Toru Niwa

Impact of Continuous Administration of Tolvaptan on Preventing Medium-Term Worsening Renal Function and Long-Term Adverse Events in Heart Failure Patients with Chronic Kidney Disease

Tolvaptan (TLV) has an inhibiting effect for worsening renal function (WRF) in acute decompensated heart failure (HF) patients. However, there are limited data regarding the effect of continuous TLV administration on medium-term WRF.This was a retrospective observational study in hospitalized HF patients with chronic kidney disease (CKD). TLV was administered to those patients with fluid retention despite standard HF therapy. We compared 34 patients treated with TLV (TLV group) to 33 patients treated with conventional HF therapy with high-dose loop diuretics (furosemide ≥ 40 mg) (Loop group). Clinical outcomes, including the incidence of medium-term WRF, defined as increase of serum creatinine > 0.3 mg/dL, at 6 months after discharge and adverse events rate, were evaluated.Baseline patient characteristics were not different between the TLV and Loop group. The TLV group consisted of less frequent use of loop diuretics and carperitide compared with the Loop group. The incidence of medium-term WRF was significantly lower in the TLV group than in the Loop group (3.2% versus 31.0%, P = 0.002). Multivariate logistic analysis showed that the TLV non-user was an independent predictor of medium-term WRF. Kaplan-Meier analysis revealed that the long-term event-free survival was significantly higher in the TLV group (log-rank P = 0.01).Continuous administration of TLV may reduce the risk of medium-term WRF, resulting possibility in improvement of long-term adverse outcomes in HF patients with CKD.

CLINICAL IMPACT OF INTRACORONARY NICORANDIL INFUSION COMPARED TO INTRAVENOUS ADENOSINE TRIPHOSPHATE ON MEASUREMENT OF FRACTIONAL FLOW RESERVE IN INTERMEDIATE CORONARY LESIONS

Fractional flow reserve (FFR) has been recognized as useful modality to assess functional significance of coronary stenosis. It is important to obtain maximal hyperemia for optimal FFR measurement. Although adenosine triphosphate (ATP) is generally used as hyperemic stimulus, we sometimes encounter

TCT-229 The Safety and Feasibility of Nicorandil Compared to Adenosine Triphosphate as Hyperemic Agents for Fractional Flow Reserve Measurements

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