Publications by authors named "Shinya Goto"
Article Synopsis
- The study aimed to compare stroke prevention strategies, management of comorbidities, and clinical outcomes in patients with atrial fibrillation (AF) across different healthcare specialties: cardiology, primary care, and others.
- Among 52,011 patients, those in cardiology were more likely to receive non-vitamin K oral anticoagulants (NOACs) compared to those in primary care or other specialties, while comorbidity management was similar across all groups.
- Patients receiving care outside of cardiology faced higher risks for non-cardiovascular mortality, major bleeding, and worsening heart failure, indicating a need for improved AF management in these settings.
Extensive LDL-cholesterol lowering by PCSK9 inhibitor on the risk of venous thrombosis.
Eur Heart J Cardiovasc Pharmacother
November 2024
Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.
N Engl J Med
October 2024
Article Synopsis
- The EMPA-KIDNEY trial examined the effects of empagliflozin, an SGLT2 inhibitor, on patients with chronic kidney disease at risk for progression, assessing outcomes during and after the trial.
- A total of 6609 patients were randomized, with 4891 participating in a follow-up period after the trial where they were observed for an additional 2 years, without trial medication but allowed to use other SGLT2 inhibitors.
- Results showed that fewer primary outcome events (like kidney disease progression or cardiovascular death) occurred in the empagliflozin group (26.2%) compared to the placebo group (30.3%), suggesting lasting benefits of the drug even after the trial ended. *
The burden of cardiovascular disease in Asia from 2025 to 2050: a forecast analysis for East Asia, South Asia, South-East Asia, Central Asia, and high-income Asia Pacific regions.
Lancet Reg Health West Pac
August 2024
Article Synopsis
- A study forecasts a 91.2% increase in crude cardiovascular disease (CVD) mortality in Asia from 2025 to 2050, despite a 23.0% decrease in the age-standardized mortality rate.
- Ischaemic heart disease and stroke will remain the top causes of mortality, with Central Asia experiencing the highest mortality rates while high systolic blood pressure is identified as the leading risk factor across most of Asia.
- The research highlights the need for targeted health interventions due to the significant variations in CVD burden across different regions in Asia.
Background: The extent to which differences in results from Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) and Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial (ROCKET) atrial fibrillation (AF)-the landmark trials for the approval of apixaban and rivaroxaban, respectively, for non-valvular AF-were influenced by differences in their protocols is debated. The potential influence of selection criteria on trial results was assessed by emulating these trials in data from the Global Anticoagulant Registry in the Field (GARFIELD)-AF registry.
Methods: Vitamin K antagonist (VKA) and non-vitamin K oral antagonist (NOAC) users from GARFIELD-AF were selected according to eligibility for the original ARISTOTLE or ROCKET AF trials.
Article Synopsis
- - EMPA-KIDNEY studied the effects of empagliflozin (10 mg daily) on patients with chronic kidney disease, involving 6,609 participants, including 612 from Japan, to assess its impact on kidney disease progression and cardiovascular death.
- - Japanese participants exhibited higher albumin levels and eGFR compared to those from other regions, with a significant reduction in the primary outcome for those on empagliflozin (13.1%) versus placebo (16.9%) over a median follow-up of 2 years.
- - The results indicated that empagliflozin safely lowers the risk of kidney disease progression and cardiovascular death across diverse populations, with effects being consistent in both Japanese and non-Japanese participants
Article Synopsis
- Empagliflozin, a medication tested in the EMPACT-MI trial, showed promise in reducing heart failure (HF) hospitalizations but did not impact overall mortality when administered within two weeks post-acute myocardial infarction (AMI).
- In the study of over 6,500 patients, worsening left ventricular ejection fraction (LVEF) and congestion significantly increased the risk of death and HF hospitalizations.
- The drug effectively lowered the risk for HF hospitalizations regardless of the patients' LVEF status or congestion, and its safety profile remained consistent across different patient groups.
Article Synopsis
- Empagliflozin is known to improve cardiovascular outcomes in various patient groups, but its safety and effectiveness in those who have experienced an acute myocardial infarction were previously unclear.
- In a study involving 6522 patients at risk for heart failure after a heart attack, participants were given either empagliflozin or a placebo, with their health monitored over about 18 months.
- The results showed that empagliflozin did not significantly reduce the risk of hospitalization for heart failure or death compared to placebo, though it did show some potential benefits regarding hospitalizations specifically for heart failure.
Article Synopsis
- * In the EMPACT-MI trial, 6,522 patients were randomly assigned to receive either empagliflozin or placebo, with the results showing a significant difference in HF events after a median follow-up of 17.9 months.
- * The study also noted that patients taking empagliflozin required fewer additional heart failure medications after discharge, indicating a broader benefit in managing heart failure risks.
The structure and functions of the extracellular domain of platelet integrin α β (platelet membrane glycoprotein: GPIIb-IIIa) change substantially upon platelet activation. However, the stability of the integrated model of extracellular/transmembrane/intracellular domains of integrin α β with the inactive state of the extracellular domain has not been clarified. The integrated model of integrin α β was developed by combining the extracellular domain adopted from the crystal structure and the transmembrane and intracellular domain obtained by Nuclear Magnetic Resonace (NMR).
View Article and Find Full Text PDFThis study aimed to understand the response of neutrophils stimulated by Streptococcus uberis, a major cause of mastitis. It was found that the production of neutrophil extracellular traps (NETs) was induced in milk clots from mastitic milk produced by S. uberis-infected bovine udders.
View Article and Find Full Text PDFBackground: Guidelines for patients with atrial fibrillation (AF) at high thromboembolic risk recommend oral anticoagulants (OACs) for preventing stroke and systemic embolism (SE). The reasons for guideline non-adherence are still unclear.
Aim: The aim is to identify clinical, demographic and non-patient characteristics associated with withholding OAC in patients with AF at high stroke risk.
Article Synopsis
- The study compares outcomes of rhythm control versus rate control in patients with recent onset atrial fibrillation, using data from the GARFIELD-AF registry.
- Of the 45,382 patients, 52.6% received rhythm control and were generally younger and had fewer prior stroke or embolism incidents compared to the rate control group.
- Results showed significantly lower risks of all-cause mortality and non-haemorrhagic stroke for those who underwent early rhythm control, highlighting its potential benefits for patient outcomes.
Background: Oral anticoagulants (OAC) are underutilized in older patients with atrial fibrillation, despite proven clinical benefits. Our objective was to investigate baseline characteristics, treatment patterns, and impact of anticoagulation upon clinical outcomes with respect to age.
Methods: Adults with newly diagnosed atrial fibrillation were recruited into the prospective observational registry, GARFIELD-AF, and followed up for 24 months.
Asian perspective on the recently published practice guideline for acute coronary syndrome by ESC.
Eur Heart J Acute Cardiovasc Care
February 2024
Article Synopsis
- The study explores how disruptions in the glutathione-based lipid redox system cause increased oxidized lipid production and cell death (ferroptosis) during ischemia-reperfusion (IR) events in cardiomyocytes.
- Clinical methods such as microdialysis and high-resolution mass spectrometry were used to analyze metabolite fluctuations, revealing significant glutathione release into extracellular spaces and decreased intracellular levels during IR.
- The research also showed that inhibiting the transporter MRP1 can reduce reactive oxygen species and lipid peroxidation, thus preventing ferroptosis and potential cell death following ischemic events.
Immune checkpoint molecules PD-1/PD-L1 cause T-cell exhaustion and contribute to disease progression in chronic infections of cattle. We established monoclonal antibodies (mAbs) that specifically inhibit the binding of bovine PD-1/PD-L1; however, conventional anti-PD-1 mAbs are not suitable as therapeutic agents because of their low binding affinity to antigen. In addition, their sensitivity for the detection of bovine PD-1 is low and their use for immunostaining PD-1 is limited.
View Article and Find Full Text PDFWe investigated the phase-separated structure of nitrile butadiene rubber (NBR)/polyvinyl chloride (PVC) blends with different acrylonitrile (AN) contents in the NBR, using dynamic mechanical analysis measurements and scanning-transmission-electron-microscopy (STEM)-energy-dispersive-X-ray-spectroscopy (EDS) elemental analysis. Two separate sharp tan peaks were observed in the blend at the lower AN content of 18.0%, whereas a broad peak was observed in the blends with the higher AN contents of 29.
View Article and Find Full Text PDFArticle Synopsis
- A 63-year-old woman developed acute pulmonary hypertension (PH) after her second mRNA COVID-19 vaccination, characterized by facial and pedal swelling, and difficulty breathing that emerged gradually over six weeks.
- Diagnosis through echocardiogram and cardiac catheterization revealed high pulmonary artery pressure, while imaging tests ruled out large blood clots, suggesting a microthrombus issue.
- The patient responded positively to heparin treatment and anticoagulants, showing improvement in symptoms and reduced pulmonary artery pressure, indicating a need for further research on the potential link between COVID-19 vaccination and microthrombus formation.