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Rosuvastatin Combination Therapy
The 16th Annual Scientific Meeting ameliorated in MI+HRP. Superoxide (.O2-) production and NAD(P)H oxidase activities were increased in MI, which was inhibited in MI+HRP. Conclusions: HRP ameliorated insulin resistance associated with HF by improving insulin signaling via the inhibition of NAD(P)H oxidase-induced .O2- production in the skeletal muscle. (P)RR-dependent system in the skeletal muscle is involved in this phenomenon.
O-081 Comparison of Inflammatory Markers and Lipid Profile Between High-dose Rosuvastatin Monotherapy and Ezetimibe / Rosuvastatin Combination Therapy DAISUKE YAMAZAKI, MASARU ISHIDA, KIYOSHI NOBORI, YASUNORI OGUMA, YUTAKA TERATA, TAKASHI KOYAMA, KENJI IINO, TOSHIMITSU KOSAKA, HIROYUKI WATANABE, HIROSHI ITO Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan
JHFS
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observed in patients with hypertention than those without among male (7.5% vs 4.9%). Multivariate Cox regression analyses revealed that hypertension was significantly associated with an increased risk of mortality in men HR; 1.331, P50.030), but not in women (HR; 1.091, P50.700), with a significant interaction between hypertension and sex for mortality (P50.045). Among male patients, NT-proBNP was significantly higher in both patients who developed death and who did not. Prescription rate of diuretics at discharge in male patient who were still alive was significantly higher in patients with hypertension than those without, whereas among male patients who developed death, diuretics prescription at discharge tended to be lower in patients with hypertension than those without it with a significant interaction (P50.016). Conclusions: In survived patients with AMI, there exists sex difference in mortality between patients with and without hypertension. The appropriate prescription of diuretics at discharge following AMI might attenuate the risk of death in male patients with hypertension.
O-084 Background: JUPITER trial reported aggressive lowering LDL cholesterol (LDL-C) and high-sensitivity C-reactive protein (hsCRP) were favorable. The aim of this study was to compare the anti-inflammatory effects and improvement of the lipid profile between high-dose statin monotherapy and ezetimibe / statin combination therapy. Method and Result: Thirty four patients with CAD during rosuvastatin 2.5 mg therapy, who were underachieved the goal (hsCRP O1.0mg/L and LDL-C O70mg/dL) were enrolled. Four weeks after enrollment, patients were randomly assigned to treatment with rosuvastatin 10mg monotherapy (R10) group (n516, male510, 72.1368.06yr) or rosuvastatin 2.5mg / ezetimibe 10mg combination therapy (R2.5 / E10) group (n518, male512, 70.17610.34yr). Baseline clinical characteristics, LDL-C (87.16613.06mg/dL vs. 84.94613.11mg/dL, p50.6243) and hsCRP (2.17362.391mg/L vs. 2.72462.746mg/L, p50.3605) were similar between the two groups. After 12 weeks of treatment, there was no significant difference in changes of hs-CRP (-1.19462.210mg/L vs. -1.26462.252mg/L, p50.4274) and LDL-C (-19.10614.30mg/dL vs. -20.43615.93mg/dL, p50.8091) between two groups. However, the change of HDL-C in the R10 group was higher than that in the R2.5 / E10 group (+5.426 6.09mg/dL vs. +0.196 6.91mg/dL, p50.0453). Conclusion: Our study showed that R10 group improved HDL-C compared with R2.5 / E10, although both groups have similar hsCRP and LDL-C improvement.
O-082 Influence of Coexisting Heart Failure on Non-performance of Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction KIYOTAKA HAO1, JUN TAKAHASHI1, RYUJI TSUBURAYA1, TAKASHI SHIROTO1, YOSHITAKA ITO1, YASUHARU MATSUMOTO1, MASAHARU NAKAYAMA1, KENTA ITO1, SATOSHI YASUDA2, HIROAKI SHIMOKAWA1 1 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan, 2National Cerebral and Cardiovascular Center, Suita, Osaka, Japan Background: Although primary percutaneous coronary intervention (PCI) has significantly improved the long-term survival of patients with acute myocardial infarction (AMI), some patients do not undergo primary PCI even in the present PCI era. In this study, we examined the relationship between coexisting heart failure (HF) on admission and non-performance of primary PCI in AMI patients. Method and Results: Among a total of 5,368 patients with AMI (M/F 3,881/1,487, mean age 69.0613.2 [SD] years) enrolled in the MIYAGI AMI Registry between 2006 and 2010, 1,071 patients (20.3%) did not receive primary PCI and their in-hospital mortality was significantly higher as compared with those who underwent primary PCI (25.9% vs. 6.9%, P!0.01). The patients associated with HF on admission accounted for 16.6% of all the subjects (891/5,368) and their rate of non-performance of primary PCI was significant higher as compared with those without HF (42.7% vs. 15.4%, P!0.01). Furthermore, the prevalence of HF was more prevalent in female than in male AMI patients (22.8% vs. 14.4%, P!0.01) and was significantly increased with advancing age in both genders (both P!0.01 for linear trend) along with the rate of non-performance of primary PCI. Conclusion: These results indicate that coexisting HF on admission in AMI patients is the major reason for non-performance of primary PCI, particularly in elderly female patients.
O-083 Sex Difference in the Effect of Hypertension on Long-term Mortality in Survived Patients with Acute Myocardial Infarction DAISAKU NAKATANI1, YASUHIKO SAKATA1,2, SHINICHIRO SUNA1, MASAYA USAMI1, SEN MATSUMOTO1, MASAHIKO HARA1, ISSEI KOMURO1 1 Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan, 2Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan Background: The aim of this study was to examine sex difference in the effect of hypertension on long-term mortality in survived patients with AMI. Methods and Results: We studied 7,710 patients with AMI who were discharged alive. There was no significant difference in mortality rate between patients with and without hypertension among female (8.3% vs 8.2%), whereas higher mortality rate was
No Increase in the Incidence of Takotsubo Cardiomyopathy after the Great East Japan Earthquake KOTA SUZUKI, YASUHARU MATSUMOTO, JUN TAKAHASHI, RYUJI TSUBURAYA, YOSHITAKA ITO, KOUICHIROU SUGIMURA, MASAHARU NAKAYAMA, KENTA ITO, YOSHIHIRO FUKUMOTO, HIROAKI SHIMOKAWA Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine and Tohoku University Hospital, Miyagi, Japan Background: Takotsubo cardiomyopathy (TC) was first reported by Sato et al. in 1990. Physical and emotional stresses have been postulated as its important triggers. Indeed, it was previously reported that the incidence of TC was increased after the Mid-Niigata Earthquake in 2004. However, it remains unknown whether the Great East Japan Earthquake affected its incidence in the Tohoku area. In this study, we aimed to examine the clinical profiles and incidence of TC in our hospital. Methods and Results: We had 13 patients with TC from 2004 to 2012. In 9 of them (69%), significant stressful events were identified before the presentation of TC, including emotional stress in 3 (23%) and physical stress in 6 (46%). Ten patients (77%) were female and the mean age was 75 in male and 76 in female. The prognosis of the TC patients was well as no patient died during hospitalization or after discharge. Interestingly, although we experienced physical/mental stresses in the Great East Japan Earthquake, there was no TC case in 2011 at our hospital. Conclusions: These results confirm the previous reports that most patients with TC are elderly women suffered from physical/mental stresses. Unexpectedly, there was no obvious increase in TC in our hospital, which however remains to be confirmed by the multicenter study in the Tohoku area.
O-086 Limiting Factors in Transition from Bi-level Positive Airway Pressure to Adaptive Servo-ventilation in the Treatment of Acute Decompensated Heart Failure YASUSHI WAKABAYASHI, HIROSHI WADA, KEN-ICHI SAKAKURA, NAHOKO IKEDA, YOSHITAKA SUGAWARA, ZYUNYA AKO, SHIN-ICHI MOMOMURA The Cardiovascular Department, Saitama Medical Center, Jichi Medical University, Saitama, Japan Background: Noninvasive positive pressure ventilation (NPPV) including bi-level PAP (BiPAP) is recommended by the guidelines as a treatment for acute decompensated heart failure (ADHF). However, current BiPAP device is bulky and cumbersome to manipulate. Adaptive servo-ventilation (ASV), a novel type of NPPV is easy to use and may be useful as a transitional treatment from CCU to general ward. The purpose of this study is to elucidate the limiting factors for switching from BiPAP to ASV. Method: Forty eight patients who admitted to our institute between December 2011 and May 2012 with the diagnosis of ADHF, and treated with BiPAP were included. Result: Among 48 patients, 31 patients (65%) were treated only with BiPAP. In 17 (35%) patients switching from BiPAP to ASV was attempted. ASV was well tolerated in 13 patients while not tolerated in 4 patients. There was no significant difference in background between the tolerable and intolerable groups. The reasons of intolerance were hypoxemia in two patients and uncomfortable resistance to positive pressure in another two patients. Conclusions: In most patients with ADHF, bi-level PAP could be switched to ASV properly. ASV is useful as a transitional therapy for the withdrawal from bi-level PAP. Further study is needed to examine if ASV improved outcomes of ADHF.
O-087 Beneficial Effect of Adaptive Servo Ventilation Therapy in Elderly Patients with Severe Heart Failure TORU SHIBAHARA1, IKUMI NARA1, NANAMI KAMADA1, TOSHIYA FUJIWARA1, MASAYASU NAKAGAWA1, SATOSHI KIBIRA2, HIROSHI ITO3 1 Department of Cardiology, Akita City Hospital, Akita, Japan, 2Kibira Medical Clinic, Akita, Japan, 3Department of Cardiology, Akita University School of Medicine, Akita, Japan Background: Adaptive servo ventilation (ASV) therapy has been established as an effective therapy for patients with heart failure. However, it is still unknown whether
O-081 Comparison of Inflammatory Markers and Lipid Profile Between High-dose Rosuvastatin Monotherapy and Ezetimibe / Rosuvastatin Combination Therapy DAISUKE YAMAZAKI, MASARU ISHIDA, KIYOSHI NOBORI, YASUNORI OGUMA, YUTAKA TERATA, TAKASHI KOYAMA, KENJI IINO, TOSHIMITSU KOSAKA, HIROYUKI WATANABE, HIROSHI ITO Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, Akita, Japan
JHFS
S163
observed in patients with hypertention than those without among male (7.5% vs 4.9%). Multivariate Cox regression analyses revealed that hypertension was significantly associated with an increased risk of mortality in men HR; 1.331, P50.030), but not in women (HR; 1.091, P50.700), with a significant interaction between hypertension and sex for mortality (P50.045). Among male patients, NT-proBNP was significantly higher in both patients who developed death and who did not. Prescription rate of diuretics at discharge in male patient who were still alive was significantly higher in patients with hypertension than those without, whereas among male patients who developed death, diuretics prescription at discharge tended to be lower in patients with hypertension than those without it with a significant interaction (P50.016). Conclusions: In survived patients with AMI, there exists sex difference in mortality between patients with and without hypertension. The appropriate prescription of diuretics at discharge following AMI might attenuate the risk of death in male patients with hypertension.
O-084 Background: JUPITER trial reported aggressive lowering LDL cholesterol (LDL-C) and high-sensitivity C-reactive protein (hsCRP) were favorable. The aim of this study was to compare the anti-inflammatory effects and improvement of the lipid profile between high-dose statin monotherapy and ezetimibe / statin combination therapy. Method and Result: Thirty four patients with CAD during rosuvastatin 2.5 mg therapy, who were underachieved the goal (hsCRP O1.0mg/L and LDL-C O70mg/dL) were enrolled. Four weeks after enrollment, patients were randomly assigned to treatment with rosuvastatin 10mg monotherapy (R10) group (n516, male510, 72.1368.06yr) or rosuvastatin 2.5mg / ezetimibe 10mg combination therapy (R2.5 / E10) group (n518, male512, 70.17610.34yr). Baseline clinical characteristics, LDL-C (87.16613.06mg/dL vs. 84.94613.11mg/dL, p50.6243) and hsCRP (2.17362.391mg/L vs. 2.72462.746mg/L, p50.3605) were similar between the two groups. After 12 weeks of treatment, there was no significant difference in changes of hs-CRP (-1.19462.210mg/L vs. -1.26462.252mg/L, p50.4274) and LDL-C (-19.10614.30mg/dL vs. -20.43615.93mg/dL, p50.8091) between two groups. However, the change of HDL-C in the R10 group was higher than that in the R2.5 / E10 group (+5.426 6.09mg/dL vs. +0.196 6.91mg/dL, p50.0453). Conclusion: Our study showed that R10 group improved HDL-C compared with R2.5 / E10, although both groups have similar hsCRP and LDL-C improvement.
O-082 Influence of Coexisting Heart Failure on Non-performance of Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction KIYOTAKA HAO1, JUN TAKAHASHI1, RYUJI TSUBURAYA1, TAKASHI SHIROTO1, YOSHITAKA ITO1, YASUHARU MATSUMOTO1, MASAHARU NAKAYAMA1, KENTA ITO1, SATOSHI YASUDA2, HIROAKI SHIMOKAWA1 1 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan, 2National Cerebral and Cardiovascular Center, Suita, Osaka, Japan Background: Although primary percutaneous coronary intervention (PCI) has significantly improved the long-term survival of patients with acute myocardial infarction (AMI), some patients do not undergo primary PCI even in the present PCI era. In this study, we examined the relationship between coexisting heart failure (HF) on admission and non-performance of primary PCI in AMI patients. Method and Results: Among a total of 5,368 patients with AMI (M/F 3,881/1,487, mean age 69.0613.2 [SD] years) enrolled in the MIYAGI AMI Registry between 2006 and 2010, 1,071 patients (20.3%) did not receive primary PCI and their in-hospital mortality was significantly higher as compared with those who underwent primary PCI (25.9% vs. 6.9%, P!0.01). The patients associated with HF on admission accounted for 16.6% of all the subjects (891/5,368) and their rate of non-performance of primary PCI was significant higher as compared with those without HF (42.7% vs. 15.4%, P!0.01). Furthermore, the prevalence of HF was more prevalent in female than in male AMI patients (22.8% vs. 14.4%, P!0.01) and was significantly increased with advancing age in both genders (both P!0.01 for linear trend) along with the rate of non-performance of primary PCI. Conclusion: These results indicate that coexisting HF on admission in AMI patients is the major reason for non-performance of primary PCI, particularly in elderly female patients.
O-083 Sex Difference in the Effect of Hypertension on Long-term Mortality in Survived Patients with Acute Myocardial Infarction DAISAKU NAKATANI1, YASUHIKO SAKATA1,2, SHINICHIRO SUNA1, MASAYA USAMI1, SEN MATSUMOTO1, MASAHIKO HARA1, ISSEI KOMURO1 1 Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan, 2Department of Cardiovascular Medicine and Department of Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan Background: The aim of this study was to examine sex difference in the effect of hypertension on long-term mortality in survived patients with AMI. Methods and Results: We studied 7,710 patients with AMI who were discharged alive. There was no significant difference in mortality rate between patients with and without hypertension among female (8.3% vs 8.2%), whereas higher mortality rate was
No Increase in the Incidence of Takotsubo Cardiomyopathy after the Great East Japan Earthquake KOTA SUZUKI, YASUHARU MATSUMOTO, JUN TAKAHASHI, RYUJI TSUBURAYA, YOSHITAKA ITO, KOUICHIROU SUGIMURA, MASAHARU NAKAYAMA, KENTA ITO, YOSHIHIRO FUKUMOTO, HIROAKI SHIMOKAWA Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine and Tohoku University Hospital, Miyagi, Japan Background: Takotsubo cardiomyopathy (TC) was first reported by Sato et al. in 1990. Physical and emotional stresses have been postulated as its important triggers. Indeed, it was previously reported that the incidence of TC was increased after the Mid-Niigata Earthquake in 2004. However, it remains unknown whether the Great East Japan Earthquake affected its incidence in the Tohoku area. In this study, we aimed to examine the clinical profiles and incidence of TC in our hospital. Methods and Results: We had 13 patients with TC from 2004 to 2012. In 9 of them (69%), significant stressful events were identified before the presentation of TC, including emotional stress in 3 (23%) and physical stress in 6 (46%). Ten patients (77%) were female and the mean age was 75 in male and 76 in female. The prognosis of the TC patients was well as no patient died during hospitalization or after discharge. Interestingly, although we experienced physical/mental stresses in the Great East Japan Earthquake, there was no TC case in 2011 at our hospital. Conclusions: These results confirm the previous reports that most patients with TC are elderly women suffered from physical/mental stresses. Unexpectedly, there was no obvious increase in TC in our hospital, which however remains to be confirmed by the multicenter study in the Tohoku area.
O-086 Limiting Factors in Transition from Bi-level Positive Airway Pressure to Adaptive Servo-ventilation in the Treatment of Acute Decompensated Heart Failure YASUSHI WAKABAYASHI, HIROSHI WADA, KEN-ICHI SAKAKURA, NAHOKO IKEDA, YOSHITAKA SUGAWARA, ZYUNYA AKO, SHIN-ICHI MOMOMURA The Cardiovascular Department, Saitama Medical Center, Jichi Medical University, Saitama, Japan Background: Noninvasive positive pressure ventilation (NPPV) including bi-level PAP (BiPAP) is recommended by the guidelines as a treatment for acute decompensated heart failure (ADHF). However, current BiPAP device is bulky and cumbersome to manipulate. Adaptive servo-ventilation (ASV), a novel type of NPPV is easy to use and may be useful as a transitional treatment from CCU to general ward. The purpose of this study is to elucidate the limiting factors for switching from BiPAP to ASV. Method: Forty eight patients who admitted to our institute between December 2011 and May 2012 with the diagnosis of ADHF, and treated with BiPAP were included. Result: Among 48 patients, 31 patients (65%) were treated only with BiPAP. In 17 (35%) patients switching from BiPAP to ASV was attempted. ASV was well tolerated in 13 patients while not tolerated in 4 patients. There was no significant difference in background between the tolerable and intolerable groups. The reasons of intolerance were hypoxemia in two patients and uncomfortable resistance to positive pressure in another two patients. Conclusions: In most patients with ADHF, bi-level PAP could be switched to ASV properly. ASV is useful as a transitional therapy for the withdrawal from bi-level PAP. Further study is needed to examine if ASV improved outcomes of ADHF.
O-087 Beneficial Effect of Adaptive Servo Ventilation Therapy in Elderly Patients with Severe Heart Failure TORU SHIBAHARA1, IKUMI NARA1, NANAMI KAMADA1, TOSHIYA FUJIWARA1, MASAYASU NAKAGAWA1, SATOSHI KIBIRA2, HIROSHI ITO3 1 Department of Cardiology, Akita City Hospital, Akita, Japan, 2Kibira Medical Clinic, Akita, Japan, 3Department of Cardiology, Akita University School of Medicine, Akita, Japan Background: Adaptive servo ventilation (ASV) therapy has been established as an effective therapy for patients with heart failure. However, it is still unknown whether