Kinya Shirota
Tottori University
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Jacc-cardiovascular Interventions | 2013
Mamoru Toyofuku; Takeshi Kimura; Takeshi Morimoto; Yasuhiko Hayashi; Nobuo Shiode; Hideo Nishikawa; Koichi Nakao; Kinya Shirota; Kazuya Kawai; Yoshikazu Hiasa; Kazushige Kadota; Yoichi Nozaki; Takaaki Isshiki; Takahito Sone; Kazuaki Mitsudo; j-Cypher Registry Investigators
OBJECTIVES This study assessed 5-year outcomes after implantation of sirolimus-eluting stents (SES) for unprotected left main coronary artery (ULMCA) disease in comparison with that for non-left main disease. BACKGROUND More information on long-term outcomes after ULMCA stenting is needed. METHODS The j-Cypher is a multicenter prospective registry of consecutive patients undergoing SES implantation in Japan. RESULTS Among 12,812 patients enrolled in the j-Cypher registry, the unadjusted mortality rate at 5 years was significantly higher in patients with ULMCA stenting than in patients without ULMCA stenting (22.8% vs. 14.1%; p < 0.0001); however, the risk for death with ULMCA stenting was no longer significant after adjusting for confounders (hazard ratio: 1.18, 95% confidence interval: 0.95 to 1.46; p = 0.14). In the lesion-level comparison, the nonbifurcation ULMCA lesions treated exclusively with SES had a significantly lower rate of target lesion revascularization (TLR) than those in non-ULMCA nonbifurcation lesions (2.4% vs. 12.7%; p = 0.04). Among bifurcation lesions, those treated with a provisional 2-stent approach had similar rates of TLR (12.1% vs. 11.4%; p = 0.79) between the ULMCA and non-ULMCA groups. Lesions treated with an elective 2-stent approach had higher TLR rates in the ULMCA group as compared with the non-ULMCA group (33.5% vs. 19.7%; p = 0.002). CONCLUSIONS The safety of ULMCA stenting relative to non-LMCA stenting was maintained through 5 years follow-up. In terms of efficacy, SES implantation in nonbifurcation ULMCA lesions was associated with an extremely low cumulative incidence of TLR, whereas the elective 2-stent approach for ULMCA bifurcation lesions was associated with a markedly higher cumulative incidence of TLR as compared with that for non-ULMCA bifurcation lesions.
American Journal of Cardiology | 1992
Kinya Shirota; Yoshihiro Sawada; Masaharu Fukuki; Tetsuya Doi; Hiroshi Kotake; Hiroto Mashiba; Takashi Kasahara; Satoshi Endo
Fifty patients with atypical chest pain were studied to compare coronary responses to intracoronary and intraaortic ergonovine. The diameters of the proximal, middle (1) and (2) (proximal segments of segments 2 and 3 [AHA classification], respectively), and distal segments of the right coronary artery were measured before and after intracoronary ergonovine (4 micrograms/minute over 4 minutes) and isosorbide dinitrate (ISDN) (2 mg) in 24 patients, and before and after intraaortic ergonovine (0.2 mg) and ISDN (5 mg) in 26. Mean vasoconstriction by intracoronary and intraaortic ergonovine were 13 +/- 1.5% and 9 +/- 0.8%, respectively (p < 0.02). Irrespective of the methods of administration, the responses to ergonovine were similar in the 4 segments. Mean vasodilation by intracoronary and intraaortic ISDN, which were used to quantify the degree of basal coronary tone, were 25 +/- 2.2% and 27 +/- 1.5%, respectively (p = not significant [NS]). There were significant negative linear correlations between the responses to ergonovine and ISDN in the middle (2) (r = -0.51; p < 0.05) and distal (r = -0.53; p < 0.01) segments in patients with intracoronary injection, and the proximal (r = -0.41; p < 0.05), middle (1) (r = -0.66; p < 0.01) and middle (2) (r = -0.69; p < 0.01) segments in patients with intraaortic injection. These observations indicate that low-dose administration of intracoronary ergonovine produces sufficient coronary vasoconstriction, similar to or slightly greater than that of intraaortic ergonovine in patients with atypical chest pain, but basal coronary tone may influence the vasoreactivity to ergonovine.
Circulation | 2009
Kenji Goto; Nobuo Shiode; Kinya Shirota; Yukihiro Fukuda; Fumiyo Kitamura; Koichi Tominaga; Yasuko Kato; Hiroshi Miura; Katsumi Inoue; Masakiyo Nobuyoshi
Internal Medicine | 2008
Kenji Goto; Nobuo Shiode; Kinya Shirota; Yukihiro Fukuda; Fumiyo Kitamura; Koichi Tominaga; Yasuko Kato
Hormone Research in Paediatrics | 1991
Chiaki Shigemasa; Kinya Shirota; Keita Urabe; Tetsuo Kouchi; Yasuo Mitani; Yoshihiko Ueta; Akio Yoshida; Hiroto Mashiba
Internal Medicine | 2008
Nobuo Shiode; Kinya Shirota; Kenji Goto; Akinori Sairaku; Shinya Mikami; Yasuko Kato; Kazuyoshi Suenari; Hiroshige Ishi
European Heart Journal | 1994
Kinya Shirota; Kazuhide Ogino; Takashi Kasahara; Hiroshi Kotake; Satoshi Endo; Hiroto Mashiba
Circulation | 2014
Tetsuya Watanabe; Koichi Inoue; Kazunori Kashiwase; Takanao Mine; Keiji Hirooka; Ryu Shutta; Yuji Okuyama; Hiroya Mizuno; Shinya Shimoshige; Sou Takenaka; Takenori Sumiyoshi; Yuzuru Yambe; Kinya Shirota; Junichi Nitta; Makoto Ito; Takehiko Keida; Shinsuke Nanto
Japanese Circulation Journal-english Edition | 2010
Nobuo Shiode; Kinya Shirota; Fumiyo Tsunoda; Yasuko Kato; Mai Fujiwara; Asao Mimura
Circulation | 2010
Nobuo Shiode; Kinya Shirota; Fumiyo Tsunoda; Yasuko Kato; Mai Fujiwara; Asao Mimura