The impact of chronic kidney disease on the antithrombotic strategies and outcomes in patients with acute coronary syndromes and atrial fibrillation: Insights from STAR-ACS study.

Background: Patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) (ACS + AF) face elevated risks of thrombotic and bleeding events, especially with comorbid chronic kidney disease (CKD). Limited research has assessed the combined influence of CKD in this high-risk population.

Methods: This first subanalysis of STAR-ACS study included 445 Japanese ACS + AF patients, stratified by CKD status (eGFR < vs.

Poor Nutritional Status Combined With Sarcopenia Were Associated With Increased Mortality and Amputation Rate in Patients With Lower Extremity Arterial Disease Following Endovascular Treatment.

Background: There is limited evidence assessing the prognostic impact of nutritional status and sarcopenia simultaneously in patients with lower extremity arterial disease (LEAD). In this study, we estimated nutritional status by determining the triglycerides, total cholesterol, and body weight index (TCBI) as well as sarcopenia by obtaining the computed tomography (CT)-based psoas muscle index (PMI) in LEAD patients. The aim of the study was to investigate the simultaneous prognostic impact of TCBI and PMI in LEAD patients.

Association between baseline white blood cell count and future cardiovascular events in patients with stable coronary artery disease- Sub-analysis of the REAL-CAD trial.

Background: Elevated white blood cell (WBC) counts have been associated with major adverse cardiovascular events (MACE). However, their incremental prognostic values, especially considering factors such as race, sex difference, clinical characteristics, and statin dosage, are not well defined. This study aimed to explore the relationship between baseline WBC counts and subsequent MACE in Japanese patients with stable coronary artery disease (CAD) receiving high and low doses of pitavastatin, as a sub-analysis of the REAL-CAD study.

Wearable Devices in Remote Cardiac Rehabilitation With and Without Weekly Online Coaching for Patients With Coronary Artery Disease: Randomized Controlled Trial.

Background: Cardiac rehabilitation (CR) is effective in preventing cardiovascular diseases; however, participation in CR programs remains limited due to the associated challenges. The integration of wearable devices and real-time monitoring offers a potential solution to enhance adherence to remote CR programs and their outcomes.

Objective: This study aimed to evaluate the efficacy of a remote CR program using wearable devices and real-time monitoring with or without online coaching (OLC) in improving exercise capacity in patients with coronary artery disease (CAD).

"Risk factors for early-onset adjacent segment disease at L5-S1 segment after isolated L4-5 lumbar fusion surgery".

Purpose: This study aimed to elucidate the pre- and postoperative radiological risk factors for L5-S1 adjacent segment disease (ASD) after isolated L4-5 posterior or transforaminal lumbar interbody fusion (PLIF/TLIF) surgeries.

Methods: A total of 152 patients with degenerative lumbar diseases who underwent isolated L4-5 PLIF/TLIF were retrospectively investigated and followed up for at least one year (mean 4.9 years) after surgery.

Euglycemic Diabetic Ketoacidosis in a Patient with Type 2 Diabetes and Preserved Insulin Secretion on Empagliflozin.

As the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors has become widespread, euglycemic diabetic ketoacidosis (EDKA), a rare but notable complication associated with SGLT2 inhibitor use, is gaining attention, although the underlying mechanisms of SGLT2 inhibitor-associated EDKA remain unclear. This report describes the case of a 77-year-old male with type 2 diabetes mellitus on an SGLT2 inhibitor who developed EDKA just after undergoing percutaneous coronary intervention following acute myocardial infarction, with only one day of fasting, despite sufficient insulin secretion. Our case report provides valuable insights into the mechanism and management of SGLT2 inhibitor-associated EDKA in urgent clinical settings.

Effects of Worsening Renal Function and Changes in Blood Urea Nitrogen Level During Hospitalization on Clinical Outcome in Patients with Acute Decompensated Heart Failure.

Worsening renal function (WRF) during hospitalization for acute decompensated heart failure (ADHF) is associated with poor clinical outcomes. Data on the impact of WRF on clinical outcomes, considering blood urea nitrogen (BUN) level and its changes in patients with ADHF, are scarce. This study aimed to investigate the effects of BUN and its changes during hospitalization on the relationship between WRF during hospitalization and post-discharge clinical outcomes in patients with ADHF.

Relationship Between Serum Levels of Pancreatic Exocrine Enzymes on Admission and Long-Term Clinical Outcomes in Patients with Acute Decompensated Heart Failure.

: Heart failure (HF) can damage organs because of poor perfusion and/or congestion. The interactions between HF and other organs have recently been studied; however, data on the interaction between HF and pancreatic exocrine function, which may affect fat and protein absorption and malnutrition, are scarce. We previously showed that the serum levels of pancreatic exocrine enzymes, as suggestive of pancreatic exocrine function, were low and associated with malnutrition or congestion in hospitalized patients with acute decompensated HF (ADHF).

The Triglycerides, total Cholesterol, and Body weight Index associating with frailty and predicting poor outcome after transcatheter aortic valve implantation: insights from LAPLACE-TAVI registry.

Aims: The nutritional status and frailty are crucial in patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), as they significantly impact outcomes. We have previously developed an easily calculable nutritional index, TCBI (Triglycerides, total Cholesterol, and Body weight Index), which has been validated as a prognostic indicator in various cardiovascular disease contexts. This study aimed to evaluate the impact of a low TCBI on the frailty and outcomes of patients undergoing TAVI.

Influence of Worsening Renal Function and Baseline Chronic Kidney Disease on Clinical Outcomes in Patients With Chronic Coronary Syndromes: Insights From the REAL-CAD Study.

Background: The effect of worsening renal function and baseline chronic kidney disease (CKD) on outcomes in patients with chronic coronary syndrome in the setting of optimal medical therapy remains unknown.

Methods And Results: The REAL-CAD (Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy With Pitavastatin in Coronary Artery Disease) study is a prospective, multicenter, randomized trial of high-dose (pitavastatin 4 mg/day) or low-dose (pitavastatin 1 mg/day) statin therapy in 12 118 patients with chronic coronary syndrome. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, stroke, or unstable angina requiring hospitalization (major adverse cardiac and cerebral events [MACCE]).

Real-world antithrombotic strategies in patients with atrial fibrillation and recently developed acute coronary syndrome.

Background: The antithrombotic strategy for patients with atrial fibrillation (AF) and coronary artery disease following percutaneous coronary intervention is shifting towards less intensive. Nevertheless, for patients with AF and acute coronary syndrome (ACS), an optimal antithrombotic strategy is yet to be established.

Methods And Results: We conducted a multi-center cohort study involving 146 Japanese centers that had prospectively registered 460 patients with AF and ACS followed for 2 years.

Challenges and Solutions for Cost-Effective and Practical Dental Cast Fabrication With a Desktop Fused Deposition Modeling (FDM) 3D Printer.

The objective of this study was to investigate the feasibility of using a cost-effective desktop three-dimensional (3D) fused deposition modeling (FDM) printer to fabricate dental casts to overcome the problems of conventional dental plaster casts, such as fragility and low portability. First, a 3D computer-aided design (CAD) model of the dental cast was prepared in the Standard Triangle Language (STL) format. Twelve 3D models were fabricated using a desktop FDM 3D printer under different 3D printing parameters/conditions, including shape, placement direction, and infill percentage.

Association between apolipoprotein C-III levels and coronary calcification detected by intravascular ultrasound in patients who underwent percutaneous coronary intervention.

There are few reports on the association between apolipoprotein C-III (ApoC-III) and coronary calcification using intravascular modalities. This study aimed to investigate the impacts of ApoC-III levels on coronary calcification using grayscale intravascular ultrasound (IVUS). Consecutive 263 culprit lesions for 202 patients who underwent percutaneous coronary intervention using grayscale IVUS were included in this study and divided into four groups based on quartile ApoC-III values.

Intramuscular condition of swallowing-related muscles using shear-wave elastography: A preliminary study in healthy adults.

Background: Assessing the internal condition of swallowing-related muscles and muscle strength and size is important because their deterioration may lead to dysphagia. However, there are few reports on stiffness of swallowing-related muscles measured using shear-wave elastography (SWE) and their qualitative characteristics.

Objectives: We measured stiffness of swallowing-related muscles using SWE to investigate the relationship between muscle stiffness and body composition as well as other relevant variables in healthy adults.

Randomized Trial for Evaluation in Secondary Prevention Efficacy of Combination Therapy-Statin and Eicosapentaenoic Acid (RESPECT-EPA).

Background: Low plasma levels of eicosapentaenoic acid (EPA) are associated with cardiovascular events. This trial aimed to assess the clinical benefits of icosapent ethyl in patients with coronary artery disease, a low EPA/arachidonic acid (AA) ratio, and statin treatment.

Methods: In this prospective, multicenter, randomized, open-label, blinded end-point study, patients with stable coronary artery disease and a low EPA/AA ratio (<0.

Elevated levels of plasma inactive stromal cell derived factor-1α predict poor long-term outcomes in diabetic patients following percutaneous coronary intervention.

Background: Since the complication of diabetes mellitus (DM) is a risk for adverse cardiovascular outcomes in patients with coronary artery disease (CAD), appropriate risk estimation is needed in diabetic patients following percutaneous coronary intervention (PCI). However, there is no useful biomarker to predict outcomes in this population. Although stromal cell derived factor-1α (SDF-1α), a circulating chemokine, was shown to have cardioprotective roles, the prognostic impact of SDF-1α in diabetic patients with CAD is yet to be fully elucidated.

Long-Term Impact of Renin-Angiotensin System Inhibitors for Secondary Prevention in Patients with Chronic Kidney Disease Who Underwent Percutaneous Coronary Intervention.

Introduction: The long-term impact of renin-angiotensin system (RAS) inhibitors for secondary prevention in patients with chronic kidney disease (CKD) and coexisting coronary artery disease remains unclear.

Methods: Altogether, 1,160 consecutive patients with CKD (mean age, 70 ± 9 years; 78% men) who underwent their first percutaneous coronary intervention (PCI) between 2000 and 2018 were included and analyzed. Based on their RAS inhibitor use, 674 patients (58%) were allocated to the RAS inhibitor group, and 486 patients (42%) were allocated to the non-RAS inhibitor group.

Poor Nutritional Status during Recovery from Acute Myocardial Infarction in Patients without an Early Nutritional Intervention Predicts a Poor Prognosis: A Single-Center Retrospective Study.

Whether malnutrition during the early phase of recovery from acute myocardial infarction (AMI) could be a predictor of mortality or morbidity has not been ascertained. We examined 289 AMI patients. All-cause mortality and composite endpoints (all-cause mortality, nonfatal stroke, nonfatal acute coronary syndrome, and hospitalization for acute decompensated heart failure) during the follow-up duration (median 39 months) were evaluated.

Differential prediction of high-sensitivity cardiac troponin-I, but not N-terminal pro-brain natriuretic peptide, in different pitavastatin doses on cardiovascular events in stable coronary artery disease.

Background: This study aimed to examine whether high-sensitivity cardiac troponin-I (hsTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) could predict future major adverse cardiovascular events (MACE) in stable coronary artery disease (CAD) patients with high- or low-dose of pitavastatin.

Methods: This was a case-cohort analysis of the REAL-CAD study, a randomized trial of high- or low-dose (4 or 1 mg/day) pitavastatin therapy in patients with stable CAD. We examined the MACE risk according to the quartile of hsTnI and NT-proBNP at baseline.

Plasma ANGPTL8 Levels and Risk for Secondary Cardiovascular Events in Japanese Patients With Stable Coronary Artery Disease Receiving Statin Therapy.

Background: The ability to predict secondary cardiovascular events could improve health of patients undergoing statin treatment. Circulating ANGPTL8 (angiopoietin-like protein 8) levels, which positively correlate with proatherosclerotic lipid profiles, activate the pivotal proatherosclerotic factor ANGPTL3. Here, we assessed potential association between circulating ANGPTL8 levels and risk of secondary cardiovascular events in statin-treated patients.