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Matsuda M, Suzuki M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Iguchi M, Abe M, Akao M, Hasegawa K, Wada H. Involvement of growth differentiation factor 15 in paradoxical relationship between body mass index and mortality in patients with suspected or known coronary artery disease; The ANOX Study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2391] [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
Obesity is a well-established risk factor for type 2 diabetes mellitus, hypertension and dyslipidemia, leading to coronary artery disease (CAD). Nevertheless, body mass index (BMI) is inversely associated with cardiovascular (CV) mortality in patients with cardiac disorders, termed “obesity paradox”. However, the underlying mechanism remains unclear.
Purpose
To clarify important factors involved in the pathogenesis of obesity paradox.
Methods
Using data from a multicenter, prospective cohort of 2,418 patients with suspected or known CAD enrolled in the ANOX study, we assessed the relationship between BMI at baseline and the incidence of CV death over 3 years, and investigated the involvement of several endocrine factors which were previously reported to have some roles in obesity and heart diseases, such as adiponectin, N-terminal pro-brain natriuretic peptide (NT-proBNP) and growth differentiation factor 15 (GDF-15), in the relationship between BMI and CV death.
Results
In Kaplan-Meier analyses, the lower quartiles of BMI and the higher quartiles of adiponectin levels were paradoxically associated with the higher cumulative incidence of CV death. To clarify the important factors involved in the paradoxical association between BMI or adiponectin and mortality, we first investigated independent determinants for BMI and adiponectin levels respectively, using multiple stepwise regression analyses among many clinical factors, and then narrow down the prognostic factors commonly associated with BMI and adiponectin, which were age, hemoglobin and NT-proBNP. Interestingly, circulating levels of GDF15 were significantly correlated with NT-proBNP levels, and the presence of anemia raised the gradient of the correlation line in a scatter plot (without anemia, r=0.139, p<0.0001; with anemia, r=0.228, p<0.0001). Moreover, the highest GDF15 quartile showed significantly lower BMI and higher adiponectin levels compared to the lower quartiles (p<0.001 and p<0.001, respectively, by Student t-test). In Cox proportional hazard models, hazard ratios (HRs) of BMI (per 1-unit increase) were 0.90 (95% confidence interval [CI], 0.85–0.96) for CV death. Additional adjustment for hemoglobin, NT-proBNP, adiponectin or GDF15 diminished the statistical significance (HR, 0.92 [95% CI, 0.87–0.99], 0.95 [0.89–1.01], 0.92 [0.87–0.99], or 0.93 [0.87–0.99], respectively).
Conclusions
The lower BMI and the higher adiponectin levels were paradoxically associated with the higher incidence of CV death in patients with CAD. This paradox may be mediated by cardiac endocrine factors induced by cardiac stresses, including GDF-15 in addition to natriuretic peptides.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital , Hakodate , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital , Sagamihara , Japan
| | - M Iguchi
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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2
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Iguchi M, Wada H, Shinozaki T, Suzuki M, Ajiro Y, Matsuda M, Koike A, Koizumi T, Shimizu M, Ono Y, Takenaka T, Kotani K, Abe M, Akao M, Hasegawa K. Vascular endothelial factor C and D in patients with heart failure with preserved, mildly reduced, and reduced ejection fraction: the PREHOSP-CHF study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.916] [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
The lymphatic system has been suggested to play an important role in cardiovascular diseases including heart failure (HF). Vascular endothelial growth factor C (VEGF-C) and D (VEGF-D) are key regulators of lymphangiogenesis, and we recently reported the association of low VEGF-C with the risk of all-cause death and high VEGF-D with the risk of HF hospitalization in patients with HF.
Purpose
To investigate the association of VEGF-C and VEGF-D with prognosis in patients with HF with preserved ejection fraction (EF) (HFpEF: EF≥50%), mildly reduced EF (HFmrEF: EF, 40–49%), and reduced EF (HFrEF: EF<40%).
Methods
The PREHOSP-CHF study is a multicenter prospective cohort study to determine the predictive value of angiogenesis-related biomarkers in HF. A total of 1,024 patients (mean age 75.5±12.6 years; 58.7% male) admitted to acute decompensated HF were included in the analyses. Serum levels of VEGF-C and VEGF-D, as well as N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin-I (hs-cTnI), high sensitivity C reactive protein, were measured at the time of discharge. Patients were followed-up over two years.
Results
The numbers of HFpEF, HFmrEF, and HFrEF were 429 (41.9%), 186 (18.2%), and 409 (39.9%), respectively. HFpEF patients were older, more likely to be female, and had more hypertension, atrial fibrillation, and anemia, but less coronary artery disease. NT-proBNP and hs-cTnI levels increased with decreasing EF. VEGF-C levels decreased with increasing EF (median [interquartile range]: HFpEF, 4508 [3318–5919] pg/ml; HFmrEF, 4719 [3663–6203] pg/ml; HFrEF, 5023 [3804–6382] pg/ml), whereas VEGF-D levels were comparable among the three EF groups (HFpEF, 404.6 [293.1–560.3] pg/ml; HFmrEF, 386.0 [298.5–556.3] pg/ml; HFrEF, 414.2 [296.1–557.3] pg/ml). In multivariate stepwise logistic regression analyses, anemia and high NT-proBNP were independently associated with low VEGF-C levels, and high NT-proBNP was independently associated with high VEGF-D levels, across all the EF groups. During the follow-up, incidences of all-cause death and HF hospitalizations were similar among the three EF groups (log-rank P=0.6 for all-cause death, and log-rank P=0.3 for HF hospitalization). On multivariate Cox proportional hazard analyses including established risk factors and cardiovascular biomarkers, VEGF-C levels tended to be inversely associated with the incidence of all-cause death in patients with HFpEF and HFrEF (Figure). On the contrary, VEGF-D levels were significantly and positively associated with the incidence of HF hospitalization in patients with HFpEF, and tended to be positively associated with it in patients with HFmrEF and HFrEF (Figure).
Conclusions
Low VEGF-C was associated with the risk of all-cause death in patients with HFpEF and HFrEF, while high VEGF-D was associated with the risk of HF hospitalization especially in HFpEF.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Grant-in-Aid for Clinical Research from the National Hospital Organization
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Saitama , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - A Koike
- National Hospital Organization Fukuokahigashi Medical Center , Fukuoka , Japan
| | - T Koizumi
- National Hospital Organization Mito Medical Center , Ibaraki , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - Y Ono
- National Hospital Organization Higashihiroshima Medical Center , Hiroshima , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - K Kotani
- Jichi Medical University , Tochigi , Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
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3
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Wada H, Shinozaki T, Suzuki M, Sakagami S, Ajiro Y, Funada J, Matsuda M, Shimizu M, Takenaka T, Morita Y, Wada K, Kotani K, Abe M, Akao M, Hasegawa K. Associations of soluble fms-like tyrosine kinase-1 with cardiovascular events and stroke in patients with atrial fibrillation and suspected or known coronary artery disease: the EXCEED-J study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.544] [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) increases the risk of stroke. Soluble fms-like tyrosine kinase-1 (sFlt-1), a vascular endothelial growth factor (VEGF) antagonist, has been suggested as a marker of endothelial dysfunction, which are associated with both AF and coronary artery disease (CAD). Recently, we demonstrated that sFlt-1 is independently associated with major adverse cardiovascular (CV) events (MACE) in patients with suspected or known CAD. However, the prognostic utility of sFlt-1 in patients with AF remains unknown.
Methods
Using data from a multicenter, prospective cohort of 3255 patients with suspected or known CAD, we investigated whether AF modifies the prognostic utility of sFlt-1. Heparin-free serum levels of sFlt-1, N-terminal pro-brain natriuretic peptide, high-sensitivity cardiac troponin-I, high-sensitivity C-reactive protein, cystatin C, neutrophil gelatinase-associated lipocalin, VEGF, and placental growth factor were measured in 324 patients with AF and 2931 patients without AF. The primary outcome was MACE defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all-cause death, CV death, stroke, heart failure (HF) hospitalization, and coronary/peripheral artery revascularization. The biomarkers were natural log-transformed for use as continuous variables.
Results
After adjustment for potential clinical confounders including anticoagulant drug use, sFlt-1 was significantly associated with MACE (hazard ratio for 1 standard deviation increase [HR], 1.55; 95% confidence interval [CI], 1.14–2.08), CV death (HR, 1.68; 95% CI, 1.10–2.48), and stroke (HR, 1.89; 95% CI, 1.16–3.10), but not with all-cause death (HR, 1.32; 95% CI, 0.99–1.73), HF hospitalization (HR, 0.97; 95% CI, 0.73–1.25), or revascularization (HR, 0.99; 95% CI, 0.74–1.28) in patients with AF, whereas sFlt-1 was significantly associated with MACE (HR, 1.19; 95% CI, 1.02–1.37), all-cause death (HR, 1.19; 95% CI, 1.05–1.34), CV death (HR, 1.26; 95% CI, 1.03–1.48), and HF hospitalization (HR, 1.26; 95% CI, 1.11–1.42), but not with stroke (HR, 1.06; 95% CI, 0.81–1.33) or revascularization (HR, 1.01; 95% CI, 0.95–1.07) in patients without AF. Among other biomarkers, only VEGF was significantly associated with MACE (HR, 1.55; 95% CI, 1.02–2.44), and no biomarkers were significantly associated with CV death or stroke in patients with AF. sFlt-1 added incremental prognostic information for MACE (P=0.005 for net reclassification improvement [NRI], P=0.026 for integrated discrimination improvement [IDI]) and stroke (P=0.034 for NRI, P=0.018 for IDI), but not for CV death (P=0.021 for NRI, P=0.134 for IDI), to the model with potential clinical confounders in patients with AF.
Conclusions
sFlt-1 independently predicted MACE and stroke in patients with AF and suspected or known CAD. sFlt-1 may serve as a novel prognostic biomarker to stratify the risk of MACE and stroke in patients with AF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Labour Sciences Research Grant (2013-2014), AMED (2015-2017, Grant Number JP17ek0210008)
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital , Sagamihara , Japan
| | - K Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Kotani
- Jichi Medical University , Shimotsuke , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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4
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Suzuki M, Kotani K, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada M, Abe M, Akao M, Hasegawa K, Wada H. Serum amyloid A-low-density-lipoprotein complex and mortality in patients with suspected or known coronary artery disease: the ANOX study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1161] [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
Serum amyloid A-low-density-lipoprotein (SAA-LDL) is a complex formed from the oxidative interaction between SAA and LDLs. A relatively small-scale study has shown that circulating SAA-LDL levels may serve as a prognostic marker in patients with stable coronary artery disease (CAD). However, the prognostic value of SAA-LDL should be confirmed in a larger-scale cohort study.
Methods
Using data from a multicenter, prospective cohort of 2416 patients with suspected or known CAD enrolled in the ANOX (Development of Novel Biomarkers Related to Angiogenesis or Oxidative Stress to Predict Cardiovascular Events) study, we assessed the prognostic value of serum levels of SAA-LDL. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. Patients were followed up over 3 years.
Results
Stepwise regression analysis including baseline data on potential clinical confounders (i.e., age, sex, body mass index, hypertension, dyslipidemia, diabetes, current smoking, estimated glomerular filtration rate, the Gensini score, previous myocardial infarction, previous stroke, previous heart failure hospitalization, atrial fibrillation, malignancies, anemia, antihypertensive drug use, statin use, and aspirin use) and established cardiovascular biomarkers (i.e., N-terminal pro-brain natriuretic peptide, high-sensitivity cardiac troponin I [hs-cTnI], and high-sensitivity C-reactive protein [hs-CRP]) revealed that independent determinants of SAA-LDL levels were female sex, dyslipidemia, the Gensini score, absence of statin use, hs-cTnI, and hs-CRP. After adjusting for potential clinical confounders and established cardiovascular biomarkers, the highest quartile of SAA-LDL levels (vs. the lowest quartile) was significantly associated with the incidence of all-cause death (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.02–2.26), but not with that of cardiovascular death (HR, 1.11; 95% CI, 0.59–2.10) or MACE (HR, 1.57; 95% CI, 0.97–2.57). Stratified analyses revealed that this association was pronounced in patients with low hs-cTnI (<75th percentile) (HR, 1.85; 95% CI, 1.06–3.30) and in patients with low hs-CRP levels (≤1.0 mg/L) (HR, 2.30; 95% CI, 1.17–4.79).
Conclusions
Elevated SAA-LDL levels were independently associated with the risk of all-cause death in patients with suspected or known CAD. The SAA-LDL level appears to serve as a prognostic biomarker for risk stratification in relatively low-risk patients with low hs-cTnI (<75th percentile) or low hs-CRP (≤1.0 mg/L).
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Suzuki
- National Hospital Organization Saitama Hospital , Wako , Japan
| | - K Kotani
- Jichi Medical University , Shimotsuke , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center , Kanazawa , Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital , Hakodate , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center , Toon , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center , Kyoto , Japan
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5
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Iguchi M, Wada H, Shinozaki T, Suzuki M, Ajiro Y, Matsuda M, Koike A, Koizumi T, Shimizu M, Ono Y, Takenaka T, Kotani K, Abe M, Akao M, Hasegawa K. Distinct association of VEGF-C and VEGF-D with prognosis in patients with chronic heart failure: the PREHOSP-CHF study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0868] [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: 11/14/2022] Open
Abstract
Abstract
Background
The lymphatic system has been suggested to play an important role in cardiovascular (CV) diseases including heart failure (HF). Vascular endothelial growth factor C (VEGF-C) and VEGF-D are key regulators of lymphoangiogenesis.
Purpose
To investigate the association of VEGF-C and VEGF-D with prognosis in patients with chronic HF (CHF).
Methods
The PREHOSP-CHF study is a multicenter prospective cohort study to determine the predictive value of angiogenesis-related biomarkers in CHF. A total of 1,024 patients (mean age, 75.5±12.6 years; male, 58.7%) admitted to acute decompensated HF were included in the analyses. The primary outcome was MACE defined as a composite of CV death or HF hospitalization. The secondary outcomes were all-cause death, CV death, and HF hospitalizations. Serum levels of VEGF-C and VEGF-D, as well as N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin-I (hs-cTnI), high sensitive C reactive protein (hs-CRP), VEGF, and soluble VEGF receptor-2 (sVEGFR-2) were measured at the time of discharge. Patients were followed-up over two years.
Results
Median [interquartile range] of VEGF-C and VEGF-D levels were 4821 [3633–6131] pg/ml and 404 [296–559] pg/ml, respectively. In multivariate stepwise regression analysis, independent determinants of VEGF-C levels were younger age, female gender, absence of prior HF hospitalization, chronic kidney disease, and anemia, lower ejection fraction, lower NT-proBNP levels, higher VEGF levels, and higher sVEGFR-2 levels, while those of VEGF-D levels were lower body mass index, presence of diabetes and atrial fibrillation, and higher NT-proBNP levels. During the follow-up, a total of 209 (20.4%) all-cause deaths, 112 (10.9%) CV deaths, and 309 (30.2%) HF hospitalizations occurred. After adjusting for established risk factors and CV biomarkers, VEGF-C levels were significantly and inversely associated with the incidence of MACE and non-CV death (Fig.1, model 4). On the other hand, VEGF-D levels were significantly and positively associated with the incidence of HF hospitalization (Fig. 1, model 4). When we divided the patients into 4 groups based on the median of VEGF-C and VEGF-D levels, patients with low VEGF-C and high VEGF-D showed significantly higher incidence of MACE, all-cause death, CV death, and HF hospitalization compared to those with high VEGF-C and low VEGF-D (Fig. 2).
Conclusions
Among patients with CHF, VEGF-C and VEGF-D had different characteristic and association with the incidence of adverse events. VEGF-C levels were inversely associated with the incidence of MACE and non-CV death, and VEGF-D levels were positively associated with the incidence of HF hospitalization. These results suggests different effects of VEGF-C and VEGF-D in CHF. Combination of VEGF-C and VEGF-D enables us to make good risk stratification in patients with CHF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Clinical Research from the National Hospital Organization Figure 1Figure 2
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - A Koike
- National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - T Koizumi
- National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - Y Ono
- National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - K Kotani
- Jichi Medical University, Tochigi, Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
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6
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Wada H, Shinozaki T, Suzuki M, Sakagami S, Ajiro Y, Funada J, Matsuda M, Shimizu M, Takenaka T, Morita Y, Yonezawa K, Kotani K, Abe M, Akao M, Hasegawa K. Impact of atrial fibrillation on soluble fms-like tyrosine kinase-1 and cardiovascular events in patients with suspected or known coronary artery disease: the EXCEED-J study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1390] [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
Soluble fms-like tyrosine kinase-1 (sFlt-1), a vascular endothelial growth factor (VEGF) antagonist, has been suggested as a marker of endothelial dysfunction. Circulating sFlt-1 levels are associated with adverse outcomes in patients with preeclampsia, chronic kidney disease, and heart failure. Atrial fibrillation (AF) and coronary artery disease (CAD) are both associated with endothelial dysfunction. However, whether sFlt-1 can predict cardiovascular (CV) events and whether AF modifies the relationship between sFlt-1 and CV events in patients with suspected or known CAD are unknown.
Methods
We performed a nationwide, multicenter, prospective cohort study to determine the prognostic value of sFlt-1 and other biomarkers in patients with suspected or known CAD undergoing elective angiography. Heparin-free fasting serum was collected from the peripheral vein to determine levels of sFlt-1, VEGF, placental growth factor, cystatin C, neutrophil gelatinase-associated lipocalin, N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin-I (hs-cTnI), and high-sensitivity C-reactive protein (hs-CRP). The primary outcome was 3-point major adverse CV events (3P-MACE) defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all-cause death, CV death, and 5P-MACE defined as a composite of 3P-MACE, heart failure hospitalization, and coronary/peripheral artery revascularization.
Results
3311 patients were consecutively enrolled between Nov 2013 and May 2017. After excluding 56 ineligible patients, 3255 patients (324 AF and 2931 non-AF) were followed up over 3 years (follow-up rate, 99%). During the follow-up, 156 patients developed 3P-MACE, 215 died from any cause, 82 died from cardiovascular disease, and 1361 developed 5P-MACE. The sFlt-1 level was significantly higher in AF compared to non-AF patients (p<0.001). Stepwise regression analysis revealed that the sFlt-1 level was independently associated with AF. After adjusting for potential clinical confounders, serum levels of sFlt-1, NT-proBNP, hs-cTnI and cystatin C, but not other biomarkers, were significantly associated with 3P-MACE in the entire cohort. These associations were still significant in non-AF patients, whereas only the sFlt-1 level was significantly associated with 3P-MACE in AF patients. Serum levels of sFlt-1, but not other biomarkers, were also significantly associated with CV death in AF patients. Among the biomarkers, only the hs-CRP level was significantly associated with all-cause death, and no biomarker was significantly associated with 5P-MACE in AF patients. Furthermore, sFlt-1 provided an incremental prognostic information for 3P-MACE to the model with potential clinical confounders in AF, but not in non-AF patients.
Conclusions
Serum levels of sFlt-1 were significantly associated with 3P-MACE in patients with suspected or known CAD. This association was pronounced in AF patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The EXCEED-J study is supported by Health Labour Sciences Research Grant (2013-2014), AMED (2015-2017, Grant Number JP17ek0210008) and Grant-in-Aid for Clinical Research from the National Hospital Organization (2018-2020).
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Wako, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - K Kotani
- Jichi Medical University,, Shimotsuke, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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7
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Wada H, Unoki T, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Kotani K, Abe M, Akao M, Hasegawa K. Impact of glucose tolerance status on the relationship between vascular endothelial growth factor D and mortality in patients with suspected coronary artery disease: a subanalysis of the ANOX study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3061] [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
Vascular endothelial growth factor D (VEGF-D) is a secreted glycoprotein that can act as lymphangiogenic and angiogenic growth factors through binding to its specific receptors, VEGFR-3 and VEGFR-2. VEGF-D signaling via VEGFR-3 plays an important role in lipoprotein metabolisms which may contribute to coronary artery disease (CAD). We recently reported that serum levels of VEGF-D are independently associated with mortality in patients with suspected or known CAD. However, the impact of glucose tolerance status on the relationship between VEGF-D and mortality in patients with suspected CAD is unclear.
Methods
Serum VEGF-D levels were measured in 1,717 patients with suspected CAD undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict CV events (ANOX) study, and followed up for 3 years. After excluding 67 patients with no HbA1c data, 1,650 patients were divided into 3 groups according to the glucose tolerance status: diabetes (DM, n=693), prediabetes (preDM, n=541) defined as an HbA1c of 5.7 to 6.4%, and normal glucose tolerance (NGT, n=416) defined as an HbA1c of 5.6% or less. The outcomes were total death, CV death, and major adverse CV events (MACE) defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 80 DM, 45 preDM, and 30 NGT patients died from any cause, 24 DM, 13 preDM, and 12 NGT died from CV disease, and 54 DM, 30 preDM, and 19 NGT developed MACE. After adjustment for established risk factors, VEGF-D levels were significantly associated with total death (hazard ratio [HR] for 1-SD increase, 1.28; 95% confidence interval [CI], 1.12–1.47), but not with CV death (HR, 1.20; 95% CI, 0.93–1.52) or MACE (HR, 1.23; 95% CI, 0.997–1.48) in DM; VEGF-D levels were not significantly associated with total death (HR, 0.97; 95% CI, 0.70–1.34), CV death (HR, 1.39; 95% CI, 0.92–2.11), or MACE (HR, 1.09; 95% CI, 0.74–1.50) in preDM; VEGF-D levels were not significantly associated with total death (HR, 1.34; 95% CI, 0.98–1.84), CV death (HR, 1.32; 95% CI, 0.78–2.13), or MACE (HR, 1.01; 95% CI, 0.66–1.46) in NGT. Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of VEGF-D levels further improved the prediction of total death (P=0.040 for continuous net reclassification improvement [NRI], P=0.007 for integrated discrimination improvement [IDI]), but not that of CV death or MACE in DM, while it did not significantly improved the prediction of total death, CV death, or MACE either in preDM or in NGT.
Conclusions
The VEGF-D level was independently associated with total death in DM, but not in preDM or in NGT. The relationship between VEGF-D and total mortality may depend on the presence of DM in patients with suspected CAD.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - T Unoki
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Wako, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - K Kotani
- Jichi Medical University, Shimotsuke, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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8
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Iguchi M, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada M, Abe M, Akao M, Hasegawa K, Wada H. Impact of anemia on the relationship between vascular endothelial growth factor C and mortality in patients with suspected or known coronary artery disease: a subanalysis of the ANOX study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1347] [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
The lymphatic system has been suggested to play an important role in cholesterol metabolism and cardiovascular (CV) disease. Recently, we demonstrated that serum levels of vascular endothelial growth factor C (VEGF-C), a central player of lymphangiogenesis, are inversely and independently associated with the risk of all-cause mortality in patients with suspected or known coronary artery disease (CAD). However, the impact of anemia on the relationship between VEGF-C and mortality in those patients is unclear.
Methods
Serum VEGF-C levels were measured in 2,418 patients with suspected or known CAD undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict CV events (ANOX) study, and followed up for 3 years. Anemia was defined as a hemoglobin level of less than 13 g/dL in men and <12 g/dL in women. Patients were divided into 2 groups according to the presence (anemic, n=882) or absence (non-anemic, n=1,536) of anemia. The primary outcome was all-cause death. The secondary outcomes were CV death, and major adverse CV events (MACE) defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 164 anemic and 90 non-anemic patients died from any cause, 64 anemic and 24 non-anemic patients died from CV disease, and 96 anemic and 69 non-anemic patients developed MACE. After adjustment for established risk factors, VEGF-C levels were significantly and inversely associated with all-cause death (hazard ratio [HR] for 1-SD increase, 0.71; 95% confidence interval [CI], 0.59–0.84), CV death (HR, 0.60; 95% CI, 0.44–0.79), and MACE (HR, 0.76; 95% CI, 0.60–0.95) in anemic, while VEGF-C levels were not significantly associated with all-cause death (HR, 0.87; 95% CI, 0.69–1.11), CV death (HR, 1.32; 95% CI, 0.85–1.93), or MACE (HR, 1.12; 95% CI, 0.87–1.42) in non-anemic patients. Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of VEGF-C levels further improved the prediction of all-cause death (P<0.001 for continuous net reclassification improvement [NRI], P=0.006 for integrated discrimination improvement [IDI]) and CV death (P<0.001 for NRI, P=0.005 for IDI), but not that of MACE (P=0.021 for NRI, P=0.059 for IDI) in anemic, whereas the addition of VEGF-C levels did not improved the prediction of all-cause death (P=0.234 for NRI, P=0.415 for IDI), CV death (P=0.190 for NRI, P=0.392 for IDI) or MACE (P=0.897 for NRI, P=0.128 for IDI) in non-anemic patients.
Conclusions
The VEGF-C level was inversely and independently associated with all-cause and CV mortality in anemic, but not in non-anemic patients with suspected or known CAD. The inverse relationship between VEGF-C and mortality may depend on the presence of anemia.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Iguchi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Wako, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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9
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Wada H, Takagi D, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada K, Abe M, Akao M, Hasegawa K. Impact of chronic kidney disease on the relationship between vascular endothelial growth factor C and mortality in patients with suspected coronary artery disease: a subanalysis of the ANOX study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3321] [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
The lymphatic system has been suggested to play an important role in cholesterol metabolism and cardiovascular (CV) disease. Recently, we demonstrated that serum levels of vascular endothelial growth factor C (VEGF-C), a central player of lymphangiogenesis, are inversely and independently associated with the risk of all-cause mortality in patients with suspected or known coronary artery disease (CAD). However, the impact of chronic kidney disease (CKD) on the relationship between VEGF-C and mortality in patients with suspected CAD is unclear.
Methods
Serum VEGF-C levels were measured in 1,717 patients with suspected but no history of CAD undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict CV events (ANOX) study, and followed up for 3 years. Patients were divided into 2 groups according to the presence (CKD, n=674) or absence (non-CKD, n=1,043) of CKD. The primary outcome was all-cause death. The secondary outcomes were CV death, and major adverse CV events (MACE) defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 95 CKD and 66 non-CKD patients died from any cause, 37 CKD and 13 non-CKD died from CV disease, and 61 CKD and 43 non-CKD developed MACE. After adjustment for established risk factors, VEGF-C levels were significantly and inversely associated with all-cause death (hazard ratio [HR] for 1-SD increase, 0.72; 95% confidence interval [CI], 0.57–0.90) and CV death (HR, 0.69; 95% CI, 0.48–0.97), but not with MACE (HR, 0.78; 95% CI, 0.60–1.03) in CKD, while VEGF-C levels were significantly and inversely associated with all-cause death (HR, 0.69; 95% CI, 0.52–0.91), but not with CV death (HR, 0.91; 95% CI, 0.50–1.66) or MACE (HR, 1.09; 95% CI, 0.81–1.44) in non-CKD. Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of VEGF-C levels further improved the prediction of all-cause death (P=0.047 for continuous net reclassification improvement [NRI], P=0.048 for integrated discrimination improvement [IDI]), but not that of CV death (P=0.016 for NRI, P=0.245 for IDI) or MACE (P=0.166 for NRI, P=0.311 for IDI) in CKD, whereas the addition of VEGF-C levels did not improve the prediction of all-cause death (P=0.053 for NRI, P=0.012 for IDI), CV death (P=0.864 for NRI, P=0.602 for IDI) or MACE (P=0.999 for NRI, P=0.154 for IDI) in non-CKD.
Conclusions
The VEGF-C level inversely and independently predicted all-cause mortality in CKD, but not in non-CKD patients with suspected CAD. The inverse relationship between VEGF-C and all-cause mortality in patients with suspected CAD seems to be remarkable in the presence of CKD.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - D Takagi
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Wako, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - K Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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10
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Wada H, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada M, Iguchi M, Abe M, Akao M, Hasegawa K. Impact of anemia on the relationships of growth differentiation factor 15 with mortality and cardiovascular events in patients with suspected or known coronary artery disease: the ANOX study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2934] [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
Growth differentiation factor 15 (GDF-15) is a stress-responsive cytokine that plays an important role in the regulation of the inflammatory response, growth and cell differentiation. An elevated GDF-15 was found in various conditions including anemia and stable coronary artery disease (CAD), and it was reported to predict mortality and cardiovascular (CV) events in general population and in patients with established CAD. However, the impact of anemia on the relationships of GDF-15 with mortality and CV events in patients with suspected or known CAD is unclear.
Methods
Serum GDF-15 levels were measured in 2,418 patients with suspected or known CAD undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict CV events (ANOX) study, and followed up for 3 years. Anemia was defined as a hemoglobin level of less than 13 g/dL in men and <12 g/dL in women. Patients were divided into 2 groups according to the presence (anemic, n=882) or absence (non-anemic, n=1,536) of anemia. The primary outcome was all-cause death. The secondary outcomes were CV death, and major adverse CV events (MACE) defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 164 anemic and 90 non-anemic patients died from any cause, 64 anemic and 24 non-anemic patients died from CV disease, and 96 anemic and 69 non-anemic patients developed MACE. After adjustment for established risk factors, GDF-15 levels were significantly associated with all-cause death (hazard ratio [HR] for 1-SD increase, 1.75; 95% confidence interval [CI], 1.51–2.04), CV death (HR, 1.67; 95% CI, 1.30–2.13), and MACE (HR, 1.46; 95% CI, 1.18–1.81) in anemic, while GDF-15 levels were also significantly associated with all-cause death (HR, 1.47; 95% CI, 1.27–1.69), CV death (HR, 1.56; 95% CI, 1.18–1.99), and MACE (HR, 1.25; 95% CI, 1.004–1.50) in non-anemic patients. Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of GDF-15 levels further improved the prediction of all-cause death (P<0.001 for continuous net reclassification improvement [NRI], P<0.001 for integrated discrimination improvement [IDI]), CV death (P=0.026 for NRI, P=0.023 for IDI), and MACE (P=0.025 for NRI, P=0.042 for IDI) in anemic, whereas it did not improved the prediction of all-cause death (P=0.072 for NRI, P=0.079 for IDI), CV death (P=0.289 for NRI, P=0.179 for IDI) or MACE (P=0.397 for NRI, P=0.230 for IDI) in non-anemic patients.
Conclusions
The GDF-15 level significantly improved the prediction of all-cause death, CV death, and MACE in anemic, but not in non-anemic patients with suspected or known CAD. The relationships of GDF-15 with mortality and CV events seem to be remarkable in the presence of anemia.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Wako, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Iguchi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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11
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Wada H, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Wada K, Abe M, Akao M, Hasegawa K. Impact of smoking status on the relationships of growth differentiation factor 15 with mortality and cardiovascular events in patients with suspected or known coronary artery disease: the ANOX study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3018] [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
Growth differentiation factor 15 (GDF-15) is a stress-responsive cytokine that plays an important role in the regulation of the inflammatory response, growth and cell differentiation. An elevated GDF-15 was found in various conditions including cigarette smoking and stable coronary artery disease (CAD), and it was reported to predict mortality and cardiovascular (CV) events in general population and in patients with established CAD. However, the impact of smoking status on the relationships of GDF-15 with mortality and CV events in patients with suspected or known CAD is unclear.
Methods
Serum GDF-15 levels were measured in 2,418 patients with suspected or known CAD undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict CV events (ANOX) study, and followed up for 3 years. Patients were divided into 3 groups according to the smoking status: current (n=428), past (n=1,035), and never smokers (n=955). The outcomes were total death, CV death, and major adverse CV events (MACE) defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 48 current, 120 past, and 86 never smokers died from any cause, 17 current, 47 past, and 24 never smokers died from CV disease, and 35 current, 80 past, and 50 never smokers developed MACE. After adjustment for established risk factors, GDF-15 levels were significantly associated with total death (hazard ratio [HR] for 1-SD increase, 1.30; 95% confidence interval [CI], 1.03–1.65), but not with CV death (HR, 1.09; 95% CI, 0.69–1.62) or MACE (HR, 0.95; 95% CI, 0.64–1.34) in current smokers; GDF-15 levels were significantly associated with total death (HR, 1.73; 95% CI, 1.46–2.05) and CV death (HR, 1.41; 95% CI, 1.09–1.85), but not with MACE (HR, 1.20; 95% CI, 0.96–1.48) in past smokers; GDF-15 levels were significantly associated with total death (HR, 1.62; 95% CI, 1.32–1.95), CV death (HR, 1.76; 95% CI, 1.22–2.46), and MACE (HR, 1.64; 95% CI, 1.27–2.07) in never smokers. Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of GDF-15 levels further improved the prediction of total death (P<0.001 for continuous net reclassification improvement [NRI], P=0.001 for integrated discrimination improvement [IDI]) and MACE (P<0.001 for NRI, P=0.045 for IDI), but not that of CV death, in never smokers, while it did not significantly improved the prediction of total death, CV death, or MACE either in current or in past smokers.
Conclusions
The GDF-15 level was independently associated with total death and MACE in never, but not in current or past smokers with suspected or known CAD. The relationships of GDF-15 with mortality and CV events seem to be attenuated by the presence of current and past smoking.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital, Wako, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - K Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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12
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Iguchi M, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonazawa K, Shimizu M, Funada J, Takenaka T, Wada M, Abe M, Akao M, Hasegawa K, Wada H. P1645Vascular endothelial growth factor-D and mortality in suspected or known coronary heart disease patients with a history of heart failure: a subanalysis of the ANOX study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0404] [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
Vascular endothelial growth factor-D (VEGF-D) is a secreted glycoprotein that can act as lymphangiogenic and angiogenic growth factors through binding to its specific receptors, VEGFR-3 (Flt-4) and VEGFR-2 (KDR/Flk-1). VEGF-D signaling via VEGFR-3 plays an important role in lipoprotein metabolisms which may contribute to coronary heart disease (CHD). Recent studies suggest that VEGF-D appears to be a biomarker of pulmonary congestion and heart failure in both dyspnea patients and the general population. However, the prognostic value of VEGF-D in suspected or known CHD patients with a history of heart failure is unknown.
Methods
Serum VEGF-D levels were measured in 253 suspected or known CHD patients with a history of heart failure undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict cardiovascular events (ANOX) study, and followed up for 3 years. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death, and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 54 patients died from any cause, 24 died from cardiovascular disease, and 35 developed MACE. After adjustment for established risk factors, VEGF-D levels were significantly associated with all-cause death (hazard ratio [HR] for 1-SD increase, 1.44; 95% confidence interval [CI], 1.18–1.75), cardiovascular death (HR, 1.73; 95% CI, 1.32–2.25), and MACE (HR, 1.49; 95% CI, 1.14–1.89). Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin-I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of VEGF-D levels further improved the prediction of all-cause death (continuous net reclassification improvement [NRI], 0.471; 95% CI, 0.176–0.766; P=0.002; integrated discrimination improvement [IDI], 0.036; 95% CI, 0.008–0.064; P=0.011) and cardiovascular death (NRI, 0.722; 95% CI, 0.326–1.118; P<0.001; IDI, 0.063; 95% CI, 0.005–0.122; P=0.033), but not that of MACE (NRI, 0.453; 95% CI, 0.100–0.805; P=0.012; IDI, 0.028; 95% CI, −0.007–0.063; P=0.116).
Conclusions
In suspected or known CHD patients with a history of heart failure undergoing elective coronary angiography, elevated VEGF-D levels may predict all-cause and cardiovascular mortality independent of established risk factors and cardiovascular biomarkers.
Acknowledgement/Funding
The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- M Iguchi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonazawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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13
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Unoki T, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada K, Abe M, Akao M, Hasegawa K, Wada H. P3639Vascular endothelial growth factor-C and mortality in patients with suspected but no history of coronary heart disease: a subanalysis of the ANOX study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0496] [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
The lymphatic system has been suggested to play an important role in cholesterol metabolism and cardiovascular disease. Recently, we demonstrated that serum levels of vascular endothelial growth factor-C (VEGF-C), a central player of lymphangiogenesis, are inversely and independently associated with the risk of all-cause mortality in patients with suspected or known coronary heart disease (CHD). However, the prognostic value of VEGF-C in patients with suspected but no history of CHD is still unclear.
Methods
Serum VEGF-C levels were measured in 1,717 patients with suspected but no history of CHD undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict cardiovascular events (ANOX) study, and followed up for 3 years. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death, and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 161 patients died from any cause, 50 died from cardiovascular disease, and 104 developed MACE. After adjustment for established risk factors, VEGF-C levels were significantly and inversely associated with all-cause death (hazard ratio [HR] for 1-SD increase, 0.69; 95% confidence interval [CI], 0.58–0.83) and cardiovascular death (HR, 0.72; 95% CI, 0.52–0.998), but not with MACE (HR, 0.91; 95% CI, 0.74–1.13). Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin-I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of VEGF-C levels further improved the prediction of all-cause death (continuous net reclassification improvement [NRI], 0.282; 95% CI, 0.121–0.443; P<0.001; integrated discrimination improvement [IDI], 0.009; 95% CI, 0.003–0.016; P=0.005), but not that of cardiovascular death (NRI, 0.178; 95% CI, r=−0.103–0.458; P=0.214; IDI, 0.004; 95% CI, r=−0.002–0.009; P=0.194) or MACE (NRI, 0.037; 95% CI, r=−0.162–0.235; P=0.717; IDI, 0.000; 95% CI, r=−0.0004–0.0005; P=0.872).
Conclusions
In patients with suspected but no history of CHD undergoing elective coronary angiography, a low VEGF-C value may predict all-cause mortality independent of established risk factors and cardiovascular biomarkers.
Acknowledgement/Funding
The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization
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Affiliation(s)
- T Unoki
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - K Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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14
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Unoki T, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Abe M, Akao M, Hasegawa K, Wada H. 5195Growth differentiation factor-15 and mortality in suspected or known coronary heart disease patients with diabetes: a subanalysis of the ANOX study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0054] [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
Diabetes is a risk factor for coronary heart disease (CHD), but further risk stratification in patients with diabetes is necessary to improve the prediction and prevention of cardiovascular events and deaths. Growth differentiation factor-15 (GDF-15) is a stress-responsive cytokine, which plays an important role in the regulation of the inflammatory response, growth and cell differentiation. Elevated GDF-15 was found in various diseases including diabetes and stable CHD, and was reported to predict mortality and cardiovascular events in general or established CHD population. However, the prognostic value of GDF-15 in suspected or known CHD patients with diabetes is unknown.
Methods
Serum GDF-15 levels were measured in 1,087 suspected or known CHD patients with diabetes undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict cardiovascular events (ANOX) study, and followed up for 3 years. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death, and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 147 patients died from any cause, 47 died from cardiovascular disease, and 94 developed MACE. After adjustment for established risk factors, GDF-15 levels were significantly associated with all-cause death (hazard ratio [HR] for 1-SD increase, 1.66; 95% confidence interval [CI], 1.48–1.86), cardiovascular death (HR, 1.63; 95% CI, 1.34–1.99), and MACE (HR, 1.41; 95% CI, 1.20–1.65). Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin-I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of GDF-15 levels further improved the prediction of all-cause death (continuous net reclassification improvement [NRI], 0.344; 95% CI, 0.172–0.517; P<0.001; integrated discrimination improvement [IDI], 0.049; 95% CI, 0.026–0.072; P<0.001), but not that of cardiovascular death (NRI, −0.013; 95% CI, −0.300–0.274; P=0.931; IDI, 0.023; 95% CI, 0.003–0.043; P=0.026) or MACE (NRI, 0.059; 95% CI, −0.151–0.268; P=0.583; IDI, 0.005; 95% CI, −0.004–0.015; P=0.244).
Conclusions
In suspected or known CHD patients with diabetes undergoing elective coronary angiography, elevated GDF-15 levels may predict all-cause mortality independent of established risk factors and cardiovascular biomarkers.
Acknowledgement/Funding
The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- T Unoki
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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15
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Wada H, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Wada M, Abe M, Akao M, Hasegawa K. P5529Vascular endothelial growth factor-D and mortality in suspected or known coronary heart disease patients with diabetes: a subanalysis of the ANOX study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0476] [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
Diabetes is a risk factor for coronary heart disease (CHD), but further risk stratification in patients with diabetes is necessary to improve the prediction and prevention of cardiovascular events and deaths. Vascular endothelial growth factor-D (VEGF-D) is a secreted glycoprotein that can act as lymphangiogenic and angiogenic growth factors through binding to its specific receptors, VEGFR-3 (Flt-4) and VEGFR-2 (KDR/Flk-1). VEGF-D signaling via VEGFR-3 plays an important role in lipoprotein metabolisms which may contribute to CHD. VEGF-D signaling has been used as a therapeutic target of human diseases such as lymphangioleiomyomatosis and refractory angina. Furthermore, in clinical settings, the VEGF-D level is already established as a diagnostic biomarker for lymphangioleiomyomatosis. However, the prognostic value of VEGF-D in suspected or known CHD patients with diabetes is unknown.
Methods
Serum VEGF-D levels were measured in 1,087 suspected or known CHD patients with diabetes undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict cardiovascular events (ANOX) study, and followed up for 3 years. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death, and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 147 patients died from any cause, 47 died from cardiovascular disease, and 94 developed MACE. After adjustment for established risk factors, VEGF-D levels were significantly associated with all-cause death (hazard ratio [HR] for 1-SD increase, 1.34; 95% confidence interval [CI], 1.21–1.47), cardiovascular death (HR, 1.40; 95% CI, 1.18–1.62), and MACE (HR, 1.22; 95% CI, 1.07–1.40). Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin-I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of VEGF-D levels further improved the prediction of all-cause death (continuous net reclassification improvement [NRI], 0.258; 95% CI, 0.088–0.429; P=0.003; integrated discrimination improvement [IDI], 0.013; 95% CI, 0.002–0.024; P=0.022), but not that of cardiovascular death (NRI, 0.046; 95% CI, −0.245–0.336; P=0.759; IDI, 0.013; 95% CI, −0.005–0.031; P=0.146) or MACE (NRI, 0.064; 95% CI, −0.146–0.274; P=0.552; IDI, 0.001; 95% CI, −0.002–0.004; P=0.557).
Conclusions
In suspected or known CHD patients with diabetes undergoing elective coronary angiography, elevated VEGF-D levels may predict all-cause mortality independent of established risk factors and cardiovascular biomarkers.
Acknowledgement/Funding
The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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16
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Wada H, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Wada M, Abe M, Akao M, Hasegawa K. P5526Vascular endothelial growth factor-D and mortality in suspected or known coronary heart disease patients with chronic kidney disease: a subanalysis of the ANOX study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0474] [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
Chronic kidney disease (CKD) is an independent risk factor for the development and progression of coronary heart disease (CHD). Vascular endothelial growth factor-D (VEGF-D) is a secreted glycoprotein that can act as lymphangiogenic and angiogenic growth factors through binding to its specific receptors, VEGFR-3 (Flt-4) and VEGFR-2 (KDR/Flk-1). VEGF-D signaling via VEGFR-3 plays an important role in lipoprotein metabolisms which may contribute to CHD. VEGF-D signaling has been used as a therapeutic target of human diseases such as lymphangioleiomyomatosis and refractory angina. Furthermore, in clinical settings, the VEGF-D level is already established as a diagnostic biomarker for lymphangioleiomyomatosis. However, the prognostic value of VEGF-D in suspected or known CHD patients with CKD is unknown.
Methods
Serum VEGF-D levels were measured in 999 suspected or known CHD patients with CKD undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict cardiovascular events (ANOX) study, and followed up for 3 years. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death, and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 154 patients died from any cause, 61 died from cardiovascular disease, and 96 developed MACE. After adjustment for established risk factors, VEGF-D levels were significantly associated with all-cause death (hazard ratio [HR] for 1-SD increase, 1.41; 95% confidence interval [CI], 1.27–1.56), cardiovascular death (HR, 1.48; 95% CI, 1.28–1.71), and MACE (HR, 1.34; 95% CI, 1.18–1.53). Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin-I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of VEGF-D levels further improved the prediction of all-cause death (continuous net reclassification improvement [NRI], 0.272; 95% CI, 0.100–0.445; P=0.002; integrated discrimination improvement [IDI], 0.015; 95% CI, 0.003–0.027; P=0.013), but not that of cardiovascular death (NRI, 0.230; 95% CI, −0.029 to 0.488; P=0.082; IDI, 0.012; 95% CI, −0.007 to 0.031; P=0.207) or MACE (NRI, 0.102; 95% CI, −0.106 to 0.310; P=0.337; IDI, 0.005; 95% CI, −0.005 to 0.015; P=0.337).
Conclusions
In suspected or known CHD patients with CKD undergoing elective coronary angiography, elevated VEGF-D levels may predict all-cause mortality independent of established risk factors and cardiovascular biomarkers.
Acknowledgement/Funding
The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization
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Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - M Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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17
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Iguchi M, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Abe M, Akao M, Hasegawa K, Wada H. P3765Low vascular endothelial growth factor-C was a predictor for cardiovascular events in patients with atrial fibrillation and suspected or known coronary artery disease: a subanalysis of the ANOX study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0616] [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
Lymphatic system has been considered to play an important role in cardiovascular disease. We recently reported that vascular endothelial growth factor-C (VEGF-C), a central player in lymphangiogenesis, predicted all-cause mortality in patients with suspected or known coronary artery disease (CAD). However, relationship between VEGF-C and atrial fibrillation (AF) remains unclear.
Methods
The ANOX study is a multicenter, prospective cohort study of 2,418 patients with suspected CAD, to determine the predictive value of possible novel biomarkers related to angiogenesis or oxidative stress for major adverse cardiovascular events (MACE) among patients undergoing elective angiography. Blood samples were collected from the arterial catheter sheath at the beginning of coronary angiography. Serum levels of VEGF-C, as well as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin-I (cTnI), and high-sensitivity C-reactive protein (hsCRP), were measured. The outcome was a MACE defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.
Results
Of a total of 2,418 patients, 261 patients had AF at baseline. AF group were older, and had more chronic kidney disease, history of heart failure, and history of stroke, but less diabetes, dyslipidemia, and CAD. The median level of NT-proBNP, cTnI, and hsCRP were higher in AF group [AF vs non-AF: NT-proBNP, 1048 pg/ml vs 162 pg/ml (p<0.0001); cTnI, 0.0003 ng/ml, vs 0.0 ng/ml (p<0.0001); hsCRP, 1.43 ug/ml vs 0.88 ug/ml (p=0.0005)], whereas median level of VEGF-C was lower in AF group [3107 pg/ml vs 3590 pg/ml (p<0.0001)]. AF was associated with lower VEGF-C and higher hsCRP after adjustment for potential confounders. During the 3-year follow-up, 29 (11.1%) patients in AF group and 136 (6.3%) patients in non-AF group developed MACE (p=0.007). Incidence of stroke was higher in AF group (17 (6.5%) vs 52 (2.4%); p<0.0009), despite that the incidence of cardiovascular death and myocardial infarction were similar between the groups. We divided the entire cohort into two groups based on the lowest quartile of VEGF-C or highest quartile of other biomarkers, lowest quartile of VEGF-C (log rank p=0.0004), as well as highest quartile of cTnI (log rank p=0.0009), were significantly associated with MACE in AF group. After adjustment for established risk factors and these biomarkers, both lowest quartile of VEGF-C (HR, 2.73; 95% CI, 1.27–6.06) and highest quartile of cTnI (HR, 2.54; 95% CI, 1.08–6.09) were significantly associated with MACE in AF group.
Conclusions
AF was associated with lower level of VEGF-C, and low VEGF-C as well as high cTnI might serve as an independent predictor of MACE in patients with AF and suspected or known CAD.
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Affiliation(s)
- M Iguchi
- National Hospital Organization Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center, Division of Translational Research, Kyoto, Japan
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18
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Takagi D, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Wada K, Abe M, Akao M, Hasegawa K, Wada H. P3635Vascular endothelial growth factor-D and mortality in patients with suspected but no history of coronary heart disease: a subanalysis of the ANOX study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0493] [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
Vascular endothelial growth factor-D (VEGF-D) is a secreted glycoprotein that can act as lymphangiogenic and angiogenic growth factors through binding to its specific receptors, VEGFR-3 (Flt-4) and VEGFR-2 (KDR/Flk-1). VEGF-D signaling via VEGFR-3 plays an important role in lipoprotein metabolisms which may contribute to coronary heart disease (CHD). VEGF-D signaling has been used as a therapeutic target of human diseases such as lymphangioleiomyomatosis and refractory angina. In clinical settings, the VEGF-D level is already established as a diagnostic biomarker for lymphangioleiomyomatosis. However, the prognostic value of VEGF-D in patients with suspected but no history of CHD is unknown.
Methods
Serum VEGF-D levels were measured in 1,717 patients with suspected but no history of CHD undergoing elective coronary angiography, enrolled in the development of novel biomarkers related to angiogenesis or oxidative stress to predict cardiovascular events (ANOX) study, and followed up for 3 years. The primary outcome was all-cause death. The secondary outcomes were cardiovascular death, and major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke.
Results
During the follow-up, 161 patients died from any cause, 50 died from cardiovascular disease, and 104 developed MACE. After adjustment for established risk factors, VEGF-D levels were significantly associated with all-cause death (hazard ratio [HR] for 1-SD increase, 1.29; 95% confidence interval [CI], 1.17–1.42), cardiovascular death (HR, 1.37; 95% CI, 1.20–1.56), and MACE (HR, 1.22; 95% CI, 1.08–1.37). Even after incorporation of N-terminal pro-brain natriuretic peptide, contemporary sensitive cardiac troponin-I, and high-sensitivity C-reactive protein into a model with established risk factors, the addition of VEGF-D levels further improved the prediction of all-cause death (continuous net reclassification improvement [NRI], 0.165; 95% CI, 0.004–0.325; P=0.044; integrated discrimination improvement [IDI], 0.012; 95% CI, 0.002–0.023; P=0.013), but not that of cardiovascular death (NRI, 0.078; 95% CI, r=−0.203–0.359; P=0.586; IDI, 0.014; 95% CI, r=−0.009–0.037; P=0.235) or MACE (NRI, r=−0.011; 95% CI, r=−0.207–0.184; P=0.337; IDI, 0.003; 95% CI, r=−0.003–0.009; P=0.354).
Conclusions
In patients with suspected but no history of CHD undergoing elective coronary angiography, elevated VEGF-D levels may predict all-cause mortality independent of established risk factors and cardiovascular biomarkers.
Acknowledgement/Funding
The ANOX study is supported by a Grant-in-Aid for Clinical Research from the National Hospital Organization.
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Affiliation(s)
- D Takagi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - K Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Ajiro Y, Koike T, Maeda R, Hasegawa S, Shibahashi E, Sugiyama K, Saito T, Mori F, Iwade K. PO121 Possible Contribution of Sleep Disorder Breathing to Heart Failure In the Patients With Hypertrophic Cardiomyopathy With Preserved Left Ventricular Ejection Fraction. Glob Heart 2018. [DOI: 10.1016/j.gheart.2018.09.122] [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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Wada H, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Wada K, Abe M, Akao M, Hasegawa K. P6253Vascular endothelial growth factor-C and cardiovascular mortality in patients with suspected and a history of coronary artery disease: from the ANOX study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6253] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - K Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Takagi D, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Abe M, Akao M, Hasegawa K, Wada H. P5336Vascular endothelial growth factor-C and cardiovascular and all-cause mortality in patients with chronic kidney disease and suspected coronary artery disease: from the ANOX study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5336] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Takagi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Unoki T, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Abe M, Akao M, Hasegawa K, Wada H. P2520Vascular endothelial growth factor-C and mortality in patients with diabetes and suspected coronary artery disease: from the ANOX study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2520] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Unoki
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Wada H, Shinozaki T, Suzuki M, Sakagami S, Ajiro Y, Funada J, Matsuda M, Shimizu M, Takenaka T, Morita Y, Kotani K, Satoh-Asahara N, Abe M, Akao M, Hasegawa K. P2720Diagnostic utility of biomarkers to predict coronary artery disease in patients with and without chronic kidney disease: baseline data from the EXCEED-J study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2720] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - S Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - J Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - K Kotani
- Jichi Medical University, Shimotsuke, Japan
| | - N Satoh-Asahara
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Wada H, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Murakami M, Abe M, Akao M, Hasegawa K. P659Impact of chronic kidney disease on biomarkers predicting severity of coronary artery disease in patients with suspected coronary heart disease: baseline data from the ANOX study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p659] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H. Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M. Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M. Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y. Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T. Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S. Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K. Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M. Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J. Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T. Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y. Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - M. Murakami
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M. Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M. Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K. Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Wada H, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Kotani K, Abe M, Akao M, Hasegawa K. P855Serum-amyloid-A/LDL complex and NT-proBNP independently correlated with severe angiographic coronary artery disease in patients with suspected, but no history of coronary heart disease: the ANOX study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p855] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H. Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M. Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M. Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y. Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T. Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S. Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K. Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M. Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J. Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T. Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y. Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - K. Kotani
- Jichi Medical University, Shimotsuke, Japan
| | - M. Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M. Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K. Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Iguchi M, Suzuki M, Matsuda M, Ajiro Y, Shinozaki T, Sakagami S, Yonezawa K, Shimizu M, Funada J, Takenaka T, Morita Y, Abe M, Akao M, Hasegawa K, Wada H. P6476Serum-amyloid-A/LDL complex independently correlated with angiographic severity of coronary artery disease in patients with cancer: baseline data from the ANOX study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6476] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M. Iguchi
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M. Suzuki
- National Hospital Organization Saitama National Hospital, Saitama, Japan
| | - M. Matsuda
- National Hospital Organization Kure Medical Center, Kure, Japan
| | - Y. Ajiro
- National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - T. Shinozaki
- National Hospital Organization Sendai Medical Center, Sendai, Japan
| | - S. Sakagami
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Japan
| | - K. Yonezawa
- National Hospital Organization Hakodate National Hospital, Hakodate, Japan
| | - M. Shimizu
- National Hospital Organization Kobe Medical Center, Kobe, Japan
| | - J. Funada
- National Hospital Organization Ehime Medical Center, Toon, Japan
| | - T. Takenaka
- National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Y. Morita
- National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | - M. Abe
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M. Akao
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K. Hasegawa
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - H. Wada
- National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Sekiguchi H, Ajiro Y, Uchida Y, Ishida I, Iwada K, Tanaka N, Shimamoto K, Tsurumi Y, Kawana M, Hagiwara N. Oxygen preconditioning prevents contrast-induced nephropathy in patients with chronic kidney disease: option CIN-CKD Randomized Trial. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4298] [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: 11/14/2022] Open
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Nanka O, Krejci E, Pesevski Z, Sedmera D, Smart N, Rossdeutsch A, Dube KN, Riegler J, Price AN, Taylor A, Muthurangu V, Turner M, Lythgoe MF, Riley PR, Kryvorot S, Vladimirskaya T, Shved I, Schwarzl M, Seiler S, Huber S, Steendijk P, Maechler H, Truschnig-Wilders M, Pieske B, Post H, Caprio C, Baldini A, Chiavacci E, Dolfi L, Verduci L, Meghini F, Cremisi F, Pitto L, Kuan TC, Chen MC, Yang TH, Wu WT, Lin CS, Rai H, Kumar S, Sharma AK, Mastana S, Kapoor A, Pandey CM, Agrawal S, Sinha N, Orlowska-Baranowska EH, Placha G, Gora J, Baranowski R, Abramczuk E, Hryniewiecki T, Gaciong Z, Verschuren JJW, Wessels JAM, Trompet S, Stott DJ, Sattar N, Buckley B, Guchelaar HJ, Jukema JW, Gharanei M, Hussain A, Mee CJ, Maddock HL, Wijnen WJ, Van Den Oever S, Van Der Made I, Hiller M, Tijsen AJ, Pinto YM, Creemers EE, Nikulina SUY, Chernova A, Petry A, Rzymski T, Kracun D, Riess F, Pike L, Harris AL, Gorlach A, Katare R, Oikawa A, Riu F, Beltrami AP, Cesseli D, Emanueli C, Madeddu P, Zaglia T, Milan G, Franzoso M, Pesce P, Sarais C, Sandri M, Mongillo M, Butler TJ, Seymour AML, Ashford D, Jaffre F, Bussen M, Ferrara N, Koch WJ, Leosco D, Akhmedov A, Klingenberg R, Brokopp C, Hof D, Zoller S, Corti R, Gay S, Flohrschutz I, Von Eckardstein A, Hoerstrup SP, Luescher TF, Heijman J, Zaza A, Johnson DM, Rudy Y, Peeters RLM, Volders PGA, Westra RL, Martin GR, Morais CAS, Oliveira SHV, Brandao FC, Gomes IF, Lima LM, Fujita S, Okamoto R, Taniguchi M, Konishi K, Goto I, Engelhardt S, Sugimoto K, Nakamura M, Shiraki K, Buechler C, Ito M, Kararigas G, Nguyen BT, Jarry H, Regitz-Zagrosek V, Van Bilsen M, Daniels A, Munts C, Janssen BJA, Van Der Vusse GJ, Van Nieuwenhoven FA, Montalvo C, Villar AV, Merino D, Garcia R, Llano M, Ares M, Hurle MA, Nistal JF, Dembinska-Kiec A, Beata Kiec-Wilk BKW, Anna Polus AP, Urszula Czech UC, Tatiana Konovaleva TK, Gerd Schmitz GS, Bertrand L, Balteau M, Timmermans A, Viollet B, Sakamoto K, Feron O, Horman S, Vanoverschelde JL, Beauloye C, De Meester C, Martinez E, Martin R, Miana M, Jurado R, Gomez-Hurtado N, Bartolome MV, San Roman JA, Lahera V, Nieto ML, Cachofeiro V, Rochais F, Sturny R, Mesbah K, Miquerol L, Kelly RG, Messaoudi S, Gravez B, Tarjus A, Pelloux V, Samuel JL, Delcayre C, Launay JM, Clement K, Farman N, Jaisser F, Hadyanto L, Castellani C, Vescovo G, Ravara B, Tavano R, Pozzobon M, De Coppi P, Papini E, Vettor R, Thiene G, Angelini A, Meloni M, Caporali A, Cesselli D, Fortunato O, Avolio E, Madeddu P, Beltrami AP, Emanueli C, Schindler R, Simrick S, Brand T, Dube KN, Riley PR, Smart NS, Oikawa A, Katare R, Herman A, Emanueli C, Madeddu P, Roura Ferrer S, Rodriguez Bago J, Soler-Botija C, Pujal JM, Galvez-Monton C, Prat-Vidal C, Llucia-Valldeperas A, Blanco J, Bayes-Genis A, Foldes G, Maxime M, Ali NN, Schneider MD, Harding SE, Reni C, Mangialardi G, Caporali A, Meloni M, Emanueli C, Madeddu P, De Pauw A, Sekkali B, Friart A, Ding H, Graffeuil A, Catalucci D, Balligand JL, Azibani F, Tournoux F, Schlossarek S, Polidano E, Fazal L, Merval R, Carrier L, Chatziantoniou C, Samuel JL, Delcayre C, Buyandelger B, Linke W, Zou P, Kostin S, Ku C, Felkin L, Birks E, Barton P, Sattler M, Knoell R, Schroder K, Benkhoff S, Shimokawa H, Grisk O, Brandes RP, Parepa IR, Mazilu L, Suceveanu AI, Suceveanu A, Rusali L, Cojocaru L, Matei L, Toringhibel M, Craiu E, Pires AL, Pinho M, Pinho S, Sena C, Seica R, Leite-Moreira A, Zaglia T, Milan G, Franzoso M, Dabroi F, Pesce P, Schiaffino S, Sandri M, Mongillo M, Kiseleva E, Krukov N, Nikitin O, Ardatova L, Mourouzis I, Pantos C, Kokkinos AD, Cokkinos DV, Scoditti E, Massaro M, Carluccio MA, Pellegrino M, Calabriso N, Gastaldelli A, Storelli C, De Caterina R, Lindner D, Zietsch C, Schultheiss HP, Tschope C, Westermann D, Everaert BR, Nijenhuis VJ, Reith FCM, Hoymans VY, Timmermans JP, Vrints CJ, Simova I, Mateev H, Katova T, Haralanov L, Dimitrov N, Mironov N, Golitsyn SP, Sokolov SF, Yuricheva YUA, Maikov EB, Shlevkov NB, Rosenstraukh LV, Chazov EI, Radosinska J, Knezl V, Benova T, Slezak J, Urban L, Tribulova N, Virag L, Kristof A, Kohajda ZS, Szel T, Husti Z, Baczko I, Jost N, Varro A, Sarusi A, Farkas AS, Orosz SZ, Forster T, Varro A, Farkas A, Zakhrabova-Zwiauer OM, Hardziyenka M, Nieuwland R, Tan HL, Raaijmakers AJA, Bourgonje VJA, Kok GJM, Van Veen AAB, Anderson ME, Vos MA, Bierhuizen MFA, Benes J, Sebestova B, Sedmera D, Ghouri IA, Kemi OJ, Kelly A, Burton FL, Smith GL, Bourgonje VJA, Vos MA, Ozdemir S, Acsai K, Doisne N, Van Der Nagel R, Beekman HDM, Van Veen TAB, Sipido KR, Antoons G, Harmer SC, Mohal JS, Kemp D, Tinker A, Beech D, Burley DS, Cox CD, Wann KT, Baxter GF, Wilders R, Verkerk A, Fragkiadaki P, Germanakis G, Tsarouchas K, Tsitsimpikou C, Tsardi M, George D, Tsatsakis A, Rodrigues P, Barros C, Najmi AK, Khan V, Akhtar M, Pillai KK, Mujeeb M, Aqil M, Bayliss CR, Messer AE, Leung MC, Ward D, Van Der Velden J, Poggesi C, Redwood CS, Marston S, Vite A, Gandjbakhch E, Gary F, Fressart V, Leprince P, Fontaine G, Komajda M, Charron P, Villard E, Falcao-Pires I, Gavina C, Hamdani N, Van Der Velden J, Stienen GJM, Niessens HWM, Leite-Moreira AF, Paulus WJ, Messer AE, Marston S, Memo M, Leung MC, Bayliss CR, Memo M, Messer AE, Marston SB, Vafiadaki E, Qian J, Arvanitis DA, Sanoudou D, Kranias EG, Elmstedt N, Lind B, Ferm-Widlund K, Westgren M, Brodin LA, Mansfield C, West T, Ferenczi M, Wijnker PJM, Foster DB, Coulter A, Frazier A, Murphy AM, Stienen GJM, Van Der Velden J, Shah M, Sikkel MB, Desplantez T, Collins TP, O' Gara P, Harding SE, Lyon AR, Macleod KT, Ottesen AH, Louch WE, Carlson C, Landsverk OJB, Stridsberg M, Sjaastad I, Oie E, Omland T, Christensen G, Rosjo H, Cartledge J, Clark LA, Ibrahim M, Siedlecka U, Navaratnarajah M, Yacoub MH, Camelliti P, Terracciano CM, Chester A, Gonzalez-Tendero A, Torre I, Garcia-Garcia F, Dopazo J, Gratacos E, Taylor D, Bhandari S, Seymour AM, Fliegner D, Jost J, Bugger H, Ventura-Clapier R, Regitz-Zagrosek V, Carpi A, Campesan M, Canton M, Menabo R, Pelicci PG, Giorgio M, Di Lisa F, Hancock M, Venturini A, Al-Shanti N, Stewart C, Ascione R, Angelini G, Suleiman MS, Kravchuk E, Grineva E, Galagudza M, Kostareva A, Bairamov A, Krychtiuk KA, Watzke L, Kaun C, Demyanets S, Pisoni J, Kastl SP, Huber K, Maurer G, Wojta J, Speidl WS, Varga ZV, Farago N, Zvara A, Kocsis GF, Pipicz M, Csonka C, Csont T, Puskas GL, Ferdinandy P, Klevstigova M, Silhavy J, Manakov D, Papousek F, Novotny J, Pravenec M, Kolar F, Novakova O, Novak F, Neckar J, Barallobre-Barreiro J, Didangelos A, Yin X, Fernandez-Caggiano M, Drozdov I, Willeit P, Domenech N, Mayr M, Lemoine S, Allouche S, Coulbault L, Galera P, Gerard JL, Hanouz JL, Suveren E, Whiteman M, Baxter GF, Studneva IM, Pisarenko O, Shulzhenko V, Serebryakova L, Tskitishvili O, Timoshin A, Fauconnier J, Meli AC, Thireau J, Roberge S, Lompre AM, Jacotot E, Marks AM, Lacampagne A, Dietel B, Altendorf R, Daniel WG, Kollmar R, Garlichs CD, Verduci L, Parente V, Balasso S, Pompilio G, Colombo G, Milano G, Squadroni L, Cotelli F, Pozzoli O, Capogrossi MC, Ajiro Y, Saegusa N, Iwade K, Giles WR, Stafforini DM, Spitzer KW, Sirohi R, Candilio L, Babu G, Roberts N, Lawrence D, Sheikh A, Kolvekar S, Yap J, Hausenloy DJ, Yellon DM, Aslam M, Rohrbach S, Schlueter KD, Piper HM, Noll T, Guenduez D, Malinova L, Ryabukho VP, Lyakin DV, Denisova TP, Montoro-Garcia S, Shantsila E, Lip GYH, Kalaska B, Sokolowska E, Kaminski K, Szczubialka K, Kramkowski K, Mogielnicki A, Nowakowska M, Buczko W, Stancheva N, Mekenyan E, Gospodinov K, Tisheva S, Darago A, Rutkai I, Kalasz J, Czikora A, Orosz P, Bjornson HD, Edes I, Papp Z, Toth A, Riches K, Warburton P, O'regan DJ, Ball SG, Turner NA, Wood IC, Porter KE, Kogaki S, Ishida H, Nawa N, Takahashi K, Baden H, Ichimori H, Uchikawa T, Mihara S, Miura K, Ozono K, Lugano R, Padro T, Garcia-Arguinzonis M, Badimon L, Yin X, Ferraro F, Viner R, Ho J, Cutler D, Mayr M, Matchkov V, Aalkjaer C, Mangialardi G, Katare R, Oikawa A, Madeddu P, Krijnen PAJ, Hahn NE, Kholova I, Sipkens JA, Van Alphen FP, Simsek S, Schalkwijk CG, Van Buul JD, Van Hinsbergh VWM, Niessen HWM, Simova I, Katova T, Haralanov L, Caro CG, Seneviratne A, Monaco C, Hou D, Singh J, Gilson P, Burke MG, Heraty KB, Krams R, Coppola G, Albrecht K, Schgoer W, Wiedemann D, Bonaros N, Steger C, Theurl M, Stanzl U, Kirchmair R, Amadesi S, Fortunato O, Reni C, Katare R, Meloni M, Ascione R, Spinetti G, Cangiano E, Valgimigli M, Madeddu P, Caporali A, Meloni M, Miller AM, Cardinali A, Vierlinger K, Fortunato O, Spinetti G, Madeddu P, Emanueli C, Pagano G, Liccardo D, Zincarelli C, Femminella GD, Lymperopoulos A, De Lucia C, Koch WJ, Leosco D, Rengo G, Hinkel R, Husada W, Trenkwalder T, Di Q, Lee S, Petersen B, Bock-Marquette I, Niemann H, Di Maio M, Kupatt C, Nourian M, Yassin Z, Kelishadi R, Nourian M, Kelishadi R, Yassin Z, Memarian SH, Heidari A, Leuner A, Poitz DM, Brunssen C, Ravens U, Strasser RH, Morawietz H, Vogt F, Grahl A, Flege C, Marx N, Borinski M, De Geest B, Jacobs F, Muthuramu I, Gordts SC, Van Craeyveld E, Herijgers P, Weinert S, Poitz DM, Medunjanin S, Herold J, Schmeisser A, Strasser RH, Braun-Dullaeus RC, Wagner AH, Moeller K, Adolph O, Schwarz M, Schwale C, Bruehl C, Nobiling R, Wieland T, Schneider SW, Hecker M, Cross A, Strom A, Cole J, Goddard M, Hultgardh-Nilsson A, Nilsson J, Mauri C, Monaco C, Mitkovskaya NP, Kurak TA, Oganova EG, Shkrebneva EI, Kot ZHN, Statkevich TV, Molica F, Burger F, Matter CM, Thomas A, Staub C, Zimmer A, Cravatt B, Pacher P, Steffens S, Blanco R, Sarmiento R, Parisi C, Fandino S, Blanco F, Gigena G, Szarfer J, Rodriguez A, Garcia Escudero A, Riccitelli MA, Wantha S, Simsekyilmaz S, Megens RT, Van Zandvoort MA, Liehn E, Zernecke A, Klee D, Weber C, Soehnlein O, Lima LM, Carvalho MG, Gomes KB, Santos IR, Sousa MO, Morais CAS, Oliveira SHV, Gomes IF, Brandao FC, Lamego MRA, Lima LM, Fornai L, Angelini A, Kiss A, Giskes F, Eijkel G, Fedrigo M, Valente ML, Thiene G, Heeren RMA, Grdinic A, Vojvodic D, Djukanovic N, Grdinic AG, Obradovic S, Majstorovic I, Rusovic S, Vucinic Z, Tavciovski D, Ostojic M, Lin CS, Kuan TC, Lai SC, Chen MY, Wu HT, Gouweleeuw L, Oberdorf-Maass SU, De Boer RA, Van Gilst WH, Maass AH, Van Gelder IC, Azibani F, Benard L, Schlossarek S, Merval R, Tournoux F, Launay JM, Carrier L, Chatziantoniou C, Samuel JL, Delcayre C, Li C, Warren D, Shanahan CM, Zhang QP, Bye A, Vettukattil R, Aspenes ST, Giskeodegaard G, Gribbestad IS, Wisloff U, Bathen TF, Cubedo J, Padro T, Alonso R, Mata P, Badimon L, Ivic I, Vamos Z, Cseplo P, Kosa D, Torok O, Hamar J, Koller A, Norita K, De Noronha SV, Sheppard MN, Torre I, Amat-Roldan I, Iruretagoiena I, Psilodimitrakopoulos S, Gonzalez-Tendero A, Crispi F, Artigas D, Loza-Alvarez P, Gratacos E, Harrison JC, Smart SD, Besely EH, Kelly JR, Yao Y, Sammut IA, Hoepfner M, Kuzyniak W, Sekhosana E, Hoffmann B, Litwinski C, Pries A, Ermilov E, Fontoura D, Lourenco AP, Vasques-Novoa F, Pinto JP, Roncon-Albuquerque R, Leite-Moreira AF, Oyeyipo IP, Olatunji LA, Usman TO, Olatunji VA, Bacova B, Radosinska J, Viczenczova C, Knezl V, Dosenko V, Benova T, Goncalvesova E, Vanrooyen J, Tribulova N, Maulik SK, Seth S, Dinda AK, Jaiswal A, Mearini G, Khajetoorians D, Kraemer E, Gedicke-Hornung C, Precigout G, Eschenhagen T, Voit T, Garcia L, Lorain S, Carrier L, Mendes-Ferreira P, Maia-Rocha C, Adao R, Lourenco AP, Cerqueira RJ, Mendes MJ, Castro-Chaves P, De Keulenaer GW, Leite-Moreira AF, Bras-Silva C, Ruiter G, Wong YY, Lubberink M, Knaapen P, Raijmakers P, Lammertsma AA, Marcus JT, Westerhof N, Van Der Laarse WJ, Vonk-Noordegraaf A, Poitz DM, Steinbronn N, Koch E, Steiner G, Strasser RH, Berezin A, Lisovaya OA, Soldatova AM, Kuznetcov VA, Yenina TN, Rychkov AYU, Shebeko PV, Altara R, Hessel MHM, Hermans JJR, Janssen BJA, Blankesteijn WM, Soldatova AM, Kuznetcov VA, Yenina TN, Rychkov AYU, Shebeko PV, Berezin A, Berezina TA, Seden V, Bonanad C, Nunez J, Navarro D, Chilet MF, Sanchis F, Bodi V, Minana G, Chaustre F, Forteza MJ, Llacer A, Femminella GD, Rengo G, Galasso G, Zincarelli C, Liccardo D, Pagano G, De Lucia C. Poster session 3. Cardiovasc Res 2012. [DOI: 10.1093/cvr/cvr336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kitada A, Tsujimoto Y, Yamamoto T, Kobayashi Y, Narumi Y, Kindo K, Aczel A, Luke G, Uemura Y, Kiuchi Y, Ueda Y, Yoshimura K, Ajiro Y, Kageyama H. Quadruple-layered perovskite (CuCl)Ca2NaNb4O13. J SOLID STATE CHEM 2012. [DOI: 10.1016/j.jssc.2011.10.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Asano T, Inagaki Y, Ajiro Y, Matsubara H, Mukai K, Matsumoto N, Mitamura H, Goto T, Narumi Y, Kindo K, Hori H. High-Field Magnetization Process in Free Radical and Metal-Assembled Molecular Magnets. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/10587250008023511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- T. Asano
- a Department of Physics , Kyushu University , Fukuoka , 812-8581 , Japan
| | - Y. Inagaki
- a Department of Physics , Kyushu University , Fukuoka , 812-8581 , Japan
| | - Y. Ajiro
- a Department of Physics , Kyushu University , Fukuoka , 812-8581 , Japan
| | - H. Matsubara
- b Department of Chemistry , Ehime University , Matsuyama , 790-8577 , Japan
| | - K. Mukai
- b Department of Chemistry , Ehime University , Matsuyama , 790-8577 , Japan
| | - N. Matsumoto
- c Department of Chemistry , Kumamoto Universitty , Kumamoto , 860-8555 , Japan
| | - H. Mitamura
- d Institute for Solid State Physics (ISSP), University of Tokyo , Kashiva , 277-8581 , Japan
| | - T. Goto
- d Institute for Solid State Physics (ISSP), University of Tokyo , Kashiva , 277-8581 , Japan
| | - Y. Narumi
- e Research Center for Materials Science at Extreme Conditions (KYOKUGEN) , Osaka University , Toyonaka , 560-8531 , Japan
| | - K. Kindo
- e Research Center for Materials Science at Extreme Conditions (KYOKUGEN) , Osaka University , Toyonaka , 560-8531 , Japan
| | - H. Hori
- f School of Materials Science, Japan Advanced Institute of Science and Technology , Tatsunokuchi , 923-1292 , Japan
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Iyoda M, Ajiro Y, Sato K, Kuroki A, Shibata T, Kitazawa K, Sugisaki T. A case of refractory uremic pleuropericarditis--successful corticosteroid treatment. Clin Nephrol 2006; 65:290-3. [PMID: 16629230 DOI: 10.5414/cnp65290] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We report the case of a patient with uremic pleuropericarditis who showed a marked improvement following corticosteroid therapy. A 66-year-old man who had been on hemodialysis therapy for 13 years was admitted to our hospital presenting with increases in bilateral pleural effusions and pericardial effusion. Repeated thoracentesis showed hemorrhagic and exudative findings. Pleural and pericardial fluid cytologic examination, bacterial culture and acid-fast staining showed negative findings. Despite the administration of antibiotics and antituberculosis drugs, low-grade fever continued and C-reactive protein level remained high. A pleural biopsy revealed fibrinous pleuritis without infectious disease or malignancy. He was diagnosed as having uremic pleuropericarditis on the basis of the clinicopathological features, but had been unresponsive to conventional treatments including repeated thoracentesis and the continuance of hemodiafiltration using nafamostat mesylate. Ultimately, both pleural and pericardial effusions were controlled after the treatment with prednisolone at an initial dose of 50 mg per day. In conclusion, corticosteroid therapy seems to be useful for treating patients with conventional therapy-resistant uremic pleuropericarditis.
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Affiliation(s)
- M Iyoda
- Department of Nephrology, Showa University School of Medicine, Tokyo, Japan.
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Iyoda M, Hato T, Matsumoto K, Ito J, Ajiro Y, Kuroki A, Shibata T, Kitazawa K, Sugisaki T. Rapidly progressive glomerulonephritis in a patient with Chlamydia pneumoniae infection: a possibility of superantigenic mechanism of its pathogenesis. Clin Nephrol 2006; 65:48-52. [PMID: 16429842 DOI: 10.5414/cnp65048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Herein we describe a case of a patient with rapidly progressive glomerulonephritis after Chlamydia pneumoniae infection. An 88-year-old woman who had had C. pneumoniae infection two months previously was admitted to our hospital with complaints of dyspnea and generalized edema. Laboratory tests revealed acute renal failure, polyclonal hypergammaglobulinemia, highly increased level of C-reactive protein, and hematoproteinuria. A renal biopsy revealed mesangial and endocapillary proliferative glomerulonephritis with crescents. She responded to high-dose steroids, cyclophosphamide, minocycline, and plasma exchange treatment with the remission of oliguric renal failure. The percentage of the subset of CD3+ TCR+ Vbeta11+ cells markedly increased to 9.6% (normal range: < 1.04%) at the onset of the disease and decreased to 0.1% after the treatment. These clinicopathological features were similar to those of superantigen-associated glomerulonephritis after methicillin-resistant Staphylococcus aureus infection. We suggest that the superantigenic mechanism is one of the possible pathomechanisms of this glomerulonephritis.
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Affiliation(s)
- M Iyoda
- Department of Nephrology, Showa University School of Medicine, Tokyo, Japan.
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Yoshida M, Shiraki K, Okubo S, Ohta H, Ito T, Takagi H, Kaburagi M, Ajiro Y. Energy structure of a finite Haldane chain in Y2BaNi0.96Mg0.04O5 studied by high field electron spin resonance. Phys Rev Lett 2005; 95:117202. [PMID: 16197040 DOI: 10.1103/physrevlett.95.117202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2005] [Indexed: 05/04/2023]
Abstract
This Letter presents the fine structure of energy levels for the edge states of a Haldane chain. In order to investigate the edge states, we have performed high field and multifrequency electron spin resonance (ESR) measurements of finite length S=1 antiferromagnetic chains in Y2BaNi0.96Mg0.04O5. Owing to the high spectral resolution by high fields and high frequencies, observed ESR signals can be separated into the contributions of the finite chains with various chain lengths. Our results clearly show that the edge spins actually interact with each other through the quantum spin chain and the interaction depends on the chain length N. This N dependence has been obtained experimentally for the first time, and shows that the correlation length xi in the real system is somewhat larger than that calculated by a simple Heisenberg model.
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Affiliation(s)
- M Yoshida
- Venture Business Laboratory, Kobe University, Kobe 657-8501, Japan
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Rousochatzakis I, Ajiro Y, Mitamura H, Kögerler P, Luban M. Hysteresis loops and adiabatic Landau-Zener-Stückelberg transitions in the magnetic molecule {V6}. Phys Rev Lett 2005; 94:147204. [PMID: 15904102 DOI: 10.1103/physrevlett.94.147204] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2004] [Indexed: 05/02/2023]
Abstract
We have observed hysteresis loops and abrupt magnetization steps in the magnetic molecule {V(6)}, where each molecule comprises a pair of identical spin triangles, in the temperature range 1-5 K for external magnetic fields B with sweep rates of several Tesla per millisecond executing a variety of closed cycles. The hysteresis loops are accurately reproduced using a generalization of the Bloch equation based on direct one-phonon transitions between the instantaneous Zeeman-split levels of the ground state (an S=1/2 doublet) of each spin triangle. The magnetization steps occur for B approximately 0, and they are explained in terms of adiabatic Landau-Zener-Stückelberg transitions between the lowest magnetic energy levels as modified by an intertriangle anisotropic exchange of order 0.4 K.
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Affiliation(s)
- I Rousochatzakis
- Ames Laboratory and Department of Physics and Astronomy, Iowa State University, Ames, Iowa 50011, USA.
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Kogure Y, Shen Y, Takase M, Ajiro Y, Suzuki M. [Report on the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America--cone beam artifact and helical artifact on the MDCT helical scan]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2004; 60:1670-1. [PMID: 15614216 DOI: 10.6009/jjrt.kj00003560629] [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] [Indexed: 05/01/2023]
Abstract
Because MDCT use narrow cone beam x-ray, to quantitatively evaluate cone beam artifact and helical artifact is very important with different x-ray beam width (detector configuration) . The both effect (helical artifact and cone beam artifact) was confirmed on the MDCT helical scan. It does not have cone beam artifact in the Isocenter or using center detector row for conventional scan, but helical artifact basically does not depend position of x-y plane. From quantitative evaluation of cone beam artifact, helical scan has fewer cone beam artifact than conventional scan on the 200 mm position of x-y plane: the cone beam artifact index is 11.76 (8 x 2.5mm conventional scan with most edge detector row) , 6.86 (8 x 2.5mm helical pitch 0.625) and 4.9 (8 x 2.5mm helical pitch 1.675). From phantom experiment, it was concluded that cone beam angle more contribute cone beam artifact than increasing slice numbers. And it was concluded that helical scan has fewer cone beam artifact than conventional scan, because helical scan use multi detector row information and special recon algorithm with cone beam correction on the GE LightSpeed MDCT scanner.
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Grenier B, Inagaki Y, Regnault LP, Wildes A, Asano T, Ajiro Y, Lhotel E, Paulsen C, Ziman T, Boucher JP. Ordering and excitations in the field-induced magnetic phase of Cs3Cr2Br9. Phys Rev Lett 2004; 92:177202. [PMID: 15169187 DOI: 10.1103/physrevlett.92.177202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2003] [Indexed: 05/24/2023]
Abstract
Field-induced magnetic order has been investigated in detail in the interacting spin 3/2 dimer system Cs3Cr2Br9. Elastic and inelastic neutron scattering measurements were performed up to H=6 T, well above the critical field H(c1) approximately 1.5 T. The ordering displays incommensurabilities and a large hysteresis before a commensurate structure is reached. This structure is fully determined. Surprisingly, the lowest excitation branch never closes. Above H(c1), the gap increases slowly with the field. An analysis in terms of projected pseudospins is given.
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Affiliation(s)
- B Grenier
- Département de Recherche Fondamentale sur la Matière Condensée, SPSMS, Laboratoire Magnétisme et Diffraction Neutronique, CEA-Grenoble, 38054 Grenoble cedex 9, France
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Nakano H, Okazaki K, Ajiro Y, Suzuki T, Oba K. Clinical usefulness of measuring pulse wave velocity in predicting cerebrovascular disease: evaluation from a cross-Sectional and longitudinal follow-up study. J NIPPON MED SCH 2001; 68:490-7. [PMID: 11744929 DOI: 10.1272/jnms.68.490] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The present study was designed both as a cross-sectional and longitudinal follow-up study to evaluate the association between pulse wave velocity (PWV) and cardiovascular disease. The subjects in this study included a total 260 patients (134 men and 126 women) ranging from 25 to 91 years (mean, 67.6+/-11.0 years). Carotid to femoral PWV was measured in all patients. The subsequent development of a cerebrovascular or coronary event was defined as a cardiovascular event. The longitudinal follow-up study was conducted with the occurrence of a cardiovascular event as the endpoint. The patients were classified into two groups: an L group with a PWV of less than 10 m/sec and an H group with a PWV of 10 m/sec or higher. Cross-sectional study at baseline: The H group patients were significantly older than the L group patients. The prevalence of hypertension, cardiovascular disease, ischemic heart disease, and cerebrovascular disease were significantly higher in the H group. Systolic blood pressure and serum uric acid were significantly higher in the H group than in the L group. However, there were no significant differences between the two groups with respect to other risk factors. Multivariate analysis using the prevalence of cardiovascular disease as the dependent variable showed "age" and "H group" to be independent variables. When the prevalence of ischemic heart disease or cerebrovascular disease was used as dependent variable, only "age" was an independent variable. Longitudinal follow-up study: The prevalence of cardiovascular event and cerebrovascular event were significantly higher in the H group than in the L group. The prevalence of coronary event in the H group tended to be higher than in the L group, but the difference was not statistically significant. Multivariate analysis using the cardiovascular event rate or coronary event rate as the dependent variable showed only "age" to be an independent variable. When the cerebrovascular event rate was used as the dependent variable, "uric acid" and "H group" were independent variables. The results of this study suggest a higher rate of cerebrovascular disease in patients with high PWV.
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Affiliation(s)
- H Nakano
- Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan.
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Nakano H, Okazaki K, Ajiro Y, Suzuki T, Oba K. Clinical usefulness of the common carotid artery blood flow velocity ratio as measured by an ultrasonic quantitative flow measurement system: evaluation with respect to prevalence of ischemic heart disease. J NIPPON MED SCH 2001; 68:482-9. [PMID: 11744928 DOI: 10.1272/jnms.68.482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The present study evaluated the clinical usefulness of the measurement of common carotid artery blood flow velocity by an ultrasonic quantitative flow measurement system (QFM), and its correlation with the prevalence of ischemic heart disease (IHD). The subjects in this study included 287 patients (149 men and 138 women; mean age, 67.6+/-11.0 years) being treated as outpatients. Bilateral common carotid artery blood flow velocity was measured using a QFM-1100 (Hayashi Denki Co., Ltd.). The "high to low velocity ratio" (H/L ratio) was calculated by dividing the higher value by the lower value of the velocity of the common carotid artery. In 43 of 287 patients, we used an SSA-270 ACE (Toshiba Co., Ltd) to determine the presence of plaque and measure intimal-medial thickness (IMT) in the common carotid arteries. The mean H/L ratio was 1.45, with a median value of 1.25. The patients were stratified into subgroups based on H/L ratios from 1.0 and above in 0.1 increments in order to compare the prevalence rates of IHD. The prevalence rates in groups with H/L ratios of 1.3 and greater were significantly higher than those in the group with H/L ratios less than 1.3. In logistic regression analysis, the unadjusted H/L ratio was an independent risk factor for IHD at ratios from greater than 1.1 to greater than 1.6. The age-adjusted H/L ratio was an independent risk factor for IHD at ratios from greater than 1.1 to greater than 1.4. IMT was significantly higher in patients with a H/L ratio of 1.4 or greater versus patients with a ratio less than 1.4 (1.154+/-0.417 mm vs. 0.421+/-0.425 mm; p<0.05). The prevalence of carotid artery plaque was also significantly higher in patients with a H/L ratio of 1.4 or greater versus patients with a ratio of less than 1.4 (76.5% vs. 38.5%; p<0.03). Therefore, determination of the carotid artery H/L ratio by means of QFM may be clinically useful in screening patients for coronary artery lesions.
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Affiliation(s)
- H Nakano
- Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan.
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Suzuki T, Oba K, Igari Y, Matsumura N, Inuzuka Y, Kigawa Y, Ajiro Y, Okazaki K, Nakano H, Metori S. [A four-year prospective study on the influence of serum elevated lipoprotein (a) concentration on ischemic heart disease and cerebral infarction in elderly patients with type 2 diabetes]. Nihon Ronen Igakkai Zasshi 2001; 38:507-13. [PMID: 11523163 DOI: 10.3143/geriatrics.38.507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To clarify the influence of elevated serum lipoprotein (a) (Lp(a)) concentration on ischemic heart disease (IHD) and the perforating artery occlusion type of cerebral infarction (CI) in elderly patients with type 2 diabetes, we measured the serum levels of Lp(a) of type 2 diabetic patients (n = 158, 81 men and 77 women). The group was followed up prospectively for 4 years and the incidence of IHD or CI was monitored. The diagnosis of CI was confirmed by computed tomography and that of IHD, which includes myocardial infarction and angina pectoris, was diagnosed by electrocardiogram and blood chemistry examination, Lp(a) concentrations of 20 mg/dl or more were identified as elevated Lp(a) levels and Lp(a) concentrations of less than 20 mg/dl were identified as normal Lp(a) levels. A Kaplan-Meier survival analysis (log-rank test) assessed the time to event rate stratified by an Lp(a) cutoff point of 20 mg/dl. The predictive value for CI or IHD events was assessed by multiple logistic regression analysis. The probability of IHD events was significantly higher in the elevated Lp(a) group than in the normal Lp(a) group without a history of IHD but was similar in the two groups for those patients with a history of IHD. There was no significant difference between the elevated Lp(a) group and the normal Lp(a) group with regard to CI events in patients without a history of CI and with a history of CI. On multiple logistic regression analysis, Lp(a), hyperlipidemia and a history of IHD were significant predictors of IHD and hypertension, hyperlipidemia and a history of CI were significant predictors of CI. These results show that elevated serum Lp(a) concentrations is an independent risk factor for IHD, but not for the perforating artery occlusion type of CI in type 2 elderly diabetic patients.
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Affiliation(s)
- T Suzuki
- Division of Geriatric Medicine, Nippon Medical School
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Oba K, Ito T, Nakatani C, Okamura K, Yamaguchi H, Ajiro Y, Suzuki T, Nakano H, Metori S, Sano K, Hyakusoku H, Yamada N. An elderly patient with gastric carcinoma developing multiple metastasis in skeletal muscle. J NIPPON MED SCH 2001; 68:271-4. [PMID: 11404776 DOI: 10.1272/jnms.68.271] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We present a 70-year-old man with gastric carcinoma developing multiple metastasis in skeletal muscle. He had a right supraclavicular lymph node swelling. Brain, chest and abdomen CT scans revealed metastatic lesions in the brain, lung, liver and bilateral adrenal glands. Further, CT showed a ring enhanced soft-tissue mass in the left lumbar muscle. Needle aspirate of the mass in both the left lumbar muscle and the right enlarged supraclavicular lymph node revealed cells suggestive of poorly differentiated adenocarcinoma. Upper gastrointestinal endoscopic evaluation demonstrated an advanced gastric carcinoma. Two months after admission, the tumor in the left lumbar muscle had grown and some new lesions in the left iliopsoas muscles appeared. Intramuscular metastasis from gastric carcinoma is an extremely rare phenomenon.
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Affiliation(s)
- K Oba
- Division of Geriatric Medicine, Nippon Medical School, Japan.
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42
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Oba K, Kudo R, Yano M, Watanabe K, Ajiro Y, Okazaki K, Suzuki T, Nakano H, Metori S. Ileus after administration of cold remedy in an elderly diabetic patient treated with acarbose. J NIPPON MED SCH 2001; 68:61-4. [PMID: 11180704 DOI: 10.1272/jnms.68.61] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A 69-year-old type 2 diabetic man was admitted due to diabetic gangrane. He had a history of subtotal gastrectomy. During hospitalization, he was treated with regular insulin and 300 mg/day of acarbose. He developed a low grade fever, cough and nasal discharge, and was given a compound "cold" remedy with anticholenergic properties. The next day, he suffered from a paralytic ileus. Oral intake and acarbose were withheld and the ileus spontaneously resolved after 2 days. These finding indicate the possibility that the ileus was triggered by drugs with anticholinergic properties in this elderly diabetic patient treated with alpha-glucosidase inhibitors.
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Affiliation(s)
- K Oba
- The Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
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43
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Takeyama S, Amaya K, Nakagawa T, Ishizuka M, Nakao K, Sakakibara T, Gotot T, Miura N, Ajiro Y, Kikuchi H. Magnetisation measurements in ultra-high magnetic fields produced by a single-turn coil system. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0022-3735/21/11/004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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44
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Oba K, Igari Y, Takai E, Soya S, Matsumura N, Watanabe K, Ajiro Y, Okazaki K, Sato S, Suzuki T, Nakano H, Metori S. Age-related changes in postprandial plasma glucose in type 2 diabetes. J NIPPON MED SCH 2000; 67:284-6. [PMID: 10938599 DOI: 10.1272/jnms.67.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- K Oba
- Division of Geriatric Medicine, Nippon Medical School, Japan
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45
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Asano T, Nojiri H, Inagaki Y, Boucher JP, Sakon T, Ajiro Y, Motokawa M. ESR investigation on the breather mode and the spinon-breather dynamical crossover in Cu benzoate. Phys Rev Lett 2000; 84:5880-5883. [PMID: 10991078 DOI: 10.1103/physrevlett.84.5880] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/1999] [Indexed: 05/23/2023]
Abstract
A "breather excitation" is observed directly by electron spin resonance in the quantum spin chain Cu benzoate, in which an unexpected field-induced gap has recently been found. The nonlinear field dependence of the resonance field agrees well with the formula based on a quantum sine-Gordon model. The power-law temperature dependence of the linewidth is observed in the gapless spinon regime while the width decreases exponentially for the gapped breather regime. In the intermediate range, a distinct anomaly is found, which is the manifestation of "the spinon-breather dynamical crossover."
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Affiliation(s)
- T Asano
- Department of Physics, Kyushu University, Fukuoka 812-8581, Japan
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46
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Oba K, Igari Y, Matsumura N, Watanabe K, Inuzuka Y, Ajiro Y, Okazaki K, Sato S, Suzuki T, Nakano H, Metori S. Effect of control of blood glucose on urinary excretion of N-acetyl-beta-D-glucosaminidase in elderly type 2 diabetes mellitus. J NIPPON MED SCH 2000; 67:143-5. [PMID: 10754606 DOI: 10.1272/jnms.67.143] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- K Oba
- The Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
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47
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Oba K, Nishihara A, Okamura K, Ajiro Y, Yamaguchi Y, Okazaki K, Sato S, Suzuki T, Nakano H, Metori S. Two cases of acute myositis associated with influenza A virus infection in the elderly. J NIPPON MED SCH 2000; 67:126-9. [PMID: 10754602 DOI: 10.1272/jnms.67.126] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
During the influenza epidemic of 1998-1999, we observed two elderly patients with influenza-like symptoms who had evidence of acute myositis with elevated serum enzymes. Influenza A infection was confirmed serologically in either case. The present cases suggest that it is important to distinguish influenzal myositis from other forms of myopathy in the elderly patients.
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Affiliation(s)
- K Oba
- The Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
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48
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Oba K, Koibuchi H, Okazaki K, Igari Y, Inuzuka Y, Yano M, Yamaguchi Y, Ajiro Y, Satoh S, Nagai S, Suzuki T, Nakano H, Metori S. [Sulfonylureas and daily blood glucose profiles in elderly diabetics]. Nihon Ronen Igakkai Zasshi 1999; 36:715-20. [PMID: 10614126 DOI: 10.3143/geriatrics.36.715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study is to clarify the relationship between the efficacy of sulfonylureas and duration of diabetes in elderly diabetics. Daily blood glucose profiles were measured in 87 Type 2 elderly diabetic patients on sulfonylureas (tolbutamide, gliclazide or glibenclamide). Plasma glucose concentrations were determined at 08.00 (before breakfast), 10.00, 12.00 (before lunch), 14.00, 18.00 (before dinner), 20.00, 24.00, 03.00, 06.00, 08.00 hours. The subjects were divided into 4 sub-groups, according to their duration of the diabetes (< 10, 10-14, 15-19, 20 or more years). Mean plasma glucose values at 08.00, 10.00, 20.00, 03.00 and 06.00 hours were not significantly different among the four groups. However, mean plasma glucose values at 12.00, 14.00, 18.00, 00.00 hours and mean total blood glucose area under the daily profile (total BG) were significantly different among the four groups and the values in patients with a history of diabetes of 15 years or more increased. Duration of diabetes positively correlated with blood glucose values at 12.00, 14.00, 18.00, 00.00, 03.00 hours and total BG, and the dose of sulfonylureas positively correlated with blood glucose values at 12.00, 14.00, 18.00, 00.00 hours and total BG in multiple regression analysis. These results suggest that duration of diabetes and dose of sulfonylureas are important determinants of blood glucose control with sulfonylureas in elderly diabetic patients.
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Affiliation(s)
- K Oba
- Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
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49
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Oba K, Hirai M, Ajiro Y, Okazaki K, Sato S, Sasai K, Suzuki T, Nakano H, Metori S. Effect of age on urinary excretion of N-acetyl-beta-D-glucosaminidase. Nihon Ika Daigaku Zasshi 1999; 66:33-6. [PMID: 10097588 DOI: 10.1272/jnms.66.33] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
To examine the relationship between the concentrations of urinary NAG and age, we measured ratios of urinary N-acetyl-beta-D-glucosaminidase (NAG) to urinary creatinine (NAG index) in 137 healthy subjects, aged from 19 to 88 years. The study is also designed to evaluate the relationship between urinary NAG and blood pressure. The subjects were divided into 7 subgroups, according to their age (< 30, 30-39, 40-49, 50-59, 60-69, 70-79, 80 or more years). There was a positive correlation between NAG index and age (r = 0.36; P < 0.001). The regression equation relating NAG index (y) to age (x) was y = 0.065x + 0.97. The mean NAG indexes for the 7 subgroups divided by age were significantly different (P < 0.01). There was a positive correlation between NAG index and systolic blood pressure (r = 0.18; P < 0.05), but was not between diastolic blood pressure and NAG index. In multiple regression analysis, age and BUN significantly correlated with NAG index (r = 0.32; P < 0.01, r = 3.3; P = 0.07, respectively), although there was no correlation between systolic blood pressure and NAG index. This cross-sectional study showed a clear elevation in NAG index with age. The rate of elevation was 0.65 per decade. Urinary excretion of NAG may be unrelated to blood pressure.
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Affiliation(s)
- K Oba
- Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
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50
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Ohba K, Koibuchi H, Matsuura Y, Okazaki K, Ajiro Y, Satoh S, Sasai K, Suzuki T, Nnakano H, Mmetori S. [Morning blood glucose determination in the monitoring of metabolic control in type 2 elderly diabetic cases treated by oral hypoglycemic agents]. Nihon Ronen Igakkai Zasshi 1999; 36:122-7. [PMID: 10363530 DOI: 10.3143/geriatrics.36.122] [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] [Indexed: 11/11/2022]
Abstract
Daily blood glucose profiles were measured in 163 Type 2 elderly diabetic cases to evaluate whether a fasting (before breakfast) or a post-prandial (after breakfast) blood glucose concentration is able to predict blood glucose values throughout the day. In the diet-treated alone group (n = 61), the percentage of daily blood glucose profiles having plasma glucose values less than the 08:00 hours (before breakfast) value were as follows: 59.0%, 32.8%, 59.0%, and 55.7% at 18.00 (before supper), 24.00, 03.00, 06.00 hours, respectively. In group treated by oral hypoglycemic agents (OHA) (n = 102), these were as follows: 45.1%, 26.5%, 52.9%, and 67.6%, respectively. In the OHA group, the mean plasma glucose value at 08:00 hours was significantly higher in patients with the lowest plasma glucose levels between 60-79 mg/dl than in patients with these levels between 80-99 mg/dl (103.7 +/- 19.6 vs 118.7 +/- 16.9 mg/dl, p < 0.01), but that at 10:00 hours was similar in the two groups (218.8 +/- 43.9 vs 214.5 +/- 40.1 mg/dl). In patients with lowest plasma glucose levels of between 60-99 mg/dl, the 08:00 hours value correlated positively with that of 24:00 (r = 0.40), 03.00 (r = 0.53), and the 06.00 hours value (r = 0.69), but no correlation was observed with the 18.00 hours value. On the other hand, the 10:00 hours value was not associated with these time-points values. Our results reveal that before breakfast plasma glucose values are more predictive of low blood glucose values in the night during sleep than after-breakfast blood glucose values, but do not predict low blood glucose values before supper in patients on OHA.
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Affiliation(s)
- K Ohba
- Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
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