| | - N Shinohara
- Graduate School of Life Sciences, Tohoku University, Sendai, Japan
| | - R P Singh
- McGuire Center for Lepidoptera and Biodiversity, Florida Museum of Natural History, University of Florida, Gainesville, FL, USA
| | - D S Smith
- Department of Biology, California State University San Bernardino, San Bernardino, CA, USA
| | - M Sobral
- Department of Soil Science and Agricultural Chemistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - G C Stotz
- Department of Plant and Environmental Sciences, Clemson University, Clemson, SC, USA
| | - A J M Tack
- Department of Ecology, Environment and Plant Sciences, Stockholm University, Stockholm, Sweden
| | - M Tayal
- Department of Plant and Environmental Sciences, Clemson University, Clemson, SC, USA
| | - J F Tooker
- Department of Entomology, The Pennsylvania State University, University Park, PA, USA
| | - D Torrico-Bazoberry
- Laboratorio de Comportamiento Animal y Humano, Centro de Investigación en Complejidad Social, Universidad del Desarrollo, Las Condes, Chile
| | - K Tougeron
- Écologie et Dynamique des Systèmes Anthropisés, Université de Picardie Jules Verne, UMR 7058 CNRS, Amiens, France
- Ecology of Interactions and Global Change, Institut de Recherche en Biosciences, Université de Mons, Mons, Belgium
| | - A M Trowbridge
- Department of Forest and Wildlife Ecology, University of Wisconsin, Madison, WI, USA
| | - S Utsumi
- Field Science Center for Northern Biosphere, Hokkaido University, Sapporo, Hokkaido, Japan
| | - O Uyi
- Department of Animal and Environmental Biology, University of Benin, Benin City, Nigeria
- Department of Entomology, University of Georgia, Tifton, GA, USA
| | - J L Vaca-Uribe
- Programa de ingeniría agroecológica, Corporación Universitaria Minuto de Dios, Bogotá, Colombia
| | - A Valtonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Joensuu, Finland
| | - L J A van Dijk
- Department of Ecology, Environment and Plant Sciences, Stockholm University, Stockholm, Sweden
- Department of Bioinformatics and Genetics, Swedish Museum of Natural History, Stockholm, Sweden
| | - V Vandvik
- Department of Biological Sciences, University of Bergen, Bergen, Norway
| | - J Villellas
- Department of Life Sciences, University of Alcalá, Madrid, Spain
| | - L P Waller
- Bioprotection Aotearoa, Lincoln University, Lincoln, New Zealand
| | - M G Weber
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI, USA
| | - A Yamawo
- Department of Biological Sciences, Hirosaki University, Hirosaki, Aomori, Japan
- Center for Ecological Research, Kyoto University, Otsu, Japan
| | - S Yim
- Biology Department, University of Nevada, Reno, Reno, NV, USA
| | - P L Zarnetske
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
- Department of Integrative Biology, Michigan State University, East Lansing, MI, USA
| | - L N Zehr
- Department of Entomology, Michigan State University, East Lansing, MI, USA
| | - Z Zhong
- Institute of Grassland Science, Key Laboratory of Vegetation Ecology, Ministry of Education/Jilin Songnen Grassland Ecosystem National Observation and Research Station, Northeast Normal University, Changchun, Jilin Province, China
- Institute of Plant Protection, Chinese Academy of Agricultural Sciences, State Key Laboratory for Biology of Plant Diseases and Insect Pests, Beijing, China
| | - W C Wetzel
- Department of Entomology, Michigan State University, East Lansing, MI, USA
- Plant Resilience Institute, Michigan State University, East Lansing, MI, USA
- Ecology, Evolution, and Behavior Program, Michigan State University, East Lansing, MI, USA
- Department of Integrative Biology, Michigan State University, East Lansing, MI, USA
- W.K. Kellogg Biological Station, Michigan State University, Hickory Corners, MI, USA
- Land Resources and Environmental Sciences, Montana State University, Bozeman, MT, USA
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Fujimoto D, Morimoto T, Tamiya M, Hata A, Matsumoto H, Nakamura A, Yokoyama T, Taniguchi Y, Uchida J, Sato Y, Yokoi T, Tanaka H, Furuya N, Masuda T, Sakata Y, Miyauchi E, Hara S, Saito G, Miura S, Kanazu M, Yamamoto N, Akamatsu H. Outcomes of Chemoimmunotherapy Among Patients With Extensive-Stage Small Cell Lung Cancer According to Potential Clinical Trial Eligibility. JAMA Netw Open 2023; 6:e230698. [PMID: 36826813 PMCID: PMC9958526 DOI: 10.1001/jamanetworkopen.2023.0698] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
IMPORTANCE Chemoimmunotherapy is the standard first-line therapy for patients with extensive-stage small cell lung cancer (ES-SCLC). However, whether findings from pivotal trials can be extrapolated to the clinical practice setting remains unclear. OBJECTIVE To compare treatment outcome gaps following first-line chemoimmunotherapy for patients with ES-SCLC between those who met and did not meet the eligibility criteria used in previous clinical trials. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study was conducted from September 1, 2019, to September 30, 2020, at 32 hospitals in Japan, with at least 12 months of follow-up. Participants included consecutive patients with ES-SCLC who received carboplatin and etoposide with atezolizumab as first-line therapy. EXPOSURES Patients who met eligibility criteria for pivotal phase 3 clinical trials were considered trial-eligible. MAIN OUTCOMES AND MEASURES The primary outcome was 6-month progression-free survival. The secondary outcomes were differences in progression-free survival, overall survival, and safety according to whether key clinical trial eligibility criteria were met. RESULTS A total of 207 patients were analyzed (median age, 72 years; range, 46-87 years; 170 [82%] were male). Sixty-four patients (31%) were older adults (age ≥75 years), and most (184 [89%]) had an Eastern Cooperative Oncology Group performance status of 0 or 1. There were 132 (64%) trial-eligible patients. The 6-month progression-free survival rate for all patients was 38.8% (95% CI, 32.4%-45.7%). The median progression-free survival was 5.1 months in trial-eligible patients and 4.7 months in trial-ineligible patients (hazard ratio, 0.72; 95% CI, 0.53-0.97; P = .03). The proportion of patients who achieved disease control was 93% (118 of 127) in trial-eligible patients and 77% (55 of 71) in trial-ineligible patients (P = .002). The median overall survival was 15.8 months in trial-eligible patients and 13.1 months in trial-ineligible patients (hazard ratio, 0.73; 95% CI, 0.51-1.07; P = .10). The rate of severe adverse events was numerically higher among trial-ineligible patients than among trial-eligible patients (39% vs 27%; P = .07). CONCLUSIONS AND RELEVANCE In this cohort study, the overall treatment outcome was comparable to that reported in pivotal clinical trials. However, treatment outcomes after chemoimmunotherapy might differ between trial-eligible and trial-ineligible patients. These findings suggest that trial-eligibility criteria may be useful in clinical practice, and further studies using data from clinical practice settings are required to inform regulatory approval and clinical decision-making.
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Affiliation(s)
- Daichi Fujimoto
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akito Hata
- Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Yoshihiko Taniguchi
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Junji Uchida
- Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takashi Yokoi
- Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan
| | - Hisashi Tanaka
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Naoki Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan
| | - Takeshi Masuda
- Department of Respiratory Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshihiko Sakata
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Eisaku Miyauchi
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Hara
- Department of Respiratory Medicine, Itami City Hospital, Itami, Japan
| | - Go Saito
- Department of Respirology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Satoru Miura
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Masaki Kanazu
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Toyonaka, Japan
| | | | - Hiroaki Akamatsu
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
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Imaji M, Fujimoto D, Sato Y, Sakata Y, Oya Y, Tamiya M, Suzuki H, Ikeda H, Kijima T, Matsumoto H, Kanazu M, Hino A, Inaba M, Tsukita Y, Arai D, Maruyama H, Hara S, Tsumura S, Kobe H, Sumikawa H, Sakata S, Yamamoto N. Safety and efficacy of osimertinib rechallenge or continuation after pneumonitis: A multicentre retrospective cohort study. Eur J Cancer 2023; 179:15-24. [PMID: 36470023 DOI: 10.1016/j.ejca.2022.10.029] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Although osimertinib is a standard first-line treatment for patients with advanced-stage non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations, the incidence rate of pneumonitis associated with osimertinib is high. However, there are few reports about the safety and efficacy of osimertinib rechallenge after the development of pneumonitis. METHODS We conducted a retrospective multicentre cohort study of consecutive patients who developed pneumonitis associated with osimertinib as a first-line and received osimertinib rechallenge. The primary outcome was the incidence rate of any grade pneumonitis after osimertinib rechallenge. The secondary outcome was treatment efficacy in patients after osimertinib rechallenge. RESULTS In total, 33 patients who received osimertinib rechallenge were included. Of them, 26 patients had grade 1, 6 patients had grade 2, and 1 patient had grade 3 initial pneumonitis. The median follow-up period after the osimertinib rechallenge was 16.9 months (interquartile range, 11.1-21.3 months). After the start of osimertinib rechallenge, five patients (15%) experienced mild relapsed pneumonitis. Three of the five patients had similar imaging patterns for initial and relapsed pneumonitis. No significant differences in characteristics were observed between patients with and without relapsed pneumonitis. The median progression-free survival after osimertinib rechallenge was not achieved (95% confidence interval: 10.3 months - not reached). CONCLUSION Osimertinib rechallenge was feasible and effective for patients who developed initial pneumonitis associated with first-line osimertinib therapy. Osimertinib might be considered a treatment option even after the development of mild initial pneumonitis.
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Affiliation(s)
- Mihoko Imaji
- Internal Medicine III, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Daichi Fujimoto
- Internal Medicine III, Wakayama Medical University, Wakayama 641-8509, Japan.
| | - Yuki Sato
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Yoshihiko Sakata
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Yuko Oya
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Motohiro Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Hideki Ikeda
- Department of Respiratory Medicine, Kimitsu Chuo Hospital, Chiba, Japan; Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takashi Kijima
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, Hyogo, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Masaki Kanazu
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Osaka, Japan
| | - Aoi Hino
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Megumi Inaba
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Yoko Tsukita
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Daisuke Arai
- Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Hirotaka Maruyama
- Department of Respiratory Medicine, Japan Organization of Occupational Health and Safety, Kumamoto Rosai Hospital, Kumamoto, Japan
| | - Satoshi Hara
- Department of Respiratory Medicine, Itami City Hospital, Hyogo, Japan
| | - Shinsuke Tsumura
- Department of Respiratory Medicine, Kumamoto Regional Medical Center, Kumamoto, Japan
| | - Hiroshi Kobe
- Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama, Japan
| | - Hiromitsu Sumikawa
- Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - Shinya Sakata
- Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III, Wakayama Medical University, Wakayama 641-8509, Japan
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Kamada Y, Shibata K, Sakata Y, Munakata H, Ishii M, Imanishi A. Drug therapy for patients with narcolepsy in a real world in Japan: A descriptive observational study using healthcare claims data. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.422] [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: 10/17/2022]
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Hirai R, Sakata Y, Mori S. A Fast 3D/3D Registration Method Based on Water Equivalent Path Length for Heavy-Ion Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2200] [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: 10/31/2022]
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Tamaki S, Nagai Y, Shutta R, Masuda D, Yamashita S, Seo M, Yamada T, Yano M, Hayashi T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. Relation of lymphopenia to comorbidity burden and its prognostic value in patients with acute decompensated heart failure with preserved left ventricular ejection fraction: a multicentre study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1082] [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
Background
Systemic inflammation resulting from comorbidities is postulated to play a central role in the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). Lymphopenia is a common manifestation of systemic inflammation and a prognostic factor in patients with HF. However, the association of lymphopenia with the comorbidity burden is unknown, and its prognostic value in patients with HFpEF admitted due to acute decompensated heart failure (ADHF) also remains elusive.
Purpose
We sought to clarify the relation of lymphopenia with the comorbidity burden, as well as its prognostic value and complementarity with the Get with the Guidelines-Heart Failure (GWTG-HF) risk score in ADHF patients with HFpEF.
Methods
Patients' data were extracted from the Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT-HFpEF), which is a prospective multicentre registry for patients with ADHF with a LVEF ≥50%. We analysed data of patients admitted between June 2016 and December 2020 who survived to discharge. The total lymphocyte count (per μL) and GWTG-HF risk score were obtained on admission, as previously reported. Comorbidity burden was defined as the number of comorbidities from the following: atrial fibrillation, hypertension, diabetes mellitus, coronary artery disease, chronic kidney disease, chronic obstructive pulmonary disease, anaemia, and obesity. The study endpoint was all-cause death.
Results
Over a median follow-up of 417 days, 181 of the 1013 included patients died. The proportion of patients with a total lymphocyte count in the lowest tertile was increasing with the increase in comorbidity burden (Figure 1). In the multivariate Cox analysis, a total lymphocyte count in the intermediate (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.00–2.41, p=0.0486) and lowest tertile (HR 2.23, 95% CI 1.47–3.38, p=0.0002) was independently associated with all-cause death. There was a significant difference in the all-cause death rate among the groups stratified by total lymphocyte count tertile (Figure 2). The total lymphocyte count had a higher C-statistic value (0.627) for the prediction of all-cause death than the GWTG-HF risk score, and the C-statistic value of the GWTG-HF risk score was improved when the total lymphocyte count was added (0.613 to 0.636, p=0.0260).
Conclusions
Lymphopenia was significantly associated with comorbidity burden. Furthermore, it was a useful marker of poor prognosis in hospitalised patients with acute HFpEF and was shown to be complementary to the contemporary HF prognostic score.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Roche Diagnostics K.K.Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- S Tamaki
- Rinku General Medical Center , Izumisano , Japan
| | - Y Nagai
- Rinku General Medical Center , Izumisano , Japan
| | - R Shutta
- Rinku General Medical Center , Izumisano , Japan
| | - D Masuda
- Rinku General Medical Center , Izumisano , Japan
| | - S Yamashita
- Rinku General Medical Center , Izumisano , Japan
| | - M Seo
- Osaka General Medical Center , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital , Sakai , Japan
| | - T Hayashi
- Osaka Police Hospital , Osaka , Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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9
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Oeun B, Hikoso S, Nakatani D, Okada K, Dohi T, Sotomi Y, Kida H, Sunaga A, Sato T, Seo M, Yano M, Hayashi T, Yamada T, Yasumura Y, Sakata Y. Clinical trajectory and outcomes of patients with heart failure with preserved ejection fraction with normal or indeterminate diastolic function. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.783] [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
Background
Heart failure (HF) with preserved ejection fraction (HFpEF) is a chronic and progressive disease, but limited therapeutic strategies are currently available. Although left ventricular diastolic dysfunction (DD) is a prominent mechanism of HFpEF, a certain number of patients with HFpEF have a normal diastolic function (ND) or indeterminate diastolic function (ID). With the progressive nature of HFpEF, diastolic function may change over time. However, the change of diastolic function, its predictor and prognosis in patients with clinically established HFpEF remains unknown.
Purpose
To investigate the clinical trajectory and outcomes of patients with HFpEF with ND or ID and to identify factors associated with progression from ND or ID at discharge to DD at 1-year follow-up.
Methods
Using data from a prospective multicenter observational study of patients with HFpEF, we extracted 289 patients with HFpEF with ND or ID at discharge who had echocardiographic data at 1-year follow-up for the re-evaluation of diastolic function. Diastolic function was assessed according to the 2016 American Society of Echocardiography recommendations. Patients were classified according to the absence or presence of progression from ND or ID to DD at 1 year. The primary endpoint was a composite of all-cause death and HF rehospitalization.
Results
Median age was 81 years, and 138 (47.8%) patients were female. At 1 year, 107 (37%) patients progressed to DD. During a median follow-up of 709 days, the composite endpoint occurred in 90 (31.1%) patients. Compared to patients without progression to DD, those with progression to DD had a significantly higher cumulative incidence rate of the composite endpoint (incidence rate: 11.7/100 person-year versus 23.3/100 person-year, P<0.001). Progression to DD (adjusted HR: 2.014, 95% CI: 1.239–3.273, P=0.005) was independently associated with the composite endpoint. Age (adjusted OR: 1.046, 95% CI: 1.008–1.087, P=0.018), body mass index (BMI) (adjusted OR: 1.107, 95% CI: 1.029–1.192, P=0.006), and serum albumin (adjusted OR: 0.459, 95% CI: 0.216–0.974, P=0.042) were independently associated with progression from ND or ID to DD at 1 year.
Conclusion
More than one-third of patients with HFpEF with ND or ID progressed to DD at 1 year and had poor clinical outcomes. Age, BMI, and serum albumin were independently associated with this progression.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by grants from Japan Society for the Promotion of Science KAKENHI (No. JP 17K09496) and Japan Agency for Medical Research and Development (No. JP16lk1010013).
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Affiliation(s)
- B Oeun
- Osaka University Graduate School of Medicine , Suita , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine , Suita , Japan
| | - K Okada
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Dohi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - H Kida
- Osaka University Graduate School of Medicine , Suita , Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Sato
- Osaka University Graduate School of Medicine , Suita , Japan
| | - M Seo
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital, Cardiology , Sakai , Japan
| | - T Hayashi
- Osaka Police Hospital, Cardiology , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Cardiology , Amagasaki , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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10
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Oka T, Koyama Y, Inoue K, Tanaka N, Tanaka K, Hirao Y, Okada M, Okamura A, Iwakura K, Fujii K, Masuda M, Watanabe T, Sunaga A, Hikoso S, Sakata Y. Extensive ablation strategy for persistent atrial fibrillation impairs left atrial function but reduces recurrence rate. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.462] [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
Background
In catheter ablation for persistent atrial fibrillation (AF), extensive ablation strategy, such as linear ablation and/or complex fractionated atrial electrogram (CFAE) ablation in addition to pulmonary vein isolation (PVI-plus), might impair left atrial function more severely than PVI-alone strategy.
Purpose
The aim of this study is to investigate the impact of extensive ablation strategy on LA function and assess the relationship between post-ablation LA function and recurrence.
Methods
This study is a post-hoc subanalysis of the EARNEST-PVI randomized controlled trial, which investigated the efficacy of the PVI-alone strategy in comparison with PVI-plus strategy for persistent AF. From the 497 participants of EARNEST-PVI trial, we enrolled 191 patients with full datasets of pre- and post-ablation cardiac computed tomography (CT) at our Hospital. Patients were divided into PVI-alone and PVI-plus groups. Within one month before and 3 months after ablation, LA volume index (LAVI) and LA emptying fraction (LAEF) were calculated by using the Comprehensive Cardiac Analysis software on the Extended Brilliance Workspace. We assessed i) post-ablation LA function, ii) AF/atrial tachycardia (AT) -free rate after single and final session, and iii) relationship between post-ablation LAEF and ablation success in each group.
Results
The indices of baseline LA remodeling were not different between PVI-alone (N=96) and PVI-plus groups (N=95) [LAVI: 71.4 (57.8, 82.0) vs. 68.7 (61.0, 78.1), P=0.92, LAEF: 13.7 (10.0, 17.4) vs. 13.0 (10.0, 16.9), PVI-alone vs. PVI-plus, P=0.78]. In overall patients, post-ablation LAEF did not differ among them [34.4 (26.1, 40.7) vs. 31.6 (26.0, 37.4), P=0.13]. In the analysis of patients showing sinus rhythm during the CT study, LAEF was significantly higher in PVI-alone (N=87) than in PVI-plus group (N=93) [35.7 (29.0, 41.0) vs. 31.7 (26.1, 37.5), P=0.011] (Figure 1A). AF/AT-free survival rate during median follow-up of 44 months was not different after first session (63.5% vs. 68.4%, P=0.33), while PVI-plus had a tendency towards higher success rate after final session (72.9% vs. 84.2%, P=0.053) (Figure 2). In receiver operating characteristics analysis for recurrence after first session, post-ablation decreased LAEF had significantly related to recurrence after PVI-alone (AUC: 0.733, P<0.0001), but not after PVI-plus (AUC: 0.567, P=0.31) (Figure 1B, C).
Conclusion
Compared with PVI-alone strategy, PVI-plus strategy damaged LA function more severely, but tended to be related to higher success rate. Post-ablation LA function was related to recurrence in PVI-alone, but not in PVI-plus. Extensive ablation might have additional anti-arrhythmic effect regardless of iatrogenic myocardial damage. Myocardial injury by extensive ablation may less attribute to recurrence than intrinsic damage of LA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Oka
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine , Suita , Japan
| | - Y Koyama
- Sakurabashi-Watanabe Hospital, Cardiovasucular Division , Osaka , Japan
| | - K Inoue
- National Hospital Organization Osaka National Hospital , Osaka , Japan
| | - N Tanaka
- Sakurabashi-Watanabe Hospital, Cardiovasucular Division , Osaka , Japan
| | - K Tanaka
- Sakurabashi-Watanabe Hospital, Cardiovasucular Division , Osaka , Japan
| | - Y Hirao
- Sakurabashi-Watanabe Hospital, Cardiovasucular Division , Osaka , Japan
| | - M Okada
- Sakurabashi-Watanabe Hospital, Cardiovasucular Division , Osaka , Japan
| | - A Okamura
- Sakurabashi-Watanabe Hospital, Cardiovasucular Division , Osaka , Japan
| | - K Iwakura
- Sakurabashi-Watanabe Hospital, Cardiovasucular Division , Osaka , Japan
| | - K Fujii
- Sakurabashi-Watanabe Hospital, Cardiovasucular Division , Osaka , Japan
| | - M Masuda
- Kansai Rosai Hospital , Amagasaki , Japan
| | - T Watanabe
- Osaka General Medical Center , Osaka , Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine , Suita , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine , Suita , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine , Suita , Japan
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11
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Iwakura K, Onishi T, Okamura A, Koyama Y, Hirao Y, Tanaka K, Iwamoto M, Tanaka N, Okada M, Watanabe H, Nakatani D, Hikoso S, Sakata Y, Sakata Y. Development of the new risk score to predict occurrence of atrial fibrillation early after acute myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.509] [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
Background/Introduction
New onset of atrial fibrillation (AF) is associated with adverse short- and long-term outcomes after acute myocardial infarction (AMI), and its prediction is relevant for the risk stratification in patients with AMI. Although several risk scores were developed for AF in the general population, there is no established risk score for AF occurrence after AMI.
Purpose
To develop a risk score to predict occurrence of AF early after AMI.
Methods
We enrolled consecutive 751 patients with AMI who admitted to our hospital between April 2006 and September 2012 for the present study. New occurrence of AF was defined as AF detected during hospital stay in a patient showing normal regular sinus rhythm at admission. Parameters relevant to the occurrence of AF was selected from the clinical characteristics, physical status and blood test data at admission, and peak CK/CK-MB, by stepwise logistic regression analysis. We constructed a risk score model to predict the new occurrence of AF, using selected parameters and their logistic regression coefficients. C-statistics was determined by constructing a receiver operating characteristic curve to evaluate the accuracy of the risk score for prediction of AF occurrence.
Results
We excluded 48 patients (6.4%) who had AF at admission, and 208 patients without sufficient data at admission, and thus, the study group consisted of 459 patients (age; 65±13 years, male gender; 79.6%). New AF occurrence was observed in 72 patients (14.5%). The following 7 parameters was selected as parameters related with AF (as p<0.1); Inferior/posterior AMI, use of β blockers, use of diuretics, single vessel disease, absence of reperfusion therapy, systolic blood pressure (sBP) at admission, and smoking. One point was given to sBP>128mmHg, 2 points to absence of reperfusion, and one point to other parameters. Sum of these points was calculated as the AF risk score (Table 1). AF occurred in 27.1% of patients with ≥5 points whereas it was observed 5.2% of those with <5 points. C-statistics of the risk score was 0.75 (95% CI 0.68–0.83).
Conclusion
We developed a novel risk score to estimate the risk of AF occurrence early after AMI, which can be a useful tool for the risk stratification after AMI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Iwakura
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - T Onishi
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - A Okamura
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - Y Koyama
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - Y Hirao
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - K Tanaka
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - M Iwamoto
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - N Tanaka
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - M Okada
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - H Watanabe
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine , Suita , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine , Suita , Japan
| | - Y Sakata
- National Cerebral and Cardiovascular Center Hospital, Department of Clinical Medicine and Development , Osaka , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine , Suita , Japan
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12
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Sunaga A, Hikoso S, Tamaki S, Yano M, Hayashi T, Oeun B, Kida H, Sotomi Y, Dohi T, Okada K, Mizuno H, Nakatani D, Yamada T, Yasumura Y, Sakata Y. Association between prognosis and the use of angiotensin-converting enzyme inhibitors and/or angiotensin II receptor blocker in frail patients with heart failure with preserved ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.770] [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
Background
The effectiveness of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARB) has not been demonstrated in patients with heart failure with preserved ejection fraction (HFpEF). We recently reported significant interaction between the use of ACE-I and/or ARB (ACE-I/ARB) and frailty on prognosis in patients with HFpEF.
Purpose
In the present study, we examined the association between ACE-I/ARB and prognosis in patients with HFpEF stratified by the presence or absence of frailty.
Methods
We examined the association between the use of ACE-I/ARB and prognosis according to the presence (Clinical Frailty Scale (CFS) ≥5) or absence (CFS ≤4) of frailty in patients with HFpEF in a post-hoc analysis of registry data. Primary endpoint was the composite of all-cause mortality and heart failure admission. Secondary endpoints were all-cause mortality and heart failure admission.
Results
Of 1059 patients, median age was 83 years and 45% were male. Kaplan-Meier analysis showed that the risk of composite endpoint (log-rank P=0.001) and all-cause death (log-rank P=0.005) in patients with ACE-I/ARB was lower in those with CFS ≥5, but similar between patients with and without ACE-I/ARB in patients with CFS ≤4 (composite endpoint: log-rank P=0.830; all-cause death: log-rank P=0.192). In a multivariable Cox proportional hazards model, use of ACE-I/ARB was significantly associated with lower risk of the composite endpoint (hazard ratio = 0.52, 95% CI: 0.33–0.83, P=0.005) and heart failure admission (hazard ratio = 0.45, 95% CI: 0.25–0.83, P=0.010) in patients with CFS ≥5, but not in patients with CFS ≤4 (composite endpoint: hazard ratio = 1.41, 95% CI: 0.99–2.02, P=0.059; heart failure admission: hazard ratio = 1.43, 95% CI: 0.94–2.18, P=0.091). The association between ACE-I or ARB and prognosis did not significantly differ by CFS (CFS ≤4: log-rank P=0.562; CFS ≥5: log-rank P=0.100, for with ACE-I vs. ARB, respectively). Adjusted HRs for CFS 1–4 were higher than 1.0, but were less than 1.0 at CFS 5.
Conclusions
In patients with HFpEF, use of ACE-I/ARB was associated with better prognosis in patients with frailty as assessed with the CFS, but not in those without frailty.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Roche
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Affiliation(s)
- A Sunaga
- Osaka University Graduate School of Medicine , Suita , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - S Tamaki
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital , Sakai , Japan
| | - T Hayashi
- Osaka Police Hospital , Osaka , Japan
| | - B Oeun
- Osaka University Graduate School of Medicine , Suita , Japan
| | - H Kida
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Dohi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - K Okada
- Osaka University Graduate School of Medicine , Suita , Japan
| | - H Mizuno
- Osaka University Graduate School of Medicine , Suita , Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Cardiology , Amagasaki , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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13
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Seo M, Watanabe T, Yamada T, Yano M, Hayashi T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. The clinical relevance of quality of life in patients with acute decompensated heart failure with preserved ejection fraction: insights from the PURSUIT-HFpEF Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1059] [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
Improvement of quality of life (QOL) is one of the most important therapeutic goals for patients with heart failure with preserved ejection fraction (HFpEF). It is, therefore, clinically relevant to comprehensively identify aggravating factors among cardiac factors, non-cardiac comorbidities, and social factors. The aim of this study was to elucidate determinant factors of impaired QOL and clarify the association between QOL and prognosis in patients with HFpEF.
Methods and results
Patient data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study. EuroQol 5 dimensions 5-level (EQ-5D-5L) data were obtained at discharge to evaluate patients' health-related QOL. A total of 864 patients were enrolled in this study. Multivariable logistic regression analysis revealed that only non-cardiac factors such as age, female sex, frailty, malnutrition and inflammation were significantly associated with low EQ-5D-5L score, whereas cardiac factors showed no significant association after multivariable adjustment. A total of 206 patients died over a mean follow-up period of 2.0±1.2 years. Kaplan–Meier survival curve analysis demonstrated a significant increase in risk of mortality stratified by tertiles of EQ-5D-5L score (p<0.0001). Cox multivariable analysis revealed that patients with low EQ-5D-5L score had a significantly greater risk of mortality than those with high EQ-5D-5L score (adjusted hazard ratio: 2.20 (1.40–3.45), p=0.001).
Conclusion
Among patients with HFpEF, non-cardiac factors such as age, female sex, frailty, malnutrition and inflammation are significantly associated with impaired QOL. The QOL score itself also offers useful prognostic information in patients with HFpEF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Seo
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - T Watanabe
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital, Cardiology , Osaka , Japan
| | - T Hayashi
- Osaka Police Hospital, Cardiology , Osaka , Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Cardiology , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Cardiovascular Medicine , Osaka , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Cardiovascular Medicine , Osaka , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Cardiovascular Medicine , Osaka , Japan
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14
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Nakagawa Y, Sairyo M, Miyazawa K, Tamaki S, Yano M, Hayashi T, Yamada T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. Insight into the relationship between heart rate and mortality in patients in sinus rhythm with heart failure with preserved ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.772] [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
Background
There are several reports showing that elevated heart rate (HR) is associated with poor outcomes in patients in sinus rhythm (SR) with heart failure with preserved ejection fraction (HFpEF), although the association is weak or none in HFpEF patients with atrial fibrillation (Af). However, in previous studies, cardiac and non-cardiac factors which may be associated with elevated HR, have not been fully adjusted for.
Purpose
The purpose of this study is to explore covariates of elevated HR and to investigate the relationship between heart rate and mortality in HFpEF patients in SR.
Methods and results
Of the 1161 patients, who registered prospective multicenter, observational study of patients with HFpEF (PURSUIT-HFpEF), 726 patients in SR were examined. We performed laboratory testing and echocardiography in the compensated stage (in stable condition after treatment of acute decompensated HF). Geriatric nutritional risk index (GNRI) was calculated as nutrition index. Resting heart rate (HR) was analyzed as categorical (tertiles, T1–3). We followed the patients for median of 598 days (interquartile range 329–1028 days) to observe the outcome all-cause mortality.
The Kaplan analysis revealed that there was a significant difference between heart rate and mortality (log-rank, p=0.001). Characteristics were compared between patients in T1 (HR ≤63) and T3 (HR ≥75). There were no differences in cardiac factors between patients in T1 and T3. C-reactive protein (CRP) was significantly higher in patients in T3 than those in T1 (p=0.0004,). GNRI was significantly lower in patients in T3 than those in T1 (p=0.001). After adjustment for covariates including N-terminal pro-B type natriuretic peptide and estimated glomerular filtration rate, CRP and GNRI significantly correlated with HR (continuous variable) by multiple regression analysis (beta-coefficient = 1.52, p=0.003 and beta-coefficient = −0.14, p=0.04, respectively). Taking T1 as the reference, multivariable Cox regression analysis revealed that T3 was independently associated with mortality (hazard ratio: 2.10, 95% confidence interval: 1.33–3.32, p=0.001).
Conclusion
Although elevated HR was associated with enhanced inflammation and malnutrition, it itself was an independent predictor of death in HFpEF patients in SR.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Roche Diagnosis K.K.Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- Y Nakagawa
- Kawanishi city Hospital , Kawanishi , Japan
| | - M Sairyo
- Kawanishi city Hospital , Kawanishi , Japan
| | - K Miyazawa
- Kawanishi city Hospital , Kawanishi , Japan
| | - S Tamaki
- Osaka General Medical Center , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital , Osaka , Japan
| | - T Hayashi
- Osaka Police Hospital , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center , Osaka , Japan
| | - Y Yasumura
- Amagasaki Central Hospital , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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15
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Sakamoto D, Seo M, Yamada T, Yano M, Hayashi T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. Prognostic impact of the serial change of a systemic inflammation-nutrition index in patients with heart failure with preserved ejection fraction: insights from pursuit-hfpef registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.876] [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
Background
Malnutrition and inflammation are associated with poor outcomes with heart failure (HF). It has been reported that advanced lung cancer inflammation index (ALI), calculated by body mass index × serum albumin level / neutrophil to lymphocyte ratio (NLR) can be useful for the risk stratification and predicting the post-discharge prognosis of the patients with acute decompensated heart failure (ADHF). However, there is no information available on the prognostic value of the serial ALI change in ADHF patients with preserved ejection fraction (HFpEF).
Methods and results
Patients' data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study, which is a prospective multicenter observational registry for ADHF-HFpEF in Osaka. Laboratory data and body weight measurements were performed at the discharge and 1 year after the discharge. We analyzed 527 patients after exclusion of patients on dialysis, in-hospital death, missing follow-up data, or missing data to calculate ALI. The study patients were categorized by the serial change from baseline to 1 year after the discharge (ΔALI) as follows: low tertile: ΔALI <−6.99 (n=176), middle tertile: −6.99 ≤ ALI <8.44 (n=176), and high tertile: 8.44 ≤ ΔALI (n=175). The endpoints of the present study were all-cause death (ACD) and cardiovascular death (CVD). During a mean follow-up period of 1.5±1.0 years, 94 patients had ACD and 40 patients had CVD. The Kaplan-Meier analysis revealed that the patients with middle and low ΔALI at 1 year after heart failure hospitalization had a significantly greater risk of reaching the ACD and CVD than those with high ΔALI (ACD: 22% vs 22% vs 10%, p=0.0011, CVD: 10% vs 9% vs 3%, p=0.014). On multivariate Cox analysis, ΔALI was significantly associated with ACD independently of age, gender, serum NT-proBNP level, and baseline ALI after adjustment for NYHA functional class, serum creatinine level, serum hemoglobin level, serum CRP level, serum sodium level and LVEF.
Conclusion
This study showed that patients with the increased ALI after the discharge had improved outcome in comparison to those without the increased ALI. The serial change of ALI, a systemic inflammation-nutrition index, might be useful for stratifying ADHF patients with HFpEF at risk for the total mortality and cardiovascular mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Sakamoto
- Osaka General Medical Center , Osaka , Japan
| | - M Seo
- Osaka General Medical Center , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital, Cardiology , Osaka , Japan
| | - T Hayashi
- Osaka Police Hospital, Cardiology , Osaka , Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Cardiology , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Cardiology , Osaka , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Cardiology , Osaka , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Cardiology , Osaka , Japan
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16
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Sunaga A, Tanaka N, Masuda M, Watanabe T, Kida H, Oeun B, Sato T, Sotomi Y, Dohi T, Okada K, Mizuno H, Nakatani D, Hikoso S, Inoue K, Sakata Y. Premature atrial contraction on Holter electrocardiogram predicts the recurrence of atrial fibrillation after catheter ablation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.401] [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
It is important to detect the recurrence of atrial fibrillation (AF) after catheter ablation (CA) early, but the method of detection has not been established. The purpose of this study is to determine whether 24-h Holter electrocardiogram (ECG) can predict the recurrence of AF after CA.
Methods
We studied 336 patients of 497 patients enrolled in EARNEST-PVI trial to investigate whether the total number of premature atrial contraction (PAC) and the maximum number of PAC run by 24-h Holter ECG at 6 months after CA predicted AF recurrence after 6 months. We excluded 86 patients with recurrence by 6 months after CA and 75 patients without Holter ECG at 6 months after CA.
Results
Median age was 66 years, male were 77% and median follow-up period was 1138 days. Receiver operating characteristic curve analysis identified the total number of PAC ≥270 beats and the maximum number of PAC run ≥8 beats as the optimal cutoff for prediction of AF recurrence. Kaplan-Meier analysis showed patients with the total number of PAC ≥270 beats had more frequent AF recurrence than those without (Kaplan-Meier estimated 3-year AF recurrence rate 34% vs. 17%, Log-rank P=0.001) and patients with the maximum number of PAC run ≥8 beats had more frequent AF recurrence than those without (Kaplan-Meier estimated 3-year AF recurrence rate 33% vs. 20%, Log-rank P=0.006). Multivariate analysis revealed that the total number of PAC ≥270 beats and the maximum number of PAC run were significantly associated with AF recurrence (hazard ratio [95% confidence interval] 1.83 [1.16–2.91], P=0.01 and 1.01 [1.01–1.02], P=0.001, respectively)
Conclusion
The total number of PAC and the maximum number of PAC run on the Holter ECG may be useful in predicting AF recurrence after CA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Sunaga
- Osaka University Graduate School of Medicine , Suita , Japan
| | - N Tanaka
- Sakurabashi-Watanabe Hospital , Osaka , Japan
| | - M Masuda
- Kansai Rosai Hospital , Amagasaki , Japan
| | - T Watanabe
- Osaka General Medical Center, Cardiology , Osaka , Japan
| | - H Kida
- Osaka University Graduate School of Medicine , Suita , Japan
| | - B Oeun
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Sato
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - T Dohi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - K Okada
- Osaka University Graduate School of Medicine , Suita , Japan
| | - H Mizuno
- Osaka University Graduate School of Medicine , Suita , Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine , Suita , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - K Inoue
- National Hospital Organization Osaka National Hospital , Osaka , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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Sato Y, Sumikawa H, Shibaki R, Morimoto T, Sakata Y, Oya Y, Tamiya M, Suzuki H, Matsumoto H, Kijima T, Hashimoto K, Kobe H, Hino A, Inaba M, Tsukita Y, Ikeda H, Arai D, Maruyama H, Sakata S, Fujimoto D. 1103P Drug-related pneumonitis induced by osimertinib as first-line treatment for EGFR-positive non-small cell lung cancer: A real-world setting. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1228] [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: 11/27/2022] Open
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18
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Terai H, Soejima K, Shimokawa A, Horinouchi H, Shimizu J, Hase T, Kanemaru R, Watanabe K, Ninomiya K, Aragane N, Yanagitani N, Sakata Y, Seike M, Fujimoto D, Kasajima M, Kubo A, Kusumoto S, Oyamada Y, Fujiwara K, Mori M, Hashimoto M, Shingyoji M, Kodani M, Sakamoto J, Agatsuma T, Kashiwabara K, Inomata M, Tachihara M, Tanaka K, Hayashihara K, Koyama N, Matsui K, Minato K, Jingu D, Sakashita H, Hara S, Naito T, Okada A, Tanahashi M, Sato Y, Asano K, Takeda T, Nakazawa K, Harada T, Shibata K, Kato T, Miyaoka E, Yoshino I, Gemma A, Mitsudomi T. Real-world data analysis of pembrolizumab monotherapy for non-small cell lung cancer utilizing Japanese post-marketing all-case surveillance data. JTO Clin Res Rep 2022; 3:100404. [PMID: 36275911 PMCID: PMC9579417 DOI: 10.1016/j.jtocrr.2022.100404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/26/2022] [Indexed: 10/25/2022] Open
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19
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Sato Y, Sumikawa H, Shibaki R, Morimoto T, Sakata Y, Oya Y, Tamiya M, Suzuki H, Matsumoto H, Yokoi T, Hashimoto K, Kobe H, Hino A, Inaba M, Tsukita Y, Ikeda H, Arai D, Maruyama H, Hara S, Tsumura S, Sakata S, Fujimoto D. Drug-Related Pneumonitis Induced by Osimertinib as First-Line Treatment for Epidermal Growth Factor Receptor Mutation-Positive Non-Small Cell Lung Cancer. Chest 2022; 162:1188-1198. [DOI: 10.1016/j.chest.2022.05.035] [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] [Received: 01/28/2022] [Revised: 04/17/2022] [Accepted: 05/09/2022] [Indexed: 10/18/2022] Open
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20
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Harada K, Yamamura T, Muto O, Nakamura M, Sogabe S, Sawada K, Nakano S, Yagisawa M, Muranaka T, Dazai M, Tateyama M, Ito K, Saito R, Kobayashi Y, Kato S, Miyagishima T, Kawamoto Y, Yuki S, Sakata Y, Sakamoto N, Komatsu Y. SO-30 Impact of single-heterozygous UGT1A1 on the clinical outcomes of nano-liposomal irinotecan plus 5-fluorouracil/leucovorin for patients with pancreatic ductal adenocarcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.429] [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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21
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Kawachi H, Tamiya M, Taniguchi Y, Yokoyama T, Yokoe S, Oya Y, Imaji M, Okabe F, Kanazu M, Sakata Y, Uematsu S, Tanaka S, Arai D, Saito G, Kobe H, Miyauchi E, Okada A, Hara S, Kumagai T. Efficacy of Immune Checkpoint Inhibitor With or Without Chemotherapy for Non–Squamous Non-Small Cell Lung Cancer with Malignant Pleural Effusion: A Retrospective Multicenter Cohort Study. JTO Clin Res Rep 2022; 3:100355. [PMID: 35769388 PMCID: PMC9234704 DOI: 10.1016/j.jtocrr.2022.100355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction Malignant pleural effusion (MPE) is associated with poor treatment outcome in patients with NSCLC receiving immune checkpoint inhibitors (ICIs). ICIs and chemotherapy (ICI/Chemo) combination therapy is currently the standard therapy for NSCLC, and some ICI/Chemo regimens for nonsquamous (non-Sq) NSCLC contain bevacizumab (BEV), which is effective for controlling MPE and may enhance immune response. This study aimed to determine the optimal first-line treatment for this clinical population. Methods We retrospectively enrolled consecutive patients with non-Sq NSCLC with MPE who received ICI/Chemo or pembrolizumab monotherapy. Treatment outcomes were analyzed in patients with programmed death-ligand 1 (PD-L1) tumor proportion score more than or equal to 50% who were administered ICI/Chemo or pembrolizumab monotherapy (PD-L1 high cohort) and in patients with any PD-L1 status, treated with ICI/Chemo with or without BEV (ICI/Chemo cohort). We used propensity score matching (PSM) to reduce bias. Results PD-L1 high and ICI/Chemo cohorts included 143 and 139 patients, respectively. In PD-L1 high cohort, 37 patients received ICI/Chemo. With PSM, the median progression-free survival was significantly longer in the ICI/Chemo group than in the pembrolizumab group (11.1 versus 3.9 mo, respectively, p = 0.0409). In the ICI/Chemo cohort, 23 patients received BEV. With PSM, no significant difference occurred in median progression-free survival between BEV and non-BEV groups (6.1 versus 7.4 mo, p = 0.9610). Conclusion ICI/Chemo seemed more effective than pembrolizumab monotherapy for patients with non-Sq NSCLC with MPE. Nevertheless, the synergistic effect of BEV with ICI/Chemo may be limited. Further studies are needed to clarify the key factor in the tumor-induced immunosuppression environment in these patients.
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22
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Okada M, Inoue K, Tanaka N, Masuda M, Furukawa Y, Hirata A, Egami Y, Watanabe T, Minamiguchi H, Miyoshi M, Sunaga A, Sotomi Y, Dohi T, Shungo H, Sakata Y. Impact of heart rate reduction on recurrence after catheter ablation of persistent atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.030] [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: Private company. Main funding source(s): Johnson & Johnson KK
OnBehalf
OCVC Arrhythmia Investigators
Background
Predicting heart rate (HR) after restoration of sinus rhythm (SR) remains one of the challenges when performing catheter ablation (CA) of persistent atrial fibrillation (AF).
Purpose
To evaluate the association between pre-ablation HR during AF and post-ablation HR during SR, and whether the HR reduction is associated with AF recurrence.
Methods
The analysis was performed from the EARNEST-PVI trial, a randomized controlled trial designed to assess a CA strategy for persistent AF, which was conducted in the Osaka region of Japan. After excluding patients with beta-blocker prescription, a total of 216 patients (median age, 67 years; 20% female; 23% long-standing persistent AF) with AF rhythm at baseline and SR at discharge were enrolled in this study. Baseline HR during AF and post-ablation HR during SR was measured on admission and at discharge using the 12-lead electrocardiograms, respectively.
Results
There was a mild correlation between baseline HR (median 82 [interquartile range 72-95] bpm) and post-ablation HR (78 [48-117] bpm) (r = 0.27, p <0.001). Reduction in HR was positively associated with baseline HR (r = 0.79, p <0.001) and was negatively associated with post-ablation HR (r = - 0.37, p <0.001). During the follow-up of 1 year, 56 patients (25.9%) experienced AF recurrence. HR reduction had the higher diagnostic accuracy in predicting AF recurrence than HR at baseline and HR after CA (area under the curve, 0.625; 95% confidence interval, 0.557–0.690; p = 0.003). AF recurrence rate was significantly higher in 141 patients with smaller HR reduction (cut-off, <14bpm) than those with larger HR reduction (31.9% vs. 14.7%, p = 0.009). After adjustment of age, gender, long-standing persistent AF, and CA strategy, HR reduction of <14 bpm was a significant predictor of AF recurrence (hazard ratio, 2.32; 95% confidence interval, 1.20–4.51; p = 0.013).
Conclusions
There was a mild correlation between HR during AF and HR after restoration of SR in patients underwent CA of persistent AF. HR reduction after restoration of SR predicted AF recurrence.
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Affiliation(s)
- M Okada
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - N Tanaka
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - M Masuda
- Kansai Rosai Hospital, Amagasaki, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - A Hirata
- Osaka Police Hospital, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Osaka, Japan
| | | | | | - M Miyoshi
- Osaka Kouseinenkin Hospital, Osaka, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - H Shungo
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Osaka, Japan
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23
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Nakagawa Y, Tamaki S, Yano M, Hayashi T, Yamada T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. Characteristics and prognosis in heart failure with preserved ejection fraction patients without left ventricular hypertrophy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0733] [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
Background
Clinical heterogeneity exists in heart failure with preserved ejection fraction (HFpEF). Left ventricular (LV) structure in HFPEF is characterized by normal LV cavity size and LV hypertrophy (LVH). However some of HFPEF patients do not have LV hypertrophy, and these patients may have distinct characteristics,
Purpose
The purpose of this study is to clarify the clinical characteristics and the prognosis for HFPEF patients without LVH.
Methods
We studied 1097 patients, who were hospitalized for acute decompensated heart failure with LVEF ≥50%, and enrolled in the PURSUIT-HFpEF registry. Laboratory testing and echocardiography were examined in the compensated stage (in stable condition after treatment of acute decompensated HF). We divided these patients into 2 groups based on LV mass index (LVMI) in the compensated stage according to the American Society of Echocardiography/European Association of Cardiovascular Imaging recommendations; patients with LVH (48%) and those without LVH (52%).
Results
Patients without LVH had significantly lower levels of C-reactive protein and N-terminal pro brain natriuretic peptide (NT-proBNP) and higher levels of estimated glomerular filtration rate in the compensated stage than those with it (p<0.05 for all). Cox hazard regression analysis showed that absence of LVH was favorably associated with the primary composite endpoint of all-cause death, HF rehospitalization, and cerebrovascular events (hazard ratio 0.776, 95% confidence interval 0.620-to 0.970, p<0.05).
On the other hand, the frequency of atrial fibrillation (Af) in the decompensated stage was higher in patients without LVH than those with it (52.1% vs 39.3%, p<0.001). Multivariate logistic analysis showed that absence of LVH was independently associated with presence of Af in the decompensated stage (odds ratio=1.520, 95% confidence interval 1.130 to 2.050, P<0.01)
Conclusions
HFPEF patients without LVH have less organ damage and favorable prognosis. Af may play a role in the decompensation of HF in HFPEF patients without LVH.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Roche Diagnostics K.K. (Grant number: not applicable)Fuji Film Toyama Chemical Co., Ltd. (Grant number: not applicable)
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Affiliation(s)
- Y Nakagawa
- Kawanishi city Hospital, Kawanishi, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | - M Yano
- Osaka Rosai Hospital, Division of Cardiology, Sakai, Japan
| | | | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
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24
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Iwakura K, Onishi T, Sotomi Y, Okada M, Koyama Y, Okamura A, Tamaki S, Yano M, Hayashi T, Yamada T, Yasumura Y, Fujii K, Hikoso S, Sakata Y. Prediction of functional capacity by the HFA-PEFF score in patients with acute decompensated heart failure with preserved ejection fraction: a post-hoc analysis from the PURSUIT-HFpEF registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0728] [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
Background
Diagnosing heart failure with preserved ejection fraction (HFpEF) is still challenging, and the H2FPEF- and the HFA-PEFF score were proposed as simple and reliable diagnostic tools. We recently reported that the HFA-PEFF score was significantly associated with the composite endpoint of all-cause death and heart failure readmission in patients with acute decompensated HFpEF (Sotomi. Eur J Heart Fail, in press).
Purpose
To investigate the relation whether the HFA-PEFF or H2FPEF score can evaluate functional capacity in patients with HFpEF
Methods
We calculated H2FPEF score and the second step of HFA-PEFF score among the registered patients in the PURSUIT-HFpEF (Prospective, Multicenter, Observational Study of Patients with Heart Failure with Preserved Ejection Fraction) study, which is a multicenter registration of patients hospitalized for acute decompensated HFpEF. We performed 6 minute walk (6MW) test and measured NT-proBNP before discharge. We followed the study patients for median of 360 days (IQR 237–630 days) to observe the major adverse cardiovascular events (MACE; composite of death, heart failure hospitalization and stroke).
Results
We enrolled 757 patients (age 81±9 years, male gender 45%) hospitalized for acute decompensated HFpEF for the present study. The H2FPEF score was obtained in 588 (77.7%) patients and all patients had ≥2 points. The HFA-PEFF score was obtained in 615 (81.2%) patients, though global longitudinal strain was not available. We divided these patients into 3 groups based on the HFA-PEFF score (score 2 to 4, 5, and 6) or on the H2FPEF score (score 0 to 3, 4 to 5 and 6 to 8). There were a significant difference in NT-pro BNP between 3 groups based on HFA-PEFF score (p=0.01, Table 1), and patients with score 6 had significantly higher NT-proBNP than those with score 2 to 4 (p=0.02). A significant difference was observed in 6MW distance among these groups (p=0.04, Table), and those with score 6 had significantly shorter distance than those with score 2 to 4 (p=0.04). Cox proportional hazard model selected HFA-PEFF score as a significant predictor for MACE, and Kaplan-Meier survival analysis demonstrated that classification of HFA-PEFF score significantly stratified the patients' risk for MACE. On the other hand, there was no significant difference in 6MW distance among 3 groups based on H2FPEF score (p=0.53), and H2FPEF score was not an independent predictor for MCE by the Cox model analysis. Moreover, the lowest H2PEF score group had higher NT-proBNP than other 2 groups (p=0.02)
Conclusions
The HFA-PEFF score predicted functional capacity as well as prognosis in patients hospitalized for HFpEF, while the H2PEF score did not.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- K Iwakura
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - T Onishi
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - M Okada
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - Y Koyama
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - A Okamura
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | - M Yano
- Osaka Rosai Hospital, Osaka, Japan
| | | | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - K Fujii
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Osaka, Japan
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Okada M, Inoue K, Tanaka N, Masuda M, Furukawa Y, Hirata A, Egami Y, Watanabe T, Minamiguchi H, Miyoshi M, Sunaga A, Sotomi Y, Dohi T, Hikoso S, Sakata Y. Reappraising the role of baseline plasma C-reactive protein levels on recurrence after catheter ablation of persistent atrial fibrillation: insight from EARNEST-PVI trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0507] [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
Background
Subclinical inflammation is an important pathogenesis of developing and sustaining atrial fibrillation (AF). Because AF itself contribute to the inflammatory response, the role of baseline subclinical inflammation on AF recurrence after catheter ablation (CA) remains controversial in patients with persistent AF.
Purpose
To evaluate whether baseline plasma C-reactive protein (CRP) levels, a sensitive marker of inflammation, are associated with AF recurrence following CA.
Methods
The analysis was performed from the EARNEST-PVI trial, a randomized controlled trial designed to assess a CA strategy for persistent AF, which was conducted in the Osaka region of Japan. A total of 441 patients (median age, 67 years; 26% female; 25% long-standing persistent AF) whose plasma CRP levels were measured at baseline were included in this study.
Results
At baseline, a median (interquartile range) of plasma CRP level was 0.10 [0.06–0.19] mg/dl. Plasma CRP levels significantly increased at discharge (0.83 [0.21–1.84] mg/dl, p<0.001) and decreased 1 year after CA (0.10 [0.05–0.20] mg/dl, p=0.040) compared to the baseline value. During the follow-up of 1 year, 115 patients (26%) experienced AF recurrence, and the incidence was significantly higher in 124 patients with low CRP levels at baseline (cut-off ≤0.06 mg/dl) than the other 317 patients (33.9% vs. 23.0%, p=0.017). After adjustment of age, gender, body mass index, long-standing persistent AF, CA strategy, and plasma brain natriuretic peptide levels, low plasma CRP levels was a significant predictor of AF recurrence (hazard ratio, 1.51; 95% confidence interval, 1.02–2.24; p=0.042).
Conclusions
Low plasma CRP levels at baseline predicted AF recurrence in the EARNEST-PVI trial. Reappraising the role of CRP on AF recurrence may be needed in patients with persistent AF.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Johnson & Johnson KK
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Affiliation(s)
- M Okada
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - N Tanaka
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - M Masuda
- Kansai Rosai Hospital, Amagasaki, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - A Hirata
- Osaka Police Hospital, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Osaka, Japan
| | | | | | - M Miyoshi
- Osaka Kouseinenkin Hospital, Osaka, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Osaka, Japan
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Tanaka N, Inoue K, Masuda M, Furukawa Y, Hirata A, Egami Y, Watanabe T, Minamiguchi H, Miyoshi M, Okada M, Sunaga A, Sotomi Y, Dohi T, Hikoso S, Sakata Y. Renal function and arrhythmia outcomes in persistent atrial fibrillation patients after catheter ablation: subanalysis of the EARNEST-PVI trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0532] [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
Background
Atrial fibrillation (AF) reduces the renal function. Renal dysfunction and AF often coexist. Catheter ablation (CA) of persistent AF can maintain a sinus rhythm and may improve the renal function.
Purpose
We sought to elucidate whether the estimated glomerular filtration rate (eGFR) in patients with persistent AF was increased after CA, especially with the presence of an AF recurrence.
Methods
We enrolled 487 persistent AF patients whose eGFR data were available both before and 1-year after the CA out of 512 patients in the EARNEST-PVI trial.
Results
The mean age was 65±9 year and 113 patients (24.8%) had long-standing persistent AF. We compared the eGFR at baseline with that 1-year after the CA. AF recurrences were recognized in 118 patients (25.8%). The eGFR was similar between the group without recurrence and that with recurrence at baseline (without AF recurrence vs. with AF recurrence; 63.8±14.3 vs. 62.7±13.6 mL/min/1.73m2, p=0.46). In patients without AF recurrence, the G1, G2, G3a, G3b, G4, and G5 were 13 (3.8%), 198 (58.4%), 98 (28.9%), 26 (7.7%), 3 (0.9%), and 1 (0.3%), respectively at baseline. In the patients with AF recurrence, the G1, G2, G3a, G3b, G4, and G5 were 3 (2.5%), 68 (57.8%), 38 (32.2%), 6 (5.1%), 3 (2.5%), and 0 (0%), respectively at baseline. The ΔeGFR was significantly higher in the patients without AF recurrence than in those with AF recurrence (without AF recurrence vs. with AF recurrence; 5.1 [−0.3, 10.8] vs. 3.0 [−3.0, 7.6], p=0.0033). In the patients without AF recurrence, a better eGFR class at 1-year after the CA than in those before the CA was recognized in 75 patients (22.1%), while it was recognized in 19 patients (16.1%) with AF recurrences.
Conclusion
Successful catheter ablation in patients with persistent AF led to a better renal outcome.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This study was funded by Medtronic, Johnson & Johnson, and Abbott.
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Affiliation(s)
- N Tanaka
- Sakurabashi-Watanabe Hospital, Cardiovascular Center, Osaka, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Cardiovascular Center, Osaka, Japan
| | - M Masuda
- Kansai Rosai Hospital, Amagasaki, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - A Hirata
- Osaka Police Hospital, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Sakai, Japan
| | - T Watanabe
- Osaka General Medical Center, Osaka, Japan
| | | | - M Miyoshi
- Osaka Hospital, Japan Community Healthcare Organization, Osaka, Japan
| | - M Okada
- Sakurabashi-Watanabe Hospital, Cardiovascular Center, Osaka, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Suita, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
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Watanabe T, Yamada T, Tamaki S, Yano M, Hayashi T, Yasumura Y, Hikosou S, Sotomi Y, Morita T, Furukawa Y, Kawasaki M, Kikuchi A, Kawai T, Sakata Y, Fukunami M. The impact of substrate and trigger ablation for reduction of functional mitral regurgitation in patients with persistent atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0477] [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
Background
Functional mitral regurgitation (FMR) is not uncommon in atrial fibrillation (AF) patients. Left atrial (LA) substrate remodeling and corresponding mitral valve annulus dilation has been reported as the most possible cause of FMR. Percutaneous catheter ablation (CA) is an effective treatment for AF. Although significant FMR could be improved by sinus restoration, patients with mitral regurgitation were more likely to experience recurrent AF post ablation, especially those with significant mitral regurgitation. There is no information available on the efficacy of CA for persistent AF in patients with FMR.
Purpose
The purpose of this study is to investigate the predictors of FMR improvement by CA and to determine the efficacy of substrate and trigger CA for persistent AF in patients with FMR.
Methods
We prospectively studied 512 consecutive patients admitted for persistent AF ablation from the EARNEST-PVI (Prospective Multicenter Randomized Study of Effect of Extensive Ablation on Recurrence in Patients with Persistent Atrial Fibrillation Treated with Pulmonary Vein Isolation) trial.
On admission, enrolled patients were randomly assigned in a 1:1 ratio to pulmonary vein isolation (PVI) or PVI-plus additional ablation (linear ablation or/and CFAE ablation). Of the 512 patients, we studied 94 patients with preoperative echocardiography showing moderate or greater baseline FMR. FMR grades were classified into 5 grades (0/1/2/3/4). The FMR improvement group (FMRI(+)) was defined as a case in which the FMR was improved by two or more grades compared the preoperative echocardiography and the one year follow-up examination.
Results
Of the 94 patients, 42 were in the PVI group and 52 were in the PVI-plus additional ablation group. There were 30 cases in the FMRI(+) group and 64 cases in the FMRI(−) group. There were no significant baseline differences in age, sinus rhythm maintenance, plasma B-type natriuretic peptide (BNP) level, left ventricular diastolic dimension, or left atrium dimension between the FMRI(+) and FMRI(−) groups. AF duration was significantly shorter in the FMRI(+) group than FMRI(−) groups (5.8±9.4 months vs 12.4±15.4 months, p<0.0001). In addition, significantly more additional ablation cases were observed in the FMRI(+) group than in the FMRI(−) group (73.3% vs 46.8%, p=0.016). In multivariate analyses, only additional ablation was an independent predictor of FMRI (odds ratio 0.226 95% CI 0.081–0.626; p=0.004).
Conclusions
Catheter ablation is a valid option for the treatment of AF in patients with functional MR and additional substrate and trigger ablation were the only independent predictor of FMR improvement.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Watanabe
- Osaka General Medical Center, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | - M Yano
- Osaka Rosai Hospital, Osaka, Japan
| | - T Hayashi
- Osaka Police Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - S Hikosou
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Morita
- Osaka General Medical Center, Osaka, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - M Kawasaki
- Osaka General Medical Center, Osaka, Japan
| | - A Kikuchi
- Osaka General Medical Center, Osaka, Japan
| | - T Kawai
- Osaka General Medical Center, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
| | - M Fukunami
- Osaka General Medical Center, Osaka, Japan
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Kanda T, Masuda M, Inoue K, Furukawa Y, Hirata A, Egami Y, Watanabe T, Minamiguchi H, Miyoshi M, Matsuda Y, Sunaga A, Sotomi Y, Dohi T, Hikoso S, Sakata Y. Differences in quality of life improvement with pulmonary vein isolation alone vs. more extensive ablation of persistent atrial fibrillation: insights from the EARNEST-PVI trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0512] [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
Background
Improving the quality of life (QoL) is one of the main purposes of catheter ablation (CA) of persistent atrial fibrillation (AF). QoL improvement in persistent AF patients has not been fully clarified. The EARNEST-PVI trial was a multi-center randomized trial comparing clinical outcomes of pulmonary vein isolation (PVI) alone and more intensive ablation in addition to PVI including complex fractionated atrial electrogram (CFAE) and linear ablation (PVI plus).
Purpose
To investigate the QoL change after persistent AF ablation and the differences between the PVI-alone strategy and the PVI plus strategy.
Methods
In the EARNEST-PVI trial, patients with persistent AF who underwent an initial catheter ablation (n=512) were randomly assigned in a 1:1 ratio to either PVI alone or PVI plus. Quality of life was assessed at baseline and at 12 months after ablation for AF using the 36-Item Short Form Health Survey. Scores were also converted to a physical health component summary (PCS), a mental health component summary (MCS) and a role/social component summary (RCS).
Results
In the EARNEST-PVI trial, the PVI alone strategy was associated with higher recurrence rate compared with the PVI plus additional ablation strategy. After excluding 68 patients for whom preoperative or postoperative QoL assessment was not available, 222 patients were evaluated respectively. Overall, significant improvements in PCS (46.2±11.4 to 48.7±11.4]), MCS (50.1±8.8 to 54.3±8.6) and RCS (44.6±13.3 to 48.6±11.3) occurred 12 months after ablation (P<0.001, respectively). Although significant QoL improvement occurred in both PVI alone and PLI plus strategies, the changes in PCS was greater in the PVI-plus than that in PVI-alone (3.5±10.3 vs 1.5±10.6, P=0.04).
Conclusions
Ablation for persistent atrial fibrillation improved both physical and mental quality of life. The PVI-plus strategy showed greater improvement in physical QoL.
Funding Acknowledgement
Type of funding sources: None. QoL improvement
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Affiliation(s)
- T Kanda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - M Masuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Cardiovascular center, Osaka, Japan
| | - Y Furukawa
- Osaka General Medical Center, Division of Cardiology, Osaka, Japan
| | - A Hirata
- Osaka Police Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - T Watanabe
- Yao Municipal Hospital, Division of Cardiology, Yao, Japan
| | - H Minamiguchi
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - M Miyoshi
- Japan Community Health care Organization Osaka Hospital, Division of Cardiology, Osaka, Japan
| | - Y Matsuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
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Saito G, Oya Y, Taniguchi Y, Kawachi H, Daichi F, Matsumoto H, Iwasawa S, Suzuki H, Niitsu T, Miyauchi E, Yokoi T, Yokoyama T, Uenami T, Sakata Y, Arai D, Okada A, Nagata K, Teraoka S, Kokubo M. Real-world survey of pneumonitis and its impact on durvalumab consolidation therapy in patients with non-small cell lung cancer who received chemoradiotherapy after durvalumab approval (HOPE-005/CRIMSON). Lung Cancer 2021; 161:86-93. [PMID: 34543942 DOI: 10.1016/j.lungcan.2021.08.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 07/17/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The incidence of real-world pneumonitis and durvalumab rechallenge during chemoradiotherapy and durvalumab consolidation for non-small cell lung cancer is unknown. MATERIALS AND METHODS We retrospectively evaluated the medical records of 302 consecutive patients diagnosed with non-small cell lung cancer who started chemoradiotherapy between May 2018 and May 2019. RESULTS Median age was 70 (range: 40-87) years. Volume of lung parenchyma that received 20 Gy (V20) exceeded 35% in 2% and mean lung dose exceeded 20 Gy in 1% of patients. Durvalumab consolidation was delivered to 225 patients (75%). Overall, 83% (n = 251), 34% (n = 103), 7% (n = 21), and 1% (n = 4) of the patients developed any grade of pneumonitis, symptomatic pneumonitis, ≥grade 3 pneumonitis, and fatal (grade 5) pneumonitis, respectively. Corticosteroids were administered to 25% of the patients to treat pneumonitis. Multivariate analysis identified the predictive factors for the development of symptomatic pneumonitis: V20 Gy or more ≥ 25% (odds ratio [OR]: 2.37, P = 0.008) and mean lung dose (MLD) ≥ 10 Gy (OR: 1.93, P < 0.0047). Of the 52 patients who received corticosteroids for pneumonitis after durvalumab initiation, 21 were rechallenged with durvalumab. Overall, 81% of patients met the PACIFIC study's rechallenge criteria and did not experience a severe pneumonitis relapse. CONCLUSION High V20 and MLD were independent risk factors of symptomatic pneumonitis. More than 80% of the patients who were rechallenged with durvalumab after pneumonitis met the PACIFIC study's rechallenge criteria. Consequently, severe relapse did not occur. Cooperation between radiation and medical oncologists is important for safe chemoradiotherapy and the safe completion of durvalumab consolidation therapy.
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Affiliation(s)
- Go Saito
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuko Oya
- Department of Thoracic Oncology, Aichi Cancer Center, Aichi, Japan.
| | - Yoshihiko Taniguchi
- Department of Internal Medicine, Kinki-chuo Chest Medical Center, Osaka, Japan
| | - Hayato Kawachi
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Fujimoto Daichi
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Shunichiro Iwasawa
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan; Medical Sciences Department, Medical Affairs Division, Chugai Pharmaceutical Co., Ltd, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Osaka, Japan
| | - Takayuki Niitsu
- Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan
| | - Eisaku Miyauchi
- Department of Respiratory Medicine, Tohoku University Hospital, Miyagi, Japan
| | - Takashi Yokoi
- Department of Thoracic Oncology, Hyogo College of Medicine, Hyogo, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama, Japan
| | - Takeshi Uenami
- Department of Thoracic Oncology, National Hospital Organization, Toneyama National Hospital, Osaka, Japan
| | - Yoshihiko Sakata
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Daisuke Arai
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Asuka Okada
- Department of Respiratory Medicine, Saiseikai Suita Hospital, Osaka, Japan
| | - Kenji Nagata
- Department of Respiratory Medicine, Itami City Hospital, Hyogo, Japan
| | - Shunsuke Teraoka
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masaki Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Hyogo, Japan
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30
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Terashima T, Higashibeppu Y, Yamashita T, Sakata Y, Azuma M, Fujimoto K, Munakata H, Ishii M, Kaneko S. 954P Comparison of medical costs and outcome between hepatectomy and radiofrequency ablation for hepatocellular carcinoma. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.174] [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: 11/30/2022] Open
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31
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Kaneko S, Ito K, Yuki S, Harada K, Yagisawa M, Sawada K, Ishiguro A, Muto O, Hatanaka K, Okuda H, Sato A, Sasaki Y, Nakamura M, Sasaki T, Tsuji Y, Ando T, Kato K, Wakabayashi T, Kotaka M, Takahashi Y, Sakata Y, Komatsu Y. P-81 HGCSG1901: A retrospective cohort study evaluating the safety and efficacy of S-1 and irinotecan plus bevacizumab in patients with metastatic colorectal cancer: Analysis of second-line treatment. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.136] [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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32
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Yoshikawa A, Ito K, Yuki S, Kawamoto Y, Saito R, Yamamura T, Yagisawa M, Ishiguro A, Muto O, Hatanaka K, Okuda H, Sato A, Sasaki Y, Nakamura M, Sasaki T, Kobayashi T, Dazai M, Nakatsumi H, Ueda A, Sakata Y, Komatsu Y. P-79 HGCSG1901: A retrospective cohort study evaluating the safety and efficacy of S-1 and irinotecan plus bevacizumab in patients with metastatic colorectal cancer: Analysis of second-line treatment after anti-EGFR antibody. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.134] [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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33
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Ito K, Yuki S, Nakano S, Yagisawa M, Sawada K, Ishiguro A, Muto O, Hatanaka K, Okuda H, Sato A, Sasaki Y, Nakamura M, Sasaki T, Kobayashi T, Dazai M, Nakatsumi H, Ueda A, Tateyama M, Sogabe S, Matsumoto R, Sakata Y, Komatsu Y. P-35 HGCSG1901: A retrospective cohort study evaluating the safety and efficacy of S-1 and irinotecan plus bevacizumab in patients with metastatic colorectal cancer: Analysis of first-line treatment. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.090] [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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34
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Asase M, Watanabe T, Takegami M, Nishimura K, Kinugawa K, Nishimura T, Toda K, Saiki Y, Niinami H, Nunoda S, Matsumiya G, Nishimura M, Arai H, Yanase M, Nakatani T, Sakata Y, Ono M, Nin K, Fukushima N. Impact of Type of Left Ventricular Assist Device (LVAD) on Health-Related Quality of Life during Prolonged LVAD Support. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1260] [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: 12/01/2022] Open
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35
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Okada T, Koseki M, Inui H, Kanno K, Saga A, Ohama T, Nishida M, Yamashita S, Sakata Y. Prevalence of coronary artery disease and achievement of low-density lipoprotein cholesterol management targets in familial hypercholesterolemia patients at Osaka University Hospital. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.136] [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: 11/28/2022]
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36
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Koseki M, Kanno K, Saga A, Chang J, Inui H, Okada T, Ohama T, Nishida M, Kamada Y, Miyoshi E, Yamashita S, Sakata Y. Immunometabolic disorder in cardiovascular system and liver mediated by long-term exposure to diet-derived oxidized cholesterol, 7-ketocholesterol. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.701] [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: 11/26/2022]
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37
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Iwakura K, Onishi T, Okada M, Inoue K, Koyama Y, Okamura A, Yamada T, Yasumura Y, Tamaki S, Hayashi T, Yano M, Fujii K, Hikoso S, Sakata Y. Validation of the HFA-PEFF- and H2FPEF score in Japanese patients with heart failure with preserved ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Diagnosing heart failure with preserved ejection fraction (HFpEF) still remains challenging, and simple and reliable diagnostic tools have been required. Recently, novel and evidence-based diagnostic algorithms for HFpEF were proposed, such as H2FPEF score (Circulation. 2018) and HFA-PEFF score (Eur Heart J 2019), and their accuracy was validated in the outside patient group. However, there are regional and ethnic variations in patient characteristics of HFpEF, particularly between Western and Asian countries, and it is not elucidated whether these diagnostic scores are useful in Asian population.
Purpose
To investigate the validity of the HFA-PEFF- and H2FPEF score in Japanese patients with HFpEF.
Methods
We calculated H2FPEF score and the second step of HFA-PEFF score among the registered patients in the PURSUIT-HFpEF (Prospective, Multicenter, Observational Study of Patients with Heart Failure with Preserved Ejection Fraction) study, which is a multicenter registration of patients hospitalized for HFpEF. The obtained scores were compared with the scores of the HFpEF cohort in the previous validation studies. We followed the study patients for median of 360 days (IQR 237–630 days) to observe the major adverse cardiovascular events (MACE; composite of death, heart failure hospitalization and stroke).
Results
We enrolled 757 patients hospitalized for HFpEF between June 2016 and August 2019 for the present study. H2FPEF score was obtained in 588 (77.7%) patients among them. Compared with the HFpEF cohorts in the previously reported sub-analysis of TOPCAT trial, the PURSUIT-HFpEF cohort had lower mean value of HFpEF score (4.0±1.8 points vs. 6.0±2.0 points in Americans or 5.3±1.9 points in Russians). It had significantly higher proportion (40.3%, p<0.001) of patients in the low likelihood of HFpEF category (0–3 points) than the TOPCAT cohorts (8.0% in Americans and 19.6% in Russians).
HFA-PEFF score was obtained in 615 (81.2%) patients, though global longitudinal strain was not available. The mean value of HFA-PEFF score was 5.0±0.8, and all patients had ≥2 points. The proportion of patients in the high likelihood of HFpEF category (5–6 points) was 88.3%, which was significantly higher (p<0.001) than those of the HFpEF cohort from Europe and USA in the previous validation study (Eur J Heart Fail 2019). There was no correlation between H2FPEF score and HFA-PEFF score (R=0.06, p=0.14). Cox proportional hazard model selected HFA-PEFF score as a significant predictor for MACE during follow-up period, whereas H2PEF score was not selected. Kaplan-Meier survival analysis demonstrated that patients with 6 points of HFA-PEFF score had higher incidence rate of MACE than those with ≤5 points (p=0.002).
Conclusion
The HFA-PEFF score could be more useful for the diagnosis and risk stratification for HFpEF than the H2PEF score in the Japanese cohort.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Roche Diagnostics K.K.; Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- K Iwakura
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - T Onishi
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - M Okada
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - Y Koyama
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - A Okamura
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Sakai, Japan
| | - K Fujii
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
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Kikuchi A, Yamada T, Watanabe T, Morita T, Furukawa Y, Tamaki S, Kawasaki M, Kawai T, Seo M, Yasumura Y, Hayashi T, Yano M, Hikoso S, Sakata Y. Impact of simple nutrition index on the long-term mortality of acute decompensated heart failure patients with preserved left ventricular ejection fraction: insight from PURSUIT-HFpEF registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1191] [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
Background
The novel nutrition index; triglyceride (TG) × total cholesterol (TG) × body weight (BW) index (TCBI) has been reported to be an easy and useful predictor for patients with coronary artery disease. However, there is no information available on the prognostic value of TCBI in patients with heart failure with preserved LVEF (HFpEF) who admitted with acute decompensated heart failure (ADHF).
Methods and results
Data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study. PURSUIT-HFpEF study is a prospective multicenter observational study in which collaborating hospitals recorded clinical, echocardiographic, and outcome data of ADHF pts with HFpEF. We enrolled consecutive 757 HFpEF patients who admitted with ADHF from June 2016 to June 2019. TCBI was calculated by the formula; TG × TC × BW / 1000 at the discharge. After we excluded patients with in-hospital death or without sufficient data, we analyzed 419 patients. The primary endpoint was all-cause mortality. During a median follow up period of 1.1 (0.9–1.9) years, 59 patients died. ROC analysis revealed that TCBI at discharge was a fair discriminator for predicting all-cause mortality (AUC 0.676, sensitivity 53%, specificity 78%). Multivariate Cox proportional analysis showed that TCBI (p=0.002) was an independent predictor for all cause death after adjustment with major confounders such as age, gender, NT-proBNP, hemoglobin and serum creatinine level. We divided patients into 4 groups according to quartiles of TCBI. Kaplan-Meier analysis showed a significantly higher risk of all-cause death in relation to the decrease in TCBI.
Conclusion
TCBI, a simple and novel nutrition index, is a useful and strong long-term prognostic indicator in ADHF patients with HFpEF.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Roche Diagnositics K.K.; Fuji Film Toyoma Chemical Co. Ltd.
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Affiliation(s)
- A Kikuchi
- Osaka General Medical Center, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - T Watanabe
- Osaka General Medical Center, Osaka, Japan
| | - T Morita
- Osaka General Medical Center, Osaka, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | - M Kawasaki
- Osaka General Medical Center, Osaka, Japan
| | - T Kawai
- Osaka General Medical Center, Osaka, Japan
| | - M Seo
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Amagasaki, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Sakai, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Osaka, Japan
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39
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Mori S, Hirai R, Sakata Y. Simulated Four-Dimensional CT for Markerless Tumor Tracking Using Deep Learning Network With Multi-Task Learning. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.647] [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: 11/17/2022]
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40
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Sera F, Ohtani T, Nakamoto K, Yamada T, Yasumura Y, Tamaki S, Hayashi T, Yano M, Hikoso S, Yamauchi-Takihara K, Sakata Y. Clinical characteristics and prognostic impact of pulmonary hypertension in heart failure with preserved ejection fraction: the PURSUIT HFpEF study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2286] [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
Background
Heart failure (HF) with preserved ejection fraction (HFpEF) can develop pulmonary hypertension (PH), which can result from pre-capillary PH as well as post-capillary PH. However, the prevalence and clinical significance of pre-capillary component of PH in HFpEF remain unknown.
Purpose
We aimed to investigate prevalence, clinical features, and prognostic impact of pre-capillary and/or post capillary PH associated with HFpEF.
Methods
From the PURSUIT-HFpEF (Prospective Multicenter Observational Study of Patients with Heart Failure with Preserved Ejection Fraction) registry, 204 patients (men: 46%, age: 79±9 years) who were hospitalized with HF and underwent right heart catheterization were divided into 4 groups according to the PH guidelines: non-PH, isolated post-capillary PH (Ipc-PH), pre-capillary PH, and combined pre- and post-capillary PH (Cpc-PH). Patients who had been diagnosed with idiopathic pulmonary arterial hypertension were excluded from the analysis.
Results
The prevalence of PH was 31% (Ipc-PH: 22%, pre-capillary PH: 3%, Cpc-PH: 6%). The prevalence of subcategories of PH was significantly different depending on mean right atrial pressure (RAP) (figure). Echocardiography at discharge showed no significant differences in RV diameter or TAPSE, but smaller LV diameter and higher E/e' in pre-capillary PH and Cpc-PH, which resulted in a higher operant diastolic elastance (Ed). Composite endpoint of all-cause mortality and HF hospitalization at 1 year occurred 13% in non-PH, 25% in Ipc-PH, 49% in pre-capillary PH, and 63% in Cpc-PH, respectively (p=0.001 by log-rank test).
Conclusions
Distinct prevalence of PH was observed in the groups with different RAP levels. Pre-capillary component of PH was associated with impaired LV diastolic function and worse outcomes in HFpEF.
Figure 1
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Roche Diagnostics K.K.; Fuji Film Toyama Chemical Co. Ltd
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Affiliation(s)
- F Sera
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Ohtani
- Osaka University Graduate School of Medicine, Suita, Japan
| | - K Nakamoto
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Amagasaki, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Sakai, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | | | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
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Kawai T, Nakatani D, Yamada T, Watanabe T, Morita T, Furukawa Y, Tamaki S, Kawasaki M, Kikuchi A, Seo M, Nakamura J, Hikoso S, Fukunami M, Sakata Y. Role of diuretics on long-term mortality may differ in volume status in patients with acute myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1598] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Diuretics has been reported to have a potential for an activation of the renin-angiotensin-aldosterone system and the sympathetic nervous system, leading to a possibility of poor clinical outcome in patients with cardiovascular disease. However, few data are available on clinical impact of diuretics on long-term outcome in patients with acute myocardial infarction (AMI) based on plasma volume status.
Methods
To address the issue, a total of 3,416 survived patients with AMI who were registered to a large database of the Osaka Acute Coronary Insufficiency Study (OACIS) were studied. Plasma volume status was assessed with the estimated plasma volume status (ePVS) that was calculated at discharge as follows: actual PV = (1 − hematocrit) × [a + (b × body weight)] (a=1530 in males and a=864 in females, b=41.0 in males and b=47.9 in females); ideal PV = c × body weight (c=39 in males and c=40 in females), and ePVS = [(actual PV − ideal PV)/ideal PV] × 100 (%). Multivariable Cox regression analysis and propensity score matching were performed to account for imbalances in covariates. The endpoint was all-cause of death (ACD) within 5 years.
Results
During a median follow-up period of 855±656 days, 193 patients had ACD. In whole population, there was no significant difference in long-term mortality risk between patients with and without diuretics in both multivariate cox regression model and propensity score matching population. When patients were divided into 2 groups according to ePVS with a median value of 4.2%, 46 and 147 patients had ACD in groups with low ePVS and high ePVS, respectively. Multivariate Cox analysis showed that use of diuretics was independently associated with an increased risk of ACD in low ePVS group, (HR: 2.63, 95% confidence interval [CI]: 1.22–5.63, p=0.01), but not in high ePVS group (HR: 0.70, 95% CI: 0.44–1.10, p=0.12). These observations were consistent in the propensity-score matched cohorts; the 5-year mortality rate was significantly higher in patients with diuretics than those without among low ePVS group (4.7% vs 1.7%, p=0.041), but not among high ePVS group (8.0% vs 10.3%, p=0.247).
Conclusion
Prescription of diuretics at discharge was associated with increased risk of 5-year mortality in patients with AMI without PV expansion, but not with PV expansion. The role of diuretics on long-term mortality may differ in plasma volume status. Therefore, prescription of diuretics after AMI may be considered based on plasma volume status.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Kawai
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - D Nakatani
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - T Watanabe
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - T Morita
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - Y Furukawa
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - S Tamaki
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - M Kawasaki
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - A Kikuchi
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - M Seo
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - J Nakamura
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Fukunami
- Osaka General Medical Center, Cardiology, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Osaka, Japan
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Kawasaki M, Yamada T, Watanabe T, Morita T, Furukawa Y, Tamaki S, Kikuchi A, Kawai T, Seo M, Fukunami M, Yasumura Y, Hayashi T, Yano M, Hikoso S, Sakata Y. Prognostic value of nutritional status in patients with heart failure with preserved ejection fraction, with and without atrial fibrillation: insights From PURSUIT-HFpEF Registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0859] [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
Background
Malnutrition is one of the most important comorbidities among heart failure (HF) patients, and serum cholinesterase (CHE) has been reported to be a prognostic factor in HF patients. On the other hand, atrial fibrillation (AF) is frequently observed in patients with HF with preserved ejection fraction (HFpEF). However, there is little information available on the prognostic value of nutritional status in HFpEF patients, with and without AF. We sought to clarify the prognostic value of CHE in HFpEF with and without AF and compare it with that of other nutrition indices such as gastric nutritional risk index (GNRI), controlling nutritional status (CONUT), and the prognostic nutritional index (PNI).
Methods and results
Patients data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study, which is a prospective multicenter observational registry for acute decompensated heart failure patients with left ventricular ejection fraction ≥50% in Osaka. We analyzed 380 patients (median age: 80 [75–87] years, male: 46%) after exclusion of patients with in-hospital death, missing follow-up data, or missing data to calculate nutritional indices. On admission, 155 patients had AF. Laboratory data were obtained at discharge. During a mean follow up period of 1.1±0.6 years, 131 patients had a composite endpoint (CE) of all-cause death and hospitalization for worsening heart failure or cerebrovascular disorder. In multivariate Cox analysis, in patients with AF, CHE was significantly associated with CE independently of age, gender and body mass index after the adjustment with serum albumin, total cholesterol levels and total lymphocyte count, while it was not significantly associated with CE in patients without AF. C-index of CHE (0.708) was higher than that of GNRI (0.555, p=0.0028), CONUT (0.651, p=0.208) and PNI (0.635, p=0.208) in AF patients, while there were no significant differences in those nutritional indices in patients without AF. Kaplan-Meier curve analysis revealed that AF patients with lower CHE (<208 U/L = median value) had higher risk of CE than those with higher CHE (44% vs 18%, adjusted HR 3.26 95% CI [1.66–6.67], p=0.0005), while there was no significant difference in the occurrence rate of CE between patients with and without higher CHE in non-AF group (42% vs 31%, adjusted HR 1.28 95% CI [0.78–2.13], p=0.33).
Conclusions
Prognostic value of CHE would be stronger than other nutritional indices in HFpEF patients with AF, while it would be weak in HFpEF patients without AF.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Roche Diagnostics K.K.; Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- M Kawasaki
- Osaka General Medical Center, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - T Watanabe
- Osaka General Medical Center, Osaka, Japan
| | - T Morita
- Osaka General Medical Center, Osaka, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | - A Kikuchi
- Osaka General Medical Center, Osaka, Japan
| | - T Kawai
- Osaka General Medical Center, Osaka, Japan
| | - M Seo
- Osaka General Medical Center, Osaka, Japan
| | - M Fukunami
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital, Amagasaki, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
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Okada M, Inoue K, Onishi T, Iwakura K, Yamada T, Yasumura Y, Tamaki S, Hayashi T, Yano M, Hikoso S, Sakata Y. The impact of frailty and aging on prognosis in patients with heart failure with preserved ejection fraction – insights from PURSUIT-HFpEF registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0961] [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
Frailty and aging are two common conditions both associated with increased vulnerability to stressful events with high risk of adverse outcomes.
Purpose
To evaluate the association between frailty and aging and their impacts on clinical outcome in patients with heart failure with preserved ejection fraction (HFpEF).
Methods
Analysis was performed from a prospective multicenter observational registry for HFpEF (PURSUIT-HFpEF Registry) conducted in the Osaka region of Japan. A total of 757 patients hospitalized for acute heart failure (diagnosed by using Framingham criteria) met the inclusion criteria: a left ventricular ejection fraction ≥50% and brain natriuretic peptide ≥100pg/ml. We included 483 patients (age, 80±9 years; men, 45%; atrial fibrillation, 35%) whose follow-up data after survival discharge were available. Patients' frailty and aging were evaluated using the clinical frailty scale (CFS) and age quartiles (Q1: <76 years (n=122), Q2: 76–82 years (n=111), Q3: 82–87 years (n=127), Q4: >87 years (n=123)), respectively. The primary clinical endpoint was defined as the composite of death, re-hospitalization for heart failure, and cerebrovascular accident.
Results
The median (interquartile range) CFS rating was 3 (2–5), and there was a little correlation between CFS rating and age (r2=0.16, p<0.001). The prevalence of frailty, defined as a CFS rating >4 (n=132), was positively correlated with age quartiles (Q1: 9.0%, Q2: 21.4%, Q3: 29.9%, Q4: 48.0%, p<0.001). During the median follow-up period 396 days (interquartile range, 344–698) after discharge, the clinical endpoint was observed in 172 patients. The incidence was higher in patients with frailty than those without it (49.6% vs. 30.4%, log-rank p<0.001). It was also correlated with age quartiles (Q1: 23.0%, Q2: 34.2%, Q3: 36.2%, Q4: 48.8%, log-rank p=0.001). Multivariate Cox regression analysis revealed that frailty (hazard ratio, 1.52; 95% confidence interval, 1.09–2.10; p=0.013) and age (hazard ratio per quartile increase, 1.24; 95% confidence interval, 1.07–1.43; p=0.004) were both associated with the clinical endpoint. Subgroup analysis in 352 patients without frailty also revealed the significant impact of age on the endpoint (1.26; 1.06–1.51; p=0.008). However, in 131 patients with frailty, there was no significant impact of age on the endpoint (1.16; 0.90–1.51; p=0.25).
Conclusions
Frailty was common and was associated with aging in HFpEF patients. Although they were both associated with unfavorable events, aging was no longer a significant predictor of adverse outcomes under the frailty conditions.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Roche Diagnostics K.K. and Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- M Okada
- Sakurabashi Watanabe Hospital, Osaka, Japan
| | - K Inoue
- Sakurabashi Watanabe Hospital, Osaka, Japan
| | - T Onishi
- Sakurabashi Watanabe Hospital, Osaka, Japan
| | - K Iwakura
- Sakurabashi Watanabe Hospital, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Osaka, Japan
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Okada M, Inoue K, Onishi T, Iwakura K, Yamada T, Yasumura Y, Tamaki S, Hayashi T, Yano M, Hikoso S, Sakata Y. The comparison of clinical significance between atrial and ventricular structural remodeling in patients with heart failure with preserved ejection fraction – insights from PURSUIT-HFpEF registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0845] [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
Structural remodeling is an important aspect of pathophysiology of heart failure (HF). The compensatory mechanism against diastolic dysfunction would be more obvious on the left atrium rather than left ventricle in HF with preserved ejection fraction (HFpEF).
Purpose
To investigate the impact of left atrial (LA) and left ventricular (LV) remodeling on clinical outcomes in HFpEF patients.
Methods
Analysis was performed from a prospective multicenter observational registry for HFpEF (PURSUIT-HFpEF Registry) conducted in the Osaka region of Japan. A total of 757 patients hospitalized for acute HF (diagnosed by using Framingham criteria) met the inclusion criteria: a LV ejection fraction ≥50% and brain natriuretic peptide ≥100pg/ml. We included 381 patients (age, 82±9 years; men, 45%; atrial fibrillation (AF), 34%) whose follow-up data after survival discharge were available and whose LA volume index (LAVI) and left ventricular end-diastolic volume index (LVEDVI) at discharge were measured by the biplane Simpson's method using echocardiography. The primary endpoint was defined as the composite of death, re-hospitalization for HF, and cerebrovascular accident.
Results
The LAVI and LVEDVI at discharge was 54±25 ml/m2 and 55±21 ml/m2, respectively (r2=0.014, p=0.021). When patients were classified into the LAVI tertiles groups (T1: <40ml/m2 (n=124), T2: 41–59ml/m2 (n=127), T3: >60ml/m2 (n=130)), there was a positive correlation between the prevalence of diastolic dysfunction and the LAVI tertiles (T1, 21.0%; T2, 48.8%; T3, 51.5%; p<0.001). On the other hand, significant association was not observed between the prevalence of diastolic dysfunction and the LVEDVI tertile groups (p=0.42). During the median follow-up period of 396 days (IQR, 345–698), the composite endpoint was observed in 131 patients and there was a positive correlation between the endpoint and the LAVI tertiles (T1, 24.2%; T2, 38.6%; T3, 40.3%; p=0.011). On the other hand, no correlation was found between the endpoint and the LVEDVI tertiles (p=0.13). After adjustment for age, gender, and presence of diastolic dysfunction, Cox regression analysis revealed that not LVEDVI but LAVI at discharge was a significant predictor of the composite endpoint in the entire cohort (hazard ratio per 10 ml/m2 increase; 1.09; 95% confidence interval, 1.02–1.16; p=0.009) and in the sinus rhythm subgroup (1.10; 1.01–1.20; p=0.034). However, not LAVI but LVEDVI was a significant predictor for the adverse outcomes in the AF subgroup (1.23; 1.04–1.46; p=0.016).
Conclusions
Increased LAVI at discharge, which was associated with diastolic dysfunction, related to unfavorable prognosis in patients with HFpEF. However, LAVI was no more a predictor for the adverse outcomes but LVEDVI was in the AF subgroup. The clinical significance of atrial and ventricular remodeling may differ between sinus rhythm and AF rhythm in HFpEF population.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Roche Diagnostics K.K. and Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- M Okada
- Sakurabashi Watanabe Hospital, Osaka, Japan
| | - K Inoue
- Sakurabashi Watanabe Hospital, Osaka, Japan
| | - T Onishi
- Sakurabashi Watanabe Hospital, Osaka, Japan
| | - K Iwakura
- Sakurabashi Watanabe Hospital, Osaka, Japan
| | - T Yamada
- Osaka General Medical Center, Osaka, Japan
| | - Y Yasumura
- Amagasaki Central Hospital, Amagasaki, Japan
| | - S Tamaki
- Osaka General Medical Center, Osaka, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Osaka, Japan
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Kimura T, Ito T, Honda S, Nishihira K, Kojima S, Takegami M, Asaumi Y, Suzuki M, Kosuge M, Takahashi J, Sakata Y, Takayama M, Sumiyoshi T, Kimura K, Yasuda S. Sex differences in door-to-balloon time and long-term adverse events after percutaneous coronary intervention for acute coronary syndrome: a sub-study from the Prospective JAMIR study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3177] [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
Background
Shortening of onset to admission time (OAT) and door-to-balloon time (DBT) is associated with lower adverse cardiac event after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Bleeding event also results in poor outcome in patients with AMI after primary PCI. Little is known about sex differences in DBT and ischemic, bleeding events after AMI.
Purpose
This study aimed to assess the sex differences of OAT, DTB and adverse cardiac event, incident of bleeding event after primary PCI in patients with AMI.
Methods
The Japan AMI Registry (JAMIR) is a multicenter, nationwide, prospective registry enrolling patients with AMI from 50 institutes between December 2015 and May 2017. Primary endpoints of this study were ischemic event (composite of cardiovascular death, myocardial infarction and ischemic stroke) and bleeding event (BARC type 3 or 5,).Median follow-up period was 12 months.
Results
A total of 3,411 patients were enrolled at first. Among them, 329 patients without treated with PCI and 199 patients missing OAT time were excluded from this study. A total 2883 patients of men (n=2240, 77.7%) and women (n=643, 22.3%) were enrolled. OAT and DBT of women were significantly longer than that of men (OAT: 130min, interquartile range 62–300 min vs. 155 min, interquartile range 69–350 min, p=0.040, DBT: 67 min, interquartile range 50–95 min vs. 75 min, interquartile range 53–120 min, p<0.001). There was no significant difference in ischemic events between men and women (7.1% vs. 7.5%, log-rank p=0.741, Figure 1). Multivariate Cox regression analysis showed female sex was significantly associated with lower ischemic event (hazard ratio 0.57; 95% confidence interval 0.38–0.85; p=0.007). Bleeding event of women was significantly higher than that of men (BARC type 3 or 5: 3.8% vs. 7.8%, p<0.001, Figure 2).
Conclusion
The real-world database of the JAMIR showed that the female sex was significant factor for the delay in primary percutaneous coronary intervention and high incident of bleeding, however, ischemic event was lower than that of male sex. Sex difference appears to be associated with ischemic and bleeding event after acute myocardial infarction.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Kimura
- Iwate Medical University, Morioka, Japan
| | - T.I Ito
- Iwate Medical University, Morioka, Japan
| | - S Honda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | | | - S Kojima
- Kawasaki Medical School, Kurashiki, Japan
| | - M Takegami
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Suzuki
- Sakakibara Heart Institute, Fuchu, Japan
| | - M Kosuge
- Yokohama City University Hospital, Yokohama, Japan
| | | | - Y Sakata
- Tohoku University, Sendai, Japan
| | - M Takayama
- Sakakibara Heart Institute, Fuchu, Japan
| | | | - K Kimura
- Yokohama City University Hospital, Yokohama, Japan
| | - S Yasuda
- National Cerebral & Cardiovascular Center, Suita, Japan
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Shiraki T, Ohtani T, Kioka H, Mizote I, Tsukamoto Y, Nakamura D, Yokoi K, Ide S, Nakamoto K, Takeda Y, Hikoso S, Sawa Y, Sakata Y. Serial evaluation of cardiac allograft vasculopathy after heart transplantation by dual-modality intravascular ultrasound and optical coherence tomography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1293] [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
Background
Cardiac allograft vasculopathy is a combination of the development of de novo plaque and the progression of donor-transmitted plaque.
Purpose
This study aimed to evaluate the development of de novo plaque and the progression of donor-transmitted plaque within 12-month after heart transplantation (HTx) using serial intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The association between inflammatory cytokines and plaque progression was also examined.
Methods
We prospectively enrolled 40 recipients to conduct serial three-vessel IVUS and OCT analysis at 8-week and 12-month after HTx. De novo plaque was defined as having maximum intimal thickness (MIT) ≥0.5 mm at 12-month in the absence of donor-transmitted plaques (MIT ≥0.5 mm at 8-week). Serum cytokines were screened with a bead-based multiplex assay.
Results
A total of 13 de novo plaques (fibrous, n=10; fibroatheroma, n=3) were detected in eight recipients. Serum interleukin (IL)-31 at 8-week was associated with the development of de novo plaques (p=0.009). A total of 31 donor-transmitted plaques (fibrous, n=12; fibroatheroma, n=11; fibrocalcific, n=8) were detected in 17 recipients. Multiple regression analysis revealed that fibrous (p=0.026) and fibroatheroma (p=0.012) observed at 8-week were significantly associated with subsequent plaque progression within 12-month after HTx. ΔPlaque burden was significant higher in de novo plaque than donor-transmitted plaque (38.8% [29.6–41.2] versus 8.7% [1.3–13.6], p<0.001). The prevalence of macrophage accumulation was lower in de novo plaque than in donor-transmitted plaque (8% versus 52%, p=0.006). Serum IL-31 at 8-week was correlated with the progression of donor-transmitted plaque as well as de novo plaque (r=0.663, p=0.029) although other cytokines like IL-1β, IL-6, IL-17, and tissue necrotic factor alpha were not.
Conclusions
In de novo plaques, fibrous plaque was the most common and macrophage accumulation was rarely observed. In donor-transmitted plaque, fibrous and fibroatheroma were independent predictor for the subsequent plaque progression. Serum interleukin-31 surge at subacute phase may play pathogenic role in cardiac allograft vasculopathy.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grants-in-Aid for Scientific Research (KAKENHI)
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Affiliation(s)
- T Shiraki
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - T Ohtani
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - H Kioka
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - I Mizote
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - Y Tsukamoto
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - D Nakamura
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - K Yokoi
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - S Ide
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - K Nakamoto
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - Y Takeda
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
| | - Y Sawa
- Osaka University Graduate School of Medicine, Cardiovascular Surgery, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Cardiovascular Medicine, Suita, Japan
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Shindo Y, Nakatsumi H, Yuki S, Kawamoto Y, Muto O, Dazai M, Harada K, Kobayashi Y, Sogabe S, Katagiri M, Kotaka M, Nakamura M, Hatanaka K, Ishiguro A, Tsuji Y, Kobayashi T, Tateyama M, Sasaki Y, Sasaki T, Takagi R, Sakata Y, Komatsu Y. P-112 HGCSG1801: A phase II trial of 2nd-line FOLFIRI plus aflibercept in patients with metastatic colorectal cancer refractory to anti-EGFR antibody. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.194] [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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Ando T, Ito K, Yuki S, Saito R, Nakano S, Nakatsumi H, Kawamoto Y, Dazai M, Miyashita K, Hatanaka K, Harada K, Miyagishima T, Hisai H, Ishiguro A, Ueda A, Kato T, Sasaki T, Shindo Y, Yokota I, Takagi R, Sakata Y, Komatsu Y. P-98 HGCSG1902: Multicenter, prospective, observational study for cases with dysgeusia caused by chemotherapy for gastrointestinal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.180] [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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Saito G, Oya Y, Taniguchi Y, Kawachi H, Fujimoto D, Matsumoto H, Iwasawa S, Suzuki H, Niitsu T, Miyauchi E, Yokoi T, Mitsui M, Uenami T, Sakata Y, Arai D, Okada A, Hara S, Teraoka S, Kokubo M. Real-world survey of pneumonitis/radiation pneumonitis among patients with locally advanced non-small cell lung cancer treated with chemoradiotherapy after durvalumab approval: A multicenter retrospective cohort study (HOPE-005/CRIMSON). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9039 Background: Durvalumab was approved as a consolidation therapy after chemoradiotherapy (CRT) for locally advanced non-small cell lung cancer (NSCLC) and established as the standard of care. However, since the approval of durvalumab, little has been reported on the frequency, severity, or clinical course of pneumonitis/radiation pneumonitis throughout the course of CRT. Methods: We conducted a 17-center, retrospective cohort study of consecutive patients with locally advanced NSCLC who received concurrent chemoradiotherapy (CCRT) with platinum-based chemotherapy between May 2018 and May 2019. Results: A total of 275 patients were included; their median age was 69.9 (range, 40.3-87.5), mean V20 was 19.4% (range, 1.4-37.9), and mean "mean lung dose" was 10.9 Gy (range, 1.5-31.3). Of these, 204 patients received durvalumab consolidation therapy (74.2%). Median follow-up time from the initiation of CCRT was 8.4 months (range, 1.5-15.7). During follow-up, 225 patients (81.8%) developed any-grade pneumonitis/radiation pneumonitis. Of these, more than half (134 of 225) were asymptomatic (grade 1), 18 (6.5%) were ≥grade 3, and 4 patients (1.5%) had fatal pneumonitis/radiation pneumonitis. By the time of initial assessment of response to CCRT, 64 (23.3%) patients had developed radiation pneumonitis. Logistic regression revealed that only V20 ≥25 % was an independent risk factor of symptomatic (≥grade 2) pneumonitis/radiation pneumonitis (OR: 2.74, 95% CI: 1.35-5.53, p = 0.0045). Of the 275 patients, 67 were treated with corticosteroids for pneumonitis/radiation pneumonitis (24.7%), and 14 (5.1%) needed home oxygen therapy after the treatment of pneumonitis/radiation pneumonitis. Among patients treated with corticosteroids, 21 patients received durvalumab rechallenge. Of the 21 patients, 6 (29%) showed pneumonitis/radiation pneumonitis relapse, of which 3 (14%) resulted in suspension of durvalumab rechallenge, but none were fatal. Conclusions: Although over four-fifths of the patients treated with CCRT after the approval of durvalumab developed pneumonitis/radiation pneumonitis, more than half of them were asymptomatic, and ≥grade 3 events accounted for 6.5%. Sometimes patients needed corticosteroid therapy, which was in many occasions effective, and some also underwent durvalumab rechallenge. V20 was an independent risk factor of symptomatic pneumonitis/radiation pneumonitis.
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Affiliation(s)
- Go Saito
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuko Oya
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yoshihiko Taniguchi
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hayato Kawachi
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Daichi Fujimoto
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Shunichiro Iwasawa
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino-Shi, Japan
| | - Takayuki Niitsu
- Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan
| | - Eisaku Miyauchi
- Department of Respiratory Medicine, Tohoku University Hospital, Sendai, Japan
| | - Takashi Yokoi
- Department of Thoracic Oncology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Miho Mitsui
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takeshi Uenami
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Osaka, Japan
| | - Yoshihiko Sakata
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Daisuke Arai
- Pulmonary Division, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Asuka Okada
- Department of Respiratory Medicine, Saiseikai Suita Hospital, Osaka, Japan
| | - Satoshi Hara
- Department of Respiratory Medicine, Itami City Hospital, Osaka, Japan
| | - Shunsuke Teraoka
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masaki Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
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Oya Y, Saito G, Tamiya A, Kawachi H, Fujimoto D, Iwasawa S, Suzuki H, Niitsu T, Matsumoto H, Miyauchi E, Yokoi T, Mitsui M, Uenami T, Sakata Y, Nakachi I, Okada A, Hara S, Teraoka S, Kokubo M. Predictive value of the Lung Immune Prognostic Index (LIPI) in locally advanced non-small-cell lung cancer (NSCLC) patients treated with concurrent chemoradiotherapy (CCRT) in the multicenter retrospective study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e21076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21076 Background: PD-L1 inhibitor, durvalumab has been approved since the PACIFIC study showed its efficacy as consolidation therapy after CCRT for locally advanced NSCLC. But predictive factor for the efficacy of CCRT on this post PACIFIC era have not been known. LIPI has been proposed as a new biomarker for the anti-PD-1 therapy of advanced NSCLC. In this study, we investigated the usefulness of LIPI as a predictive marker in multicenter cohort of patients with locally advanced NSCLC who received CCRT as initial treatment. Methods: 219 patients with available baseline LIPI were reviewed. The progression free survival (PFS) was estimated by the Kaplan-Meier method, and LIPI were calculated at baseline. Kaplan-Meier estimates of PFS and recurrence were compared using the log-rank test for trend. Multivariable analysis was conducted using the Cox and logistic regression models, respectively, adjusted for age, sex, ECOG-PS, smoking, histology, TNM stage, chemotherapy regimens, Body mass index (BMI), PD-L1 status, EGFR or ALK mutation, and baseline LIPI. Results: 62.5% (n = 137) of the patients had a good (0 factors) LIPI, while 37.5% (n = 82) had intermediate (1 factor) and poor (2 factors) LIPI respectively. In multivariable analysis, good LIPI (0 factors) were significantly associated with longer PFS (HR = 0.46, 95% CI 0.28-0.75; P < 0.01) as did ECOG-PS0 (P < 0.01), ≤stageIIIA (P < 0.01), being treated with durvalumab after CRT (P = 0.04). There were no difference in the patient characteristics between good LIPI and intermediate/poor LIPI, significantly. Higher LIPI (1 or 2 factors) were strongly prognostic factor for recurrence after CCRT in multivariate analysis (P = 0.04), along with ECOG-PS1≤ (P < 0.01), stage IIIB≤ (P < 0.01). Conclusions: The good LIPI predictive value for PFS and disease control in patients treated with CCRT was confirmed. Although a strong statistical significance, we needs to be confirmed further with longer follow-up and prospective study.
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Affiliation(s)
- Yuko Oya
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Go Saito
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akihiro Tamiya
- Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Hayato Kawachi
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Daichi Fujimoto
- Department of Respiratory Medicine, Kobe City Medical Center, General Hospital, Kobe, Japan
| | | | - Hidekazu Suzuki
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino-Shi, Japan
| | - Takayuki Niitsu
- Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan
| | - Hirotaka Matsumoto
- Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Eisaku Miyauchi
- Department of Respiratory Medicine, Tohoku University Hospital, Sendai, Japan
| | - Takashi Yokoi
- Department of Thoracic Oncology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Miho Mitsui
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takeshi Uenami
- Department of Thoracic Oncology, National Hospital Organization Osaka Toneyama Medical Center, Osaka, Japan
| | - Yoshihiko Sakata
- Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Ichiro Nakachi
- Pulmonary Division, Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Asuka Okada
- Department of Respiratory Medicine, Saiseikai Suita Hospital, Osaka, Japan
| | - Satoshi Hara
- Department of Respiratory Medicine, Itami City Hospital, Osaka, Japan
| | - Shunsuke Teraoka
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masaki Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
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