Publications by authors named "Shuhei Tsuji"
Background: Previous randomized clinical trials did not support a benefit of screening for occult cancer after diagnosis of venous thromboembolism (VTE), although screening may be of potential benefit for selected high-risk patients.
Methods And Results: The COMMAND VTE Registry-2 enrolled consecutive patients with acute symptomatic VTE between 2015 and 2020 from 31 centers across Japan. The 3,706 patients in the registry without known active cancer at the time of VTE diagnosis were divided into 2 groups: those with (n=250) and without (n=3,456) newly diagnosed cancer during the follow-up period.
Article Synopsis
- * Out of 1507 cancer patients studied, 4.7% experienced an ischemic stroke over a median follow-up of 1020 days, with a cumulative incidence of 4.0% at 1 year.
- * Key risk factors for stroke include specific cancers (pancreatic, ovarian, lung), dyslipidemia, metastasis, elevated D-dimer levels, and younger age, highlighting the need for vigilant monitoring in these patients.
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- Extracorporeal membrane oxygenation (ECMO) may be necessary for some patients with severe pulmonary embolism (PE), but its clinical outcomes are not well understood.
- *In a study analyzing data from 2035 patients with acute PE, 76 required ECMO, with findings indicating high rates of cardiac arrest (88.2%) at diagnosis and a 30-day death rate of 30.3%, all related to PE.
- *The research highlighted significant complication rates, including a 54% incidence of major bleeding, suggesting the need for improved management strategies and future clinical trials.
Article Synopsis
- Elevated white blood cell (WBC) counts are identified as a risk factor for adverse outcomes in patients with venous thromboembolism (VTE) who do not have active cancer.
- In a study involving 5,197 patients, those with the highest WBC counts (Q4) were more likely to experience severe forms of VTE like pulmonary embolism and had a significantly higher risk of death and major bleeding over five years.
- The findings suggest that monitoring WBC counts at VTE diagnosis can help in assessing patient risk and potential outcomes.
Article Synopsis
- * The COMMAND VTE Registry-2 study tracked 5,197 patients with venous thromboembolism in Japan, finding that 2.3% of those with acute PE developed CTEPH over an average follow-up of 747 days.
- * Identified risk factors for developing CTEPH included being female, longer time from symptom onset to PE diagnosis, experiencing hypoxemia, having right heart load, lower D-dimer levels, and having
Article Synopsis
- The simplified Pulmonary Embolism Severity Index (sPESI) score helps identify low-risk patients for home treatment of pulmonary embolism, but its use with direct oral anticoagulants hasn't been thoroughly studied.
- A study of 2,496 patients with stable pulmonary embolism found that only 25% had an sPESI score of 0, and among those, only 17% were treated at home, though their 30-day mortality was notably low (0% vs. 4.8% in higher risk groups).
- Factors promoting home treatment included the absence of temporary risk factors, no elevated cardiac biomarkers, and the use of direct oral anticoagulants during the acute phase.
Article Synopsis
- A study in Japan compared outcomes of patients with venous thromboembolism (VTE) treated with warfarin (2010-2014) versus direct oral anticoagulants (DOACs) (2015-2020) from two multicenter registries.
- The use of DOACs skyrocketed from 2.6% in the warfarin era to 79% in the DOAC era, leading to a significant reduction in the 5-year recurrence rate of VTE (10.5% to 9.5%).
- However, the incidence of major bleeding remained similar between the two eras, indicating that while DOACs may reduce VTE recurrence, concerns about bleeding risks continue.
Article Synopsis
- The PE-SARD bleeding score was developed to predict early major bleeding in patients with pulmonary embolism (PE) but has not been fully validated externally.
- A study using data from the COMMAND VTE Registry involving 2,781 acute PE patients categorized them into high, intermediate, and low-risk groups based on this score, revealing a clear increase in bleeding rates with higher risk scores.
- The results indicated the score has modest effectiveness in predicting bleeding risk overall, with better performance in patients without active cancer.
Article Synopsis
- Statins are suggested to help prevent recurrent venous thromboembolism (VTE), based on findings from a large study of over 5,000 VTE patients in Japan.
- The study divided patients into two groups based on statin use at discharge, revealing that the group using statins had a significantly lower incidence of recurrent VTE compared to the non-statin group (6.8% vs. 10.1%) over five years.
- Although statins also showed a trend towards reducing major bleeding risk, this was not statistically significant after adjusting for confounding factors.
Background: Real-world data on clinical characteristics and outcomes related to the use of different direct oral anticoagulants (DOACs) for cancer-associated venous thromboembolism (VTE) is lacking.
Methods: The COMMAND VTE Registry-2 is a multicenter registry enrolling 5,197 consecutive patients with acute symptomatic VTE from 31 centers in Japan from January 2015 to August 2020. Our study population comprised 1,197 patients with active cancer who were divided into the edoxaban ( = 643, 54%), rivaroxaban ( = 297, 25%), and apixaban ( = 257, 22%) groups.
Article Synopsis
- Researchers studied unprovoked venous thromboembolisms (VTEs) in a large registry to identify distinct patient phenotypes using latent class analysis (LCA).
- The study classified patients into three subgroups based on age and health conditions: younger patients, older patients with few comorbidities, and older patients with many comorbidities.
- Findings revealed differences in treatment outcomes, with higher anticoagulation discontinuation and bleeding risks in older patients with more comorbidities, suggesting tailored management strategies could improve patient care.
We herein report a case of methotrexate-associated lymphoproliferative disorder (MTX-LPD) showing fibrin-associated large B-cell lymphoma-like heart valve lesions, and Epstein-Barr virus (EBV)-positive mucocutaneous ulcer-like cutaneous and oral mucosal lesions. MTX-LPD is a critical complication that can occur in RA patients who are treated with MTX. EBV also plays a defining or important role in LPDs.
View Article and Find Full Text PDFIntroduction: There is limited data on the safety of direct oral anticoagulants (DOACs) in fragile patients with venous thromboembolism (VTE).
Materials And Methods: We used the COMMAND VTE Registry-2 enrolling patients with acute symptomatic VTE. The study population consisted of 3928 patients receiving DOACs, who were divided into fragile (2136 patients) and non-fragile groups (1792 patients).
After 2010, the source model of the microSelectron HDR Afterloader System was slightly modified from the previous model. Granero et al. named the modified source model "mHDR-v2r (revised model mHDR-v2)" and the previous model "mHDR-v2".
View Article and Find Full Text PDFBackground: There have been still limited data on the transition of management strategies and clinical outcomes after introduction of direct oral anticoagulant (DOAC) for cancer-associated venous thromboembolism (VTE) in the real-world clinical practice.
Methods: Using the 2 series of multicenter COMMAND VTE registries in Japan enrolling consecutive patients with acute symptomatic VTE, we compared 695 patients with cancer-associated VTE in the Registry-1 of the warfarin era and 1507 patients in the Registry-2 of the DOAC era.
Results: Regarding oral anticoagulation therapy, 576 patients (82.
Article Synopsis
- - The study investigated cancer-associated venous thromboembolism (VTE) management in patients treated with direct oral anticoagulants (DOACs) across 31 centers in Japan from 2015 to 2020, involving 5,197 patients.
- - Patients with active cancer showed a higher rate of discontinuing anticoagulation treatment (62.7%) compared to those without cancer (59.1%), and they experienced more major bleeding incidents over five years (20.4% vs. 11.6%).
- - After adjusting for other factors, although the recurrence of VTE was similar between both groups, the increased risk of major bleeding persisted in those with active cancer, highlighting ongoing challenges in managing antico
Aims: As heart failure (HF) progresses, ATP levels in myocardial cells decrease, and myocardial contractility also decreases. Inotropic drugs improve myocardial contractility but increase ATP consumption, leading to poor prognosis. Kyoto University Substance 121 (KUS121) is known to selectively inhibit the ATPase activity of valosin-containing protein, maintain cellular ATP levels, and manifest cytoprotective effects in several pathological conditions.
View Article and Find Full Text PDFUnlabelled: We present a case of a ruptured mycotic coronary aneurysm effectively treated with covered stents and phased surgery. The covered stent, however, became occluded two years later. Because of the low invasiveness, a covered stent treatment may be advantageous over conventional surgery but trade off long-term vascular patency.
View Article and Find Full Text PDFArticle Synopsis
- A study called COMMAND VTE Registry-2 analyzed 5,197 patients in Japan with venous thromboembolism (VTE) to gather data on anticoagulation strategies and long-term recurrence from 2015 to 2020.
- The study found that 79% of patients received direct oral anticoagulants (DOACs), with differing rates of discontinuation and recurrence based on risk factor groups, particularly showing the highest recurrence in the unprovoked group.
- The findings suggest that understanding a patient's risk profile is crucial for making informed decisions about anticoagulation therapy, highlighting the need for tailored strategies especially concerning bleeding risks.
Adaptive thermogenesis is essential for survival, and therefore is tightly regulated by a central neural circuit. Here, we show that microRNA (miR)-33 in the brain is indispensable for adaptive thermogenesis. Cold stress increases miR-33 levels in the hypothalamus and miR-33 mice are unable to maintain body temperature in cold environments due to reduced sympathetic nerve activity and impaired brown adipose tissue (BAT) thermogenesis.
View Article and Find Full Text PDFRecently, advances in genomic technology such as RNA sequencing and genome-wide profiling have enabled the identification of considerable numbers of non-coding RNAs (ncRNAs). MicroRNAs have been studied for decades, leading to the identification of those with disease-causing and/or protective effects in vascular disease. Although other ncRNAs such as long ncRNAs have not been fully described yet, recent studies have indicated their important functions in the development of vascular diseases.
View Article and Find Full Text PDFRecent high-throughput approaches have revealed a vast number of transcripts with unknown functions. Many of these transcripts are long noncoding RNAs (lncRNAs), and intergenic region-derived lncRNAs are classified as long intergenic noncoding RNAs (lincRNAs). Although Myosin heavy chain 6 (Myh6) encoding primary contractile protein is down-regulated in stressed hearts, the underlying mechanisms are not fully clarified especially in terms of lincRNAs.
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- The Hippo signaling pathway plays a significant role in various cardiovascular diseases, particularly through the interaction of YAP and TEAD transcription factors.
- Researchers identified Homeobox A4 (HOXA4) as a key repressor that inhibits YAP/TEAD activity by competing for TEAD binding, which is crucial for regulating vascular smooth muscle cell (VSMC) behavior.
- Experimental studies in mice lacking HOXA4 show that its absence leads to diminished expression of contractile genes and worsened vascular remodeling, suggesting that HOXA4 is essential for maintaining the proper differentiation of VSMCs.
No effective treatment is yet available to reduce infarct size and improve clinical outcomes after acute myocardial infarction by enhancing early reperfusion therapy using primary percutaneous coronary intervention. The study showed that Kyoto University Substance 121 (KUS121) reduced endoplasmic reticulum stress, maintained adenosine triphosphate levels, and ameliorated the infarct size in a murine cardiac ischemia and reperfusion injury model. The study confirmed the cardioprotective effect of KUS121 in a porcine ischemia and reperfusion injury model.
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