Age and Health Status Benefits Following Initiation of Atrial Fibrillation-Specific Treatments.

Background: Atrial fibrillation (AF) is managed with various strategies, including rate and rhythm control, to improve patients' health status. Although its incidence increases with age, how age affects health status improvements following AF treatment remains unknown.

Methods: Using data from a multicenter registry for outpatients with newly recognized AF, baseline and 1-year health status was assessed with the Atrial Fibrillation Effect on Quality-of-life quesTionnaire (AFEQT).

Procedural Characteristics and Safety of Slender Percutaneous Coronary Intervention: Slender Is Better.

Objectives: We aimed to examine the procedural characteristics and safety profile of slender percutaneous coronary interventions (PCI) using a 5 Fr or smaller sheath.

Background: Smaller catheter size has been associated with fewer complications in PCI.

Methods: Our retrospective observational study included 259,401 cases of stable elective PCI from the Japan Percutaneous Coronary Intervention Registry between 2021 and 2022.

Time trends and clinical outcomes of transcatheter patent ductus arteriosus closure in adults: insights from a Japanese nationwide registry.

Large-scale data on the current status, outcomes, and complications of transcatheter patent ductus arteriosus (PDA) closure in adults remain limited. This study aimed to elucidate the current status of transcatheter PDA closure in adults. Patient data (age ≥ 16 years) between January 2015 and December 2023 were extracted from the Japanese Structural Heart Disease (J-SHD) registry.

Accuracy of Physician Estimation of Thromboembolic Risk and Its Association With Oral Anticoagulant Utilization for the Management of Atrial Fibrillation.

Clinical practice guidelines for atrial fibrillation (AF) recommend thromboembolic risk stratification using empirical risk scores. We aimed to investigate how appropriately physicians recognize patients' actual thromboembolic risk and how this correlates with the use of oral anticoagulants (OACs). This prospective cohort study enrolled consecutive patients with initial AF treatment.

Preferences for Injectable Lipid-Lowering Therapies in Japanese Patients with Atherosclerotic Cardiovascular Disease: Findings from a Japanese Cross-sectional Study.

Introduction: Understanding patient preferences for injectable lipid-lowering therapies (LLTs) is crucial for optimizing adherence and outcomes for preventing atherosclerotic cardiovascular diseases (ASCVDs). This study aimed to quantify patient preferences for injectable LLTs among Japanese patients with ASCVDs.

Methods: This cross-sectional study was conducted from January to February 2024 using an online discrete choice experiment.

Patient-centered medical tools for sustained motivation in cardiac rehabilitation of patients with heart failure: protocol of a multicenter randomized controlled trial (EXERCISE-HF trial).

Introduction: Heart failure substantially affects the quality of life of patients and imposes notable social and economic burdens. Despite the beneficial effects of cardiac rehabilitation, global participation rates remain low. Recent advances in wearable biometric technologies may improve patient adherence through real-time monitoring and personalized feedback.

Risk-Stratified Prognostic Implications of Contrast-Associated Acute Kidney Injury After Percutaneous Coronary Intervention.

Background: The clinical importance of contrast-associated acute kidney injury (CA-AKI), the most common complication after percutaneous coronary intervention (PCI), is debated.

Objectives: We aimed to assess the association between CA-AKI and long-term outcomes, overall and across the National Cardiovascular Data Registry (NCDR) AKI risk categories.

Methods: We analyzed patients undergoing PCI between September 2008 and October 2021 from a Japanese registry aligned with the NCDR and categorized them by the NCDR AKI risk score tertiles (low-risk [<4.

Left-Digit Bias in Serum Creatinine Levels and Contrast Administration: A Nationwide Cohort Study Using a Japanese Percutaneous Coronary Intervention Registry.

Background: Contemporary quality initiatives emphasize minimizing contrast volume as a key modifiable factor to prevent acute kidney injury (AKI) following percutaneous coronary intervention (PCI). Left-digit bias is a cognitive bias where the leftmost digit of a number disproportionately influences decisions. This bias may unintentionally affect contrast administration when interpreting laboratory values like serum creatinine.

Safety and Effectiveness of Apixaban in Very Elderly Patients with Atrial Fibrillation: A Retrospective Analysis of Japanese Administrative Claims Data.

Introduction: Anticoagulation is a well-established treatment for patients with atrial fibrillation (AF) for the prevention of stroke/systemic embolism (SE). However, although nearly all elderly patients with AF are at risk for thrombotic events, they also have a heightened risk of bleeding, and evidence regarding the optimal anticoagulation regimen in very elderly patients remains limited. This study aimed to evaluate the safety and effectiveness of apixaban versus warfarin in a cohort of very elderly patients with AF in Japan.

Prolonged Procedural Time and Its Association With Periprocedural Complications in Endovascular Therapy.

Background: Although prolonged operative time in surgical procedures is associated with an increased risk of complications, this has not been systematically evaluated in patients undergoing endovascular therapy (EVT).

Aims: This study determined the association between prolonged procedural time and periprocedural complications in patients undergoing EVT for symptomatic lower extremity arterial disease (LEAD).

Methods: Data from a nationwide EVT registry in Japan (J-EVT) between 2021 and 2022 were analyzed.

Residual pulmonary hypertension and clinical outcomes in acute decompensated heart failure patients stratified by left ventricular ejection fraction.

Aims: The precise outcomes for patients with residual pulmonary hypertension (PH) following the optimized treatment of acute decompensated heart failure (ADHF) remain poorly understood. This study aimed to investigate the prognostic association of PH, categorized according to left ventricular ejection fraction (LVEF), in hospitalized ADHF patients.

Methods And Results: The WET-HF registry is a multicentre, prospective cohort ADHF registry.

Association Between Mineralocorticoid Receptor Antagonist Use With Worsening Renal Function and Prognosis in Patients With Acute Heart Failure.

Background: Prognostic implications of mineralocorticoid receptor antagonist (MRA) initiation in the context of worsening renal function (WRF) in patients with acute heart failure (AHF) remain unknown.

Methods: This was a post hoc analysis using data from Japanese AHF registries (NARA-HF [Nara Registry and Analyses for Heart Failure], WET-HF [West Tokyo Heart Failure], REALITY-AHF [Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure]). MRA-naïve patients at baseline were included, comprising 1632 patients with HF with reduced ejection fraction (HFrEF) and 2407 with heart failure with mildly reduced or preserved ejection fraction (HFmr/pEF).

A Simple Prognostic Index Based on Heart Rate, Age, and Systolic Blood Pressure for the Risk Stratification of Heart Failure With Preserved Ejection Fraction.

Aim: A rapid and effective risk stratification method is highly important for the emergency care of patients with acute heart failure with preserved ejection fraction (HFpEF). Previous studies (including our own), have suggested that heart rate, age, and systolic blood pressure contribute to the pathophysiology of HFpEF. This study aimed to examine the predictive utility of the thrombolysis in myocardial infarction risk index (TRI)-consisting of heart rate, age, and systolic blood pressure-for determining the in-hospital mortality in patients with acute HFpEF.

Revised definition of pulmonary hypertension subtypes enhances prognostic stratification in hospitalized heart failure patients.

Background: Pulmonary hypertension (PH) is a common complication of heart failure (HF) that has two subtypes: isolated postcapillary PH (IpcPH) and combined postcapillary and precapillary PH (CpcPH). The definitions of these subtypes were revised in 2022, but the prognostic impacts of this change in hospitalized patients with HF remain unclear. Therefore, this study aimed to investigate how the current definitions of PH subtypes affect patient prognosis.

Dual impact of anaemia and chronic kidney disease on postpercutaneous coronary intervention outcomes: insights from the Japanese nationwide registry.

Background: Anaemia and chronic kidney disease (CKD) are both established risk factors for bleeding events after percutaneous coronary intervention (PCI). These conditions often coexist; however, previous assessments of these factors individually may have led to an underestimation of their impact on clinical outcomes.

Methods: We analysed the data of 77 482 patients who underwent PCI between 2017 and 2020 in the Japanese nationwide PCI registry.

Successful or Uncomplicated Use of Drug-Coated Balloon Versus Drug-Eluting Stent Strategies for De Novo Culprit Lesions in Acute Coronary Syndromes: Insights from a Nationwide Registry in Japan.

Background: Randomized trials demonstrated that drug-coated balloon (DCB) was not inferior to drug-eluting stent (DES) for acute coronary syndrome (ACS). However, generalizability in clinical settings remains unclear. The present study compared the outcomes of DCB and DES strategies in percutaneous coronary intervention for ACS within a nationwide procedure-based registry.

Association of Tricuspid Regurgitation With Mortality in Heart Failure With Left-Sided Heart Disease.

Background: Left-sided heart disease is the leading etiology of tricuspid regurgitation (TR) in heart failure (HF); however, the association between different HF phenotypes and the adverse effects of TR remains unclear.

Objectives: The authors aimed to elucidate the association between TR and outcomes across the subtypes of left-sided heart disease in patients hospitalized for HF.

Methods: We analyzed data from the multicenter West Tokyo Heart Failure registry between January 2006 and December 2021.

Valve-in-Valve TAVR for Degenerated Surgical Valves in Patients With Small Aortic Annuli: A Report From a Japanese Nationwide Registry.

Background: Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) provides an alternative treatment for high-risk patients with failed surgical bioprosthetic aortic valves. However, limited data exist on ViV-TAVR outcomes in patients with small aortic annuli, particularly among the relatively small-statured Japanese population.

Methods: We analyzed data from the J-TVT (Japan Transcatheter Valve Therapy) registry, which included all TAVR institutions across Japan, with data collected from July 2018, when ViV-TAVR was approved, through December 2022.

Current Trends in Device and Size Selection for Transcatheter Atrial Septal Defect Closure in Adults - Insights From a Japanese Nationwide Registry.

Background: This study investigated current trends in transcatheter atrial septal defect (ASD) closure among adult patients, with an emphasis on device and size selection, as well as acute complications.

Methods And Results: This study used the Japanese Structural Heart Disease (J-SHD) registry database, which is a prospective nationwide multicenter registry. In all, 1,921 patients who underwent transcatheter ASD closure between 2019 and 2022 were analyzed in this study.