Publications by authors named "Ikemura N"
Background: Although they are fast-growing populations in the United States, little is known about survival outcomes of Hispanic and Asian patients after in-hospital cardiac arrest.
Methods And Results: In Get With The Guidelines-Resuscitation, we identified Asian, Hispanic, and White adults with in-hospital cardiac arrest during 2005 to 2023. Using multivariable models, we compared rates of survival to discharge separately for Asian and Hispanic patients versus White patients, as well as rates of sustained return of spontaneous circulation for ≥20 minutes and favorable neurologic survival as secondary outcomes.
Article Synopsis
- A study examined patients with acute myocardial infarction (AMI) who lack standard modifiable risk factors (SMuRFs) to see how it affects their health status over time.
- Out of 4,076 patients studied, those without SMuRFs showed initially better health status scores but their long-term improvements were similar to those with SMuRFs.
- Findings suggest that AMI patients without SMuRFs can achieve comparable health status after 12 months, indicating less need for aggressive secondary prevention measures.
Importance: The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a commonly used outcome in heart failure trials. While comparing means between treatment groups improves statistical power, mean treatment effects do not necessarily reflect the clinical benefit experienced by individual patients.
Objective: To evaluate the association between mean KCCQ treatment effects and the proportions of patients experiencing clinically important improvements across a range of clinical trials and heart failure etiologies.
Background: The ISCHEMIA trial (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) demonstrated greater health status benefits with an initial invasive strategy, as compared with a conservative one, for patients with chronic coronary disease and moderate or severe ischemia. Whether these benefits vary globally is important to understand to support global adoption of the results.
Methods: We analyzed participants' disease-specific health status using the validated 7-item Seattle Angina Questionnaire (SAQ: >5-point differences are clinically important) at baseline and over 1-year follow-up across 37 countries in 6 international regions.
Article Synopsis
- The study aimed to create a patient decision aid (PDA) to help patients with chronic coronary disease (CCD) understand their options for invasive vs. conservative management, drawing on data from the ISCHEMIA trial.
- Through focus groups with patients, caregivers, and healthcare professionals, researchers identified key patient priorities, emphasizing the importance of survival and quality of life in treatment decisions, as well as a preference for visual tools to illustrate outcomes.
- Participants valued shared decision-making but often relied on clinicians for guidance, expressing a desire to use the PDA collaboratively during consultations to facilitate informed choices.
Article Synopsis
- The Kansas City Medical Optimization (KCMO) score was developed to more accurately quantify the intensity of guideline-directed medical therapy (GDMT) for heart failure patients by averaging daily doses compared to target doses.
- In a study with over 4,500 patients, baseline scores showed low average KCMO (38.8), indicating underutilization of optimal therapy, while a 1-year follow-up revealed slight declines in scores, suggesting challenges in improving GDMT intensity.
- KCMO demonstrated the highest variability among scoring methods, implying it provides a clearer picture of differences in GDMT intensity among patients, but further research is needed to determine its impact on patient outcomes and quality of care.
Background: Various treatment approaches for atrial fibrillation (AF) have demonstrated improved health status, yet the significance of these therapeutic interventions in individual patients remains unclear.
Objective: This study aimed to evaluate health status changes in patients with early AF, focusing on those who experience clinically significant deterioration after treatment initiation.
Methods: We analyzed data from a multicenter, prospective registry of newly diagnosed patients with AF.
Importance: A primary objective in managing atrial fibrillation (AF) is to optimize patients' health status, which can be done only if physicians accurately quantify the outcomes associated with AF in patients' lives.
Objective: To explore physicians' estimation of the health status of patients with AF and its association with subsequent care and outcomes.
Design, Setting, And Participants: A multicenter, prospective cohort study was conducted in 2 outpatient practices in Tokyo, Japan.
Article Synopsis
- Current guidelines recommend starting multiple cardioprotective drugs early for patients with heart failure with reduced ejection fraction, but the best order for administering these drugs is not well-established, indicating a need for personalized treatment plans.
- The LAQUA-HF trial will compare the effects of long-acting versus short-acting loop diuretics alongside different neurohormonal agents, enrolling 240 patients to assess health status changes over 6 months.
- Ethical approval has been granted for the trial, ensuring informed consent from participants, with results intended for broader dissemination to the medical community.
Background: Catheter ablation (CA) benefits atrial fibrillation (AF) patients with heart failure (HF). Brain natriuretic peptide (BNP), a marker of left-ventricular pressure load, may serve as a potential surrogate for predicting quality of life (QOL) in a broader range of patients.
Methods: Within the multicenter KiCS-AF registry, 491 AF patients underwent CA without clinical HF (e.
Aims: The discontinuation of oral anticoagulants (OACs) remains as a significant concern in the management of atrial fibrillation (AF). The discontinuation rate may vary depending on management strategy, and physicians may also discontinue OACs due to concerns about patient satisfaction with their care. We aimed to assess the incidence of OAC discontinuation and its relationship to patients' health in an outpatient AF registry.
View Article and Find Full Text PDFAims: The purpose of this study is to utilize patient-reported outcomes to determine the percentage of patients concerned about mild to moderate bleeding side effects of anticoagulants.
Methods And Results: We consecutively enrolled 3312 newly diagnosed or referred patients for atrial fibrillation (AF) management from 11 sites within the Keio interhospital Cardiovascular Studies-Atrial Fibrillation registry between September 2012 and May 2018. Of these patients, 2636 (79.
Background Catheter ablation (CA) for atrial fibrillation (AF) is preferred for paroxysmal AF (PAF) but selectively performed in patients with persistent AF (PersAF). This study aimed to investigate the prognostic differences and consequences of CA based on the AF type. Methods and Results Data from a multicenter AF cohort study were analyzed, categorizing patients as PAF or PersAF according to AF duration (≤7 or >7 days, respectively).
View Article and Find Full Text PDFBackground: Clinical practice guidelines recommend optimizing the health status of patients with atrial fibrillation (AF) as a primary treatment goal. Whether disease-specific health status is associated with subsequent clinical events is unknown.
Objectives: The aim of this study was to investigate the association between health status and subsequent clinical events among patients with AF.
Article Synopsis
- Clinical congestion is a major reason for hospital admissions in acute heart failure (AHF), yet few studies have deeply explored its patterns and prognostic significance.
- A study of 3,151 patients utilized statistical analysis to identify three groups based on physical congestive signs: 'no physical congestion,' 'congestion without jugular vein distention (JVD),' and 'congestion with JVD.'
- The findings revealed that patients with 'congestion with JVD' faced the highest risk for negative outcomes within a year, emphasizing the importance of JVD in assessing long-term risks for AHF patients.
The advances in the integrated management of patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) have reduced subsequent cardiovascular events. Nonetheless, sudden cardiac death (SCD) remains a major concern. Therefore, we aimed to investigate the time trend in SCD incidence after PCI and to identify the clinical factors contributing to SCD.
View Article and Find Full Text PDFBackground: Early detection of atrial fibrillation (AF) is important. Japan has a universal screening system, and regular health screening (HS) is available to support AF detection without a hospital visit. However, health-related outcomes and other characteristics of HS-detected and conventionally diagnosed AF remain unknown.
View Article and Find Full Text PDFBackground: Early identification of atrial fibrillation (AF) patients at risk for heart failure (HF) remains critical for improving their outcomes. We aimed to investigate whether indices of left ventricular diastolic dysfunction (LVDD) can stratify AF patients without clinical history of HF. Methods: We extracted 1775 patients’ data from a prospective cohort that consecutively recruited recently recognized AF patients with ejection fraction ≥50%.
View Article and Find Full Text PDFBackground: Recent randomized clinical trials have demonstrated that applying rhythm control during the early stage of atrial fibrillation (AF) may lead to improved clinical outcomes. However, the effects of this modality on health-related quality of life (HRQoL) have not been fully investigated. We aimed to assess the association between the AF stage, determined by the time between AF diagnosis and referral to the cardiology clinic, and HRQoL outcomes.
View Article and Find Full Text PDFDecoy receptor proteins that trick viruses to bind to them should be resistant to viral escape because viruses that require entry receptors cannot help but bind decoy receptors. Angiotensin-converting enzyme 2 (ACE2) is the major receptor for coronavirus cell entry. Recombinant soluble ACE2 was previously developed as a biologic against acute respiratory distress syndrome (ARDS) and verified to be safe in clinical studies.
View Article and Find Full Text PDFAims: The usefulness of catheter ablation (CA) for atrial fibrillation (AF) across a broad spectrum of heart failure (HF) patients remains to be established. We assessed the association of CA with both health-related quality of life (QoL) and cardiovascular events among HF patients with reduced and preserved left ventricular ejection fraction (LVEF) in an 'all-comer' outpatient-based AF registry.
Methods And Results: Of 3303 patients with AF consecutively enrolled in a retrospective multicentre registry that mandated the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire at registration and 1-year follow-up, we extracted data from 530 patients complicating clinical HF.