Prevention of Contrast-Induced Nephropathy After Emergency Percutaneous Coronary Intervention With a Single Bolus Administration of High-Concentrate Sodium Bicarbonate - Rationale and Design of a Single-Arm Study Compared With Historical Controls.

Contrast-induced nephropathy (CIN) is clinically important because of its poor prognosis. The incidence of CIN is higher in emergency than elective percutaneous coronary intervention (PCI) because there is no established method to prevent CIN. The aim of this study is to evaluate whether bolus administration of a concentrated solution of sodium bicarbonate can prevent CIN in patients undergoing emergency PCI.

Prevention of Contrast-Induced Nephropathy After Cardiovascular Catheterization and Intervention With High-Dose Strong Statin Therapy in Japan - The PREVENT CINC-J Study.

Background: Previous studies have reported that high-dose strong statin therapy reduces the incidence of contrast-induced nephropathy (CIN) in statin naïve patients; however, the efficacy of high-dose strong statins for preventing CIN in real-world clinical practice remains unclear. The aim of this study was to evaluate the efficacy of strong statin therapy in addition to fluid hydration for preventing CIN after cardiovascular catheterization.

Methods and results: This prospective, multicenter, randomized controlled trial included 420 patients with chronic kidney disease who underwent cardiovascular catheterization.

Effects of Fatty Acid Therapy in Addition to Strong Statin on Coronary Plaques in Acute Coronary Syndrome: An Optical Coherence Tomography Study.

BACKGROUND Vascular healing response associated with adjunctive n-3 polyunsaturated fatty acid therapy therapy in patients receiving strong statin therapy remains unclear. The aim of this study was to evaluate the effect of polyunsaturated fatty acid therapy with eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) in addition to strong statin therapy on coronary atherosclerotic plaques using optical coherence tomography. METHODS AND RESULTS This prospective multicenter randomized controlled trial included 130 patients with acute coronary syndrome treated with strong statins.

Association of contrast-induced nephropathy with risk of adverse clinical outcomes in patients with cardiac catheterization: From the CINC-J study.

Background: The association between the incidence of contrast-induced nephropathy (CIN) and subsequent clinical outcomes is unclear in Japan. We evaluated the association between CIN and cardiovascular and renal events after cardiac catheterization.

Methods: The CINC-J multicenter prospective cohort study examined 853 patients undergoing cardiac catheterization from 27 hospitals.

Prediction of contrast-induced nephropathy by the serum creatinine level on the day following cardiac catheterization.

Background: The majority of patients who undergo coronary arteriography are discharged from the hospital on the day of the procedure or on the following day. The aim of this study is to investigate whether the change in serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) on the day following cardiac catheterization can predict the development of contrast-induced nephropathy (CIN).

Methods: This is a multicenter prospective observational study, which consists of 860 patients who underwent cardiac catheterization.

A new drug delivery system for intravenous coronary thrombolysis with thrombus targeting and stealth activity recoverable by ultrasound.

Objectives: The purpose of this study was to develop a new intelligent drug delivery system for intracoronary thrombolysis with a strong thrombolytic effect without increasing bleeding risk.

Background: Rapid recanalization of an occluded coronary artery is essential for better outcomes in acute myocardial infarction. Catheter-based recanalization is widely accepted, but it takes time to transport patients.

Non-contact mapping system accurately localizes right-sided accessory pathways in type B Wolff-Parkinson-White syndrome.

Aims: Ablation of right-sided accessory pathways (APs) is sometimes challenging because several anatomical features of the tricuspid annulus (TA) and surrounding structures differ from those of the mitral annulus. This study investigated the electrophysiological characteristics and efficacy of a non-contact mapping (NCM) system for catheter ablation of right-sided APs.

Methods And Results: We examined nine APs in six consecutive patients who underwent catheter ablation of right-sided APs with NCM.

Thin-cap fibroatheroma and microchannel findings in optical coherence tomography correlate with subsequent progression of coronary atheromatous plaques.

Aims: Morphological characteristics of non-significant coronary plaques (NSCPs) that develop rapid progression have not been fully elucidated. The aim of this study was to clarify the morphological characteristics of NSCPs in patients with coronary artery disease (CAD) using intravascular optical coherence tomography (OCT).

Methods And Results: Fifty-three consecutive CAD patients undergoing percutaneous coronary intervention were enrolled and 69 NSCPs (per cent diameter stenosis <50%) were identified on baseline angiogram.

Intensive lipid-lowering therapy with rosuvastatin stabilizes lipid-rich coronary plaques. -Evaluation using dual-source computed tomography.-.

Background: Clinical studies using invasive modalities have reported that statin therapy stabilizes coronary plaque vulnerability. The serial changes of lipid-rich coronary plaques (LRCPs) during rosuvastatin treatment were evaluated non-invasively in patients with acute coronary syndrome (ACS) using dual-source computed tomography (DSCT).

Methods And Results: A total of 11 consecutive ACS patients, and 13 LRCPs were serially evaluated on DSCT before and 24 weeks after rosuvastatin treatment.

Optimization of energy level for coronary angiography with dual-energy and dual-source computed tomography.

Dual-energy computed tomography (DE-CT) uses polyenergetic X-rays at 100- and 140-kVp tube energy, and generates 120-kVp composite images that are referred to as polyenergetic images (PEIs). Moreover, DE-CT can produce monoenergetic images (MEIs) at any effective energy level. We evaluated whether the image quality of coronary angiography is improved by optimizing the energy levels of DE-CT.

Dual gradient-echo in-phase and opposed-phase magnetic resonance imaging to evaluate lipomatous metaplasia in patients with old myocardial infarction.

We present an alternative method for evaluating cardiac fat tissue-dual gradient-echo in-phase and opposed-phase magnetic resonance imaging (IPOP-MRI) with electrocardiographic (ECG) gating. Conventional IPOP-MRI can be used to evaluate small amounts of fat and is widely used for abdominal imaging, but cardiac motion artifacts make its use difficult for cardiac imaging. Using ECG gating prior to IPOP-MRI, we evaluated lipomatous metaplasia after myocardial infarction.

Clinical significance of papillary muscle late enhancement detected via cardiac magnetic resonance imaging in patients with single old myocardial infarction.

Background: Contrast-enhanced cardiac magnetic resonance imaging (MRI) can depict papillary muscle (PM) necrosis or fibrosis by late enhancement (LE) of PM, but its clinical significance in old myocardial infarction (OMI) has been little understood.

Methods: Myocardial LE and PM-LE were detected with contrast imaging in 60 patients with OMI caused by a single culprit coronary artery lesion. Left ventricular (LV) morphology and function, mitral valve geometry, and severity of mitral regurgitation were also evaluated by cine imaging.

Diagnostic accuracy of dual-source computed tomography in the characterization of coronary atherosclerotic plaques: comparison with intravascular optical coherence tomography.

Background: Dual-source computed tomography (DSCT) has enabled us to non-invasively visualize coronary artery stenosis, but its ability to characterize coronary atherosclerotic plaques (ASPs) has not been evaluated. Intravascular optical coherence tomography (OCT) provides tissue images of coronary artery wall that are validated by pathohistological studies. We studied the diagnostic accuracy of DSCT in the characterization of coronary ASPs, especially lipid-rich ASP with thin fibrous cap (TCFA), in comparison with OCT.

Reduction of circulating soluble fms-like tyrosine kinase-1 plays a significant role in renal dysfunction-associated aggravation of atherosclerosis.

Background: Renal dysfunction is commonly accompanied by a worsening of atherosclerosis; however, the underlying molecular mechanism is not fully understood. We examined the role played by soluble fms-like tyrosine kinase-1 (sFlt-1), an endogenous antagonist of the proatherogenic cytokine placental growth factor (PlGF), in the worsening of atherosclerosis in patients with renal dysfunction and in an animal model of renal failure.

Methods And Results: In this study, 329 patients who received cardiac catheterization and 76 patients who underwent renal biopsy were enrolled.

Long-term follow-up of neointimal coverage of sirolimus-eluting stents--evaluation with optical coherence tomography.

Background: Late stent thrombosis related to delayed neointimal growth is a major concern after drug-eluting stent (DES) implantation. The time course of neointimal growth and risk factors of uncovered stent struts after sirolimus-eluting stent (SES) was studied using optical coherence tomography (OCT).

Methods And Results: The 60 patients were enrolled and classified into G1 (follow-up period <9 months, n=27), G2 (9-24 months, n=18), and G3 (>25 months, n=15).

Morphological features of coronary arteries in patients with coronary spastic angina: assessment with intracoronary optical coherence tomography.

Background: Coronary spasm (CS) plays an important role in the pathogenesis of many types of ischemic heart disease, but morphological appearance of non-stenotic coronary segments with CS is not fully understood. We evaluate the morphological characteristics of coronary arteries in patients with coronary spastic angina (CSA) using intravascular optical coherence tomography (OCT).

Methods: We evaluated 37 patients with resting chest pain whose coronary angiograms did not reveal significant stenosis.

Treatment with recombinant placental growth factor (PlGF) enhances both angiogenesis and arteriogenesis and improves survival after myocardial infarction.

Background: Placental growth factor (PlGF), a homolog of vascular endothelial growth factor, is reported to stimulate angiogenesis and arteriogenesis in pathological conditions. It was recently demonstrated that PlGF is rapidly produced in myocardial tissue during acute myocardial infarction (MI). However, the effects of exogenous PlGF administration on the healing process after MI are not fully understood.

Progression of non-culprit coronary artery atherosclerosis after acute myocardial infarction in comparison with stable angina pectoris.

Aim: We previously found, using a mouse model, that activation of proinflammatory cytokines after acute myocardial infarction (AMI) augments neointimal hyperplasia of a remote artery. The present study assessed the progression of luminal narrowing of non-culprit coronary arteries (NCCA) in patients following AMI.

Methods: The study group comprised 21 AMI patients successfully treated with bare-metal stents and 16 stable angina (SA) patients treated with sirolimus-eluting stents.

[Assessment of coronary artery by four-detector multislice computed tomography: diagnostic accuracy and limitations for coronary artery lesions].

Objectives: The applicability of four-detector multislice computed tomography (MSCT) was investigated for evaluating coronary arteries.

Methods: MSCT (Somatom Volume Zoom, Siemens) was used to evaluate the coronary arteries in 94 patients. The reconstructed images were analyzed using retrospective electrocardiographic gating to determine the image quality of the coronary arteries.