Kisaki Amemiya

Serum zinc concentration in patients with acute myocardial infarction in percutaneous coronary intervention era

Introduction There were few studies that investigated the association between serum zinc concentration and acute myocardial infarction (AMI) in percutaneous coronary intervention era. Objective We assessed the relationships between serum zinc concentration, complications, and prognosis in AMI patients after primary percutaneous coronary intervention. Methods We conducted a single-center, prospective, observational study including 50 patients with AMI. We divided patients into two groups (High-zinc group and Low-zinc group) by median serum zinc concentration and compared two groups about clinical outcomes up to 1 year follow up. Results The mean age of patients was 66.2 ± 11.8 years old. Patients in the Low-zinc group had ST-segment elevation more frequently than those in the High-zinc group (96.0% vs. 72.0%, P = 0.02). All-cause mortality at 1 year was similar in both groups (P (log-rank) = 0.33). However, the lengths of hospital stay and in coronary care unit were longer in patients in the Low-zinc group than in those in the High-zinc group (15.6 ± 9.2 days vs. 11.9 ± 2.9 days, P = 0.06; 3.9 ± 2.8 days vs. 2.3 ± 0.8 days, P = 0.01). Multivariate regression analysis showed that low serum zinc concentration was associated with the use of cardiac or respiratory assist devices (adjusted odds ratio, 17.79; 95% CI 1.123 to 1216.5; P = 0.04). Conclusions Although there was no significance difference in mortality in Low-zinc and High-zinc groups, low serum zinc concentration was associated with longer stay in the coronary care unit, and was one of the independent predictors for the use of cardiac or respiratory assist devices.

Morphological Patterns of In-Stent Chronic Total Occlusions: An Intravascular Ultrasound Study

This was a retrospective intravascular ultrasound (IVUS) study of mechanisms of in-stent restenosis (ISR) chronic total occlusions (CTOs). ISR CTOs were defined as TIMI (Thrombolysis In Myocardial Infarction) flow grade 0 within a stented lesion (including 5-mm margins) with estimated occlusion

The association between high-dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure: High-dose loop diuretic use

Few studies have reported the impact of high‐dose loop diuretics at discharge on prognosis in Japanese patients with heart failure (HF). Our purpose was to assess the relationship between the dose of loop diuretics at discharge and cardiovascular mortality in patients with HF.

MORPHOLOGIC PATTERNS OF IN-STENT CHRONIC TOTAL OCCLUSIONS: AN INTRAVASCULAR ULTRASOUND STUDY

This was a retrospective intravascular ultrasound (IVUS) study of mechanisms of in-stent restenosis (ISR) chronic total occlusions (CTOs). ISR CTOs were defined as TIMI (Thrombolysis In Myocardial Infarction) flow grade 0 within a stented lesion (including 5-mm margins) with estimated occlusion

Serial 3-Vessel Optical Coherence Tomography and Intravascular Ultrasound Analysis of Changing Morphologies Associated With Lesion Progression in Patients With Stable Angina PectorisCLINICAL PERSPECTIVE

Background— Optical coherence tomographic (OCT) morphologies associated with lesion progression are not well studied. The aim of this study was to determine the morphological change for untreated lesion progression using both OCT and intravascular ultrasound (IVUS). Methods and Results— We used baseline and 8-month follow-up 3-vessel OCT and IVUS to assess 127 nonculprit lesions (IVUS plaque burden ≥40%) in 45 patients with stable angina after target lesion treatment. Lesion progression was defined as an IVUS lumen area decrease >0.5 mm2. A layered pattern was identified as a superficial layer that had a different optical intensity and a clear demarcation from underlying plaque. Lesion progression was observed in 19% (24/127) lesions, and its pattern was characterized into 3 types: type I, new superficial layered pattern at follow-up that was not present at baseline (n=9); type II, a layered pattern at baseline whose layer thickness increased at follow-up (n=7); or type III, no layered pattern at baseline or follow-up (n=8). The increase of IVUS plaque+media area was largest in type I and least in type III (1.9 mm2 [1.6–2.1], 1.1 mm2 [0.9–1.4], and 0.3 mm2 [−0.2 to 0.8], respectively; P=0.002). Type III, but not types I or II, showed negative remodeling during follow-up (IVUS vessel area; from 14.3 mm2 [11.4–17.2] to 13.5 mm2 [10.4–16.7]; P=0.02). OCT lipidic plaque was associated with lesion progression (odds ratio, 13.6; 95% confidence interval, 3.7–50.6; P<0.001). Conclusions— Lesion progression was categorized to distinct OCT morphologies that were related to changes in plaque mass or vessel remodeling.