Implementing the Certified Heart Failure Educator System in Japan - Initial Experience.

Background: The Japanese Circulation Society (JCS) launched a Certified Heart Failure Educator (CHFE) program in 2021. However, reports regarding this program are lacking. Here we describe the initial experience following implementation of CHFE program and assess its association with hospital quality measures.

Synergistic effects of underweight and dementia on in-hospital mortality during acute myocardial infarction.

Aims: Although the impact of underweight and dementia on mortality is clear, no large study has examined the synergistic impact of underweight and dementia on acute myocardial infarction (AMI) in real-world settings. Therefore, this study aimed to investigate the synergistic effects of underweight and dementia on in-hospital mortality in AMI patients using a nationwide administrative database.

Methods And Results: This nationwide retrospective cohort study was performed using the Japanese nationwide administrative data (JROAD-DPC) of 474,979 AMI patients between April 2012 and March 2021.

Usefulness of the AHEAD score for prediction of all-cause death in patients with acute and chronic coronary syndromes.

Background: The AHEAD (A: atrial fibrillation; H: hemoglobin; E: elderly; A: abnormal renal parameters; D: diabetes mellitus) score was developed to predict all-cause death (ACD) in patients with heart failure. However, its predictive value for ACD compared to the CHADS score in patients with coronary artery disease (CAD) remains unknown.

Methods: This retrospective multicenter cohort study analyzed data of the patients who underwent percutaneous coronary intervention for acute (ACS) or chronic coronary syndromes (CCS) using the Clinical Deep Data Accumulation System (CLIDAS) database.

Anticoagulation Therapy for Atrial Fibrillation After Transcatheter Aortic Valve Replacement: National Database Insights.

Background: Transcatheter aortic valve replacement (TAVR) is increasingly used in patients with aortic stenosis; however, the optimal postoperative anticoagulation therapy for patients with atrial fibrillation (AF) remains controversial. We aimed to investigate the association between anticoagulant therapy selection and outcomes in patients with AF after TAVR.

Methods: We retrospectively analyzed patients with AF who underwent TAVR.

Efficacy and Safety of High-Intensity Statins in Japanese Patients After Percutaneous Coronary Intervention - Insights From the Clinical Deep Data Accumulation System (CLIDAS).

Background: Lipid-lowering therapy with high-intensity statins has not been widely implemented in Japan for patients with coronary artery disease who undergo percutaneous coronary intervention (PCI). We examined the efficacy and safety of high-intensity statin therapy in a real-world setting.

Methods And Results: We used the Clinical Deep Data Accumulation System (CLIDAS) to accumulate multimodal data from the electronic medical records of 7 cardiovascular centers.

Long-term bleeding events post-percutaneous coronary intervention in patients with malignancy with and without anticoagulant therapy.

The prevalence of malignancies in patients undergoing percutaneous coronary intervention (PCI) is increasing with aging. Active malignancy is a significant contributor to high bleeding risk. For cancer patients requiring oral anticoagulant (OAC) therapy, the choice between direct oral anticoagulants (DOAC) and warfarin is critical.

Proton Pump Inhibitor Use, Gastrointestinal Bleeding Reduction, and Long-Term Prognosis After Percutaneous Coronary Intervention.

Proton pump inhibitors (PPI) reduce gastrointestinal bleeding (GIB) after percutaneous coronary intervention (PCI), but their impact on mortality and major adverse cardiovascular events (MACE) remains unclear. This study investigated the association between PPI-related GIB reduction and MACE and mortality using a real-world database. We analyzed 6,457 patients undergoing PCI (2013 to 2019), using the Clinical Deep Data Accumulation System including electronic medical records from 7 Japanese hospitals.

Risk stratification of net adverse clinical events using CHADS-PARC and CHADS scores in chronic coronary syndrome patients without atrial fibrillation: Insights from the CLIDAS-PCI.

Background: There are few data verifying the utility of the CHADS-PARC score in comparison with the CHADS score for estimating net adverse clinical events (NACE) in chronic coronary syndrome (CCS) patients without atrial fibrillation (AF) in real-world settings.

Methods: We performed analysis for a total of 3985 CCS patients without AF who underwent percutaneous coronary intervention (PCI) between April 2013 and March 2019 for whom information was obtained from the CLIDAS (Clinical Deep Data Accumulation System)-PCI database. The primary endpoint was NACE defined as the composite of 3-point major adverse cardiovascular events (3P-MACE) (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke) and GUSTO moderate/severe bleeding events.

Characteristics and outcomes in patients with in-hospital stroke: Japan stroke data bank.

Purpose: We aimed to clarify the clinical characteristics and outcomes of patients with in-hospital onset ischemic stroke (IOS) compared with those in patients with community-onset ischemic stroke (COS).

Methods: Patients from the Japan Stroke Data Bank, a hospital-based multicenter prospective registry, who were diagnosed with acute ischemic stroke (AIS) within 24 h of onset between January 2001 and December 2020 were included in this study. We assessed favorable outcomes at discharge corresponding to a modified Rankin Scale (mRS) score of 0-2, unfavorable outcomes corresponding to an mRS score of 5-6, and mortality.

Current Practice of Guideline-Directed Medical Therapy After Acute Heart Failure Hospitalization: A Nationwide Observational Study.

Background: Few studies have provided nationwide, longitudinal data on practice patterns of guideline-directed medical therapy (GDMT) for heart failure.

Objectives: The authors aimed to clarify the doses and patterns of up-titration or discontinuation of GDMT following admission for acute heart failure and to determinants associated with its continuation in Japan.

Methods: We retrospectively included data, from the Japanese nationwide health insurance claims database, of patients hospitalized for acute heart failure without a recent history of hospitalization.

Preventive Effects of Prasugrel on Cerebrovascular Events Following Percutaneous Coronary Intervention.

Background: Dual antiplatelet drug administration is recommended after percutaneous coronary intervention (PCI) stent placement. Although prasugrel, a newer P2Y12 inhibitor, reportedly suppresses cardiovascular events more effectively than the traditional agent clopidogrel, its preventive effects on cerebrovascular disorders remain a topic of ongoing debate. This study aimed to examine the cerebrovascular efficacy and safety of post-PCI prasugrel and clopidogrel using extensive real-world data in Japan.

An inverse association of cerebral amyloid-β deposition and serum docosahexaenoic acid levels in cognitively normal older adults in Japan.

BackgroundAlzheimer's disease (AD) is driven by amyloid-β (Aβ) plaque accumulation, but the mechanisms behind this process remain unclear. Omega-3 fatty acids, particularly docosahexaenoic acid (DHA), may offer protective effects, though their relationship with Aβ accumulation is not fully understood.ObjectiveThis study investigated whether serum DHA and eicosapentaenoic acid (EPA) levels, measured 6-9 years before imaging, were inversely associated with cerebral Aβ deposition in cognitively normal older adults in Japan, a population known for high omega-3 intake.

Clinical outcomes of cases requiring touch-up applications in pulmonary vein isolation with balloon ablation.

Background: Balloon ablation for pulmonary vein isolation (PVI) is a well-established treatment option for atrial fibrillation. Although some patients require touch-up ablation, generalizable evidence is limited.

Objective: This study aimed to investigate the current status and outcomes of touch-up applications using a nationwide registry in Japan.

Nationwide Trends in Idiopathic Pericarditis Management and Outcomes in Japan - A Nationwide JROAD-DPC Analysis.

Background: Idiopathic pericarditis generally has a favorable prognosis, but contemporary data on treatment patterns and outcomes remain limited.

Methods And Results: Using a nationwide Japanese database, we analyzed 8,020 pericarditis patients hospitalized between April 2016 and March 2021, and identified 3,963 (49%) patients with idiopathic pericarditis after excluding those with infectious, autoimmune or other causes. During the study period, the median age increased from 62 to 68 years (P<0.

Effects of inpatient and outpatient cardiac rehabilitation on the 5-year prognosis in patients with acute myocardial infarction.

Aims: Cardiac rehabilitation (CR) has been shown to improve the prognosis of patients with acute myocardial infarction (AMI). In Japan, the duration of hospitalization has shortened, resulting in a lower participation rate in CR among outpatients. Therefore, we evaluated the effects of CR, stratified into inpatient and outpatient phases, on the prognosis of patients with AMI in Japan.

Body Mass Index Affects Hospital-Associated Disability and Economic Burden in Elective Cardiovascular Surgery - JROAD/JROAD-DPC Database.

Background: Both underweight and overweight are recognized as important factors influencing outcomes in patients undergoing cardiovascular surgery. This study investigated the effects of body mass index (BMI) on hospital-associated disability (HAD) and hospitalization costs in patients undergoing elective cardiovascular surgery (coronary artery bypass grafting, valve surgery, aortic surgery) by analyzing data from the Japanese Registry of All Cardiac and Vascular Diseases - Diagnosis Procedure Combination (JROAD-DPC) database.

Methods And Results: All patients in the JROAD-DPC database were categorized into 5 groups according to the World Health Organization BMI criteria for Asians.

Utilization of Intensive Care Units and Outcomes Based on Admission Wards in Cardiovascular Emergencies.

Background: Cardiovascular emergencies often require intensive care unit (ICU) management, but there is limited data comparing outcomes based on the admission ward.

Methods And Results: We analyzed data from the Japanese Registry of All Cardiac and Vascular Diseases Diagnosis Procedure Combination (JROAD-DPC) database (2016-2020) for 715,054 patients (mean age, 75.4±14.

U-shaped relationship between body mass index and intracerebral hemorrhage-related functional decline.

Background: Body mass index (BMI) is associated with the sites of intracerebral hemorrhage (ICH), which affect functional decline. However, the optimal BMI range for minimizing functional decline remains unclear. This study aimed to clarify the relationship between BMI and ICH-related functional decline.

Contemporary Use of Oral Inotropes in the Outpatient Treatment of Heart Failure: Analysis of a Japanese Nationwide Database.

Clinical evidence of oral inotrope use for advanced heart failure (HF) is limited. This study investigated the contemporary use and association of oral inotropes with prognosis in the outpatient treatment of advanced HF using a nationwide administrative claims database in Japan. Patients hospitalized with acute HF between 2014 and 2021 were identified from the National Database of Health Insurance Claims and Specific Health Checkups of Japan.

Regular Smoking Accelerates the Decline in Masticatory Performance in Japanese Men: The Suita Study.

Background: Smoking is presumed to cause a decline in masticatory performance by worsening the intraoral environment in various ways. However, no longitudinal study has examined the relationship between smoking and masticatory performance.

Objectives: To clarify how smoking affects future decline in masticatory performance through a 5-year follow-up study of a general urban population.

Association of In-Hospital Cardiac Rehabilitation on Hospital-Associated Disability for Octogenarian Patients With Acute Myocardial Infarction - An Insight From the JROAD-DPC Database.

Background: This study aimed to determine the status of in-hospital cardiac rehabilitation (CR) and hospital-associated disability (HAD) for patients with acute myocardial infarction (AMI) aged >80 years.

Methods And Results: This study involved the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination databases, and included patients who were hospitalized with AMI from April 2014 to March 2021. Patients were categorized by the daily amount of CR: NA, not applicable; Low, 20-30 min; Moderate, 30-40 min; and High, >40 min.

Changes in systolic blood pressure during hospitalisation and bleeding events after percutaneous coronary intervention.

Background: Hypertension is a risk factor for bleeding events and is included in the HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/Alcohol concomitantly)score. However, the effects of blood pressure (BP) and changes in BP on bleeding events in patients undergoing percutaneous coronary intervention (PCI) remain poorly understood. This study is aimed to investigate the relationship between systolic BP (SBP) changes during hospitalisation and bleeding events in patients undergoing PCI.