Publications by authors named "Takano Masamichi"
Article Synopsis
- Recent studies indicate that calcified nodules (CN) in patients with acute coronary syndrome (ACS) are linked to worse health outcomes.
- The study involved 695 ACS patients and found that those with OCT-defined CN were typically older and had higher incidences of diabetes, hemodialysis, and severe heart failure compared to those without CN.
- Key predictors for the presence of OCT-CN included age, hemodialysis, and Killip Class III/IV heart failure, suggesting that these factors could indicate increased lesion severity and poorer prognosis for ACS patients.
Background: It was recently reported that thin-cap fibroatheroma (TCFA) detected by optical coherence tomography was an independent predictor of future cardiac events in patients with diabetes. However, the clinical usefulness of this finding is limited by the invasive nature of optical coherence tomography. Computed tomography angiography (CTA) characteristics of TCFA have not been systematically studied.
View Article and Find Full Text PDFPeripheral artery disease (PAD) compromises walking and physical activity, which results in further loss of skeletal muscle. The cross-sectional area of the thigh muscle has been shown to be correlated with systemic skeletal muscle volume. In our previous pilot study, we observed an increase in thigh muscle mass following endovascular treatment (EVT) in patients with proximal vascular lesions affecting the aortoiliac and femoropopliteal arteries.
View Article and Find Full Text PDFArticle Synopsis
- - A study involving 1,840 Japanese patients with acute coronary syndrome (ACS) identified two groups: those who experienced major bleeding and those who did not, over a 2-year follow-up period.
- - Out of the participants, 124 patients (6.7%) had major bleeding, which was linked to a significantly higher rate of cardiovascular deaths (26.4% vs. 8.5%).
- - Analysis through optical coherence tomography revealed that disrupted fibrous cap and calcified plaque were more common in patients who bled, with disrupted fibrous cap being a significant predictor of major bleeding.
Background: Recently, it was reported that noncalcified plaque (NCP) volume was an independent predictor for cardiac events. Pericoronary adipose tissue (PCAT) attenuation is a marker of vascular inflammation and has been associated with increased cardiac mortality. The aim of this study was to evaluate the relationships between NCP volume, plaque vulnerability, and PCAT attenuation.
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- Young patients with diabetes have a significantly higher prevalence of vulnerable plaque characteristics linked to acute coronary syndrome compared to those without diabetes.
- The study analyzed 1,394 patients and found that diabetes was associated with more lipid-rich plaques and other harmful features, which remained high across different age groups.
- While patients without diabetes showed increased plaque rupture and lipid-rich plaques as they aged, those with diabetes exhibited these risks early on, indicating a need for early intervention.
Background The prognostic impact of optical coherence tomography-diagnosed culprit lesion morphology in acute coronary syndrome (ACS) has not been systematically examined in real-world settings. Methods and Results This investigator-initiated, prospective, multicenter, observational study was conducted at 22 Japanese hospitals to identify the prevalence of underlying ACS causes (plaque rupture [PR], plaque erosion [PE], and calcified nodules [CN]) and their impact on clinical outcomes. Patients with ACS diagnosed within 24 hours of symptom onset undergoing emergency percutaneous coronary intervention were enrolled.
View Article and Find Full Text PDFOptical Coherence Tomography-Guided Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: Rationale and Design of the ATLAS-OCT Study.
Am J Cardiol
September 2023
Article Synopsis
- The ATLAS-OCT trial aims to investigate the feasibility of using optical coherence tomography (OCT) to guide primary percutaneous coronary intervention (PCI) in patients with STEMI, given the ongoing risks of adverse events even after successful revascularization.
- The study will enroll all STEMI patients who undergo primary PCI at specific hospitals known for their expertise in OCT, regardless of whether OCT is utilized during the procedure.
- The primary goal is to evaluate how frequently OCT imaging can be successfully conducted during PCI, along with tracking major adverse cardiac events over the course of one year.
Background: Diagnostic strategies depend on non-standardized workup, and the causes of myocardial infarction with non-obstructive coronary arteries remain unclear for some patients. Intracoronary imaging is recommended for detecting the missed causes by coronary angiography. Myocardial infarction with non-obstructive coronary arteries is a heterogeneous entity; a meta-analysis of myocardial infarction with non-obstructive coronary artery studies demonstrated that all-cause mortality rate at 1 year is 4.
View Article and Find Full Text PDFBackground: Recent retrospective investigations have suggested that optical coherence tomography (OCT) enables the diagnosis of underlying acute coronary syndrome (ACS) causes such as plaque rupture, plaque erosion, and calcified nodule. The relationships of these etiologies with clinical outcomes, and the clinical utility of OCT-guided primary percutaneous coronary intervention (PCI) are not systematically studied in real-world ACS treatment settings.
Methods: The TACTICS registry is an investigator-initiated, prospective, multicenter, observational study to be conducted at 21 hospitals in Japan.
Article Synopsis
- Optical Coherence Tomography (OCT) has evolved as a key imaging tool over the past two decades, significantly improving our understanding of coronary atherosclerosis and optimizing cardiac interventions.
- Recent advancements in OCT have enabled better identification of plaque pathology and healing processes in patients with acute coronary syndromes, potentially transforming patient management.
- This Review aims to present the latest insights on cardiac OCT, standardizing its clinical application and interpretation among researchers and clinicians globally.
A 25-year-old woman diagnosed as having a non-massive pulmonary embolism and deep vein thrombosis from the right superficial femoral to the right common iliac vein was treated by deployment of a DENALI Vena Cava Filter. Filter retrieval was attempted 6 months later using a BARD snare retrieval kit. However, the conventional technique was unsuccessful because of a tilt and attachment of the filter head to the vessel wall.
View Article and Find Full Text PDFHelicopter emergency medical service (HEMS) has the potential to improve prognosis for acute coronary syndrome (ACS). However, adequacy and effectiveness of HEMS have not been fully evaluated. A total of 862 ACS patients transferred by emergency medical services were divided into two groups: patients transferred by HEMS (n = 171) or by ground ambulance (GA; n = 691).
View Article and Find Full Text PDFBackground A recent study reported that the outcome of patients with plaque erosion treated with stenting is poor when the underlying plaque is lipid rich. However, the detailed phenotype of patients with plaque erosion, particularly as related to different age groups, has not been systematically studied. Methods and Results Patients with acute coronary syndromes caused by plaque erosion were selected from 2 data sets.
View Article and Find Full Text PDFThe development of optical coherence tomography (OCT) has revolutionized our understanding of coronary artery disease. In vivo OCT research has paralleled with advances in computational fluid dynamics, providing additional insights in the various hemodynamic factors influencing plaque growth and stability. Recent OCT studies introduced a new concept of plaque healing in relation to clinical presentation.
View Article and Find Full Text PDFBackground: South Asians, and Indians in particular, are known to have a higher incidence of premature atherosclerosis and acute coronary syndromes (ACS) with worse clinical outcomes, compared to populations with different ethnic backgrounds. However, the underlying pathobiology accounting for these differences has not been fully elucidated.
Methods: ACS patients who had culprit lesion optical coherence tomography (OCT) imaging were enrolled.
Article Synopsis
- The study analyzed cardiac outcomes in 1,683 patients with acute coronary syndrome (ACS), focusing on those with a Body Mass Index (BMI) under 18.5.
- Patients in this underweight group displayed smaller vessel sizes, longer lipid plaque lengths, and lower prevalence of common risk factors such as diabetes and hypertension.
- Despite lower metabolic risks, the underweight patients had significantly higher rates of cardiac mortality and major bleeding during a 2-year follow-up, indicating that being underweight is linked to worse outcomes in ACS.