Publications by authors named "Toi S"

Article Synopsis
  • The PPAR Stroke study investigated pemafibrate's effectiveness in slowing down cerebrovascular atherosclerosis in stroke patients with high triglycerides, involving 99 participants over a 2-year period.
  • Results showed significant reductions in triglyceride and inflammatory marker levels, with some improvement in carotid artery thickness, particularly on the left side.
  • The findings suggest that pemafibrate may have beneficial effects on lipid profiles and inflammation, potentially aiding in the management of atherosclerotic diseases following a stroke.
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Introduction: The primary objective of this study was to elucidate the predictive role of subtle motor impairment evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) Part III on mortality and functional outcome. The secondary objective was to evaluate the association of motor impairment with small vessel disease (SVD) severity.

Methods: We derived data from a Japanese cohort of patients with evidence of SVD who were enrolled from 2015 to 2019, and followed until 2023.

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Background: Total small vessel disease (SVD) score is used to measure the burden of SVD.

Objective: This study aimed to clarify the predictive value of total SVD score for incident dementia and functional outcomes in independent outpatients with vascular risk factors.

Methods: We derived data from a Japanese cohort in which patients underwent magnetic resonance imaging and cognitive examinations.

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Background: Gait impairment is observed in patients with small vessel disease (SVD); however, the association between gait function and long-term outcome remains unclear.

Objectives: This study aimed to clarify the predictive value of gait function on incident dementia, survival and functional outcome.

Methods: Data were derived from a Japanese cohort of patients with SVD.

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Article Synopsis
  • The total small vessel disease (SVD) score evaluates the extent of small vessel disease using four neuroimaging markers, with potential implications for predicting health outcomes like stroke and mortality.
  • This study analyzed data from 692 outpatients with vascular risk factors, revealing that higher total SVD scores (≥1) significantly predicted stroke and all-cause death, but not acute coronary syndrome.
  • Results indicate the importance of monitoring and managing patients with elevated total SVD scores to prevent strokes and reduce mortality rates, emphasizing the cutoff score of 1 for interventions.
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Background: This study aimed to clarify the characteristics and survival prediction value of transcranial Doppler microembolic signals (MES) in patients with acute cerebral infarction and active cancer.

Methods And Results: Between 2017 and 2022, 1089 cases of acute cerebral infarction were recorded within 7 days of disease onset. Among them, transcranial Doppler was successful in 33 patients who had active cancer, and these data were analyzed in this study.

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Aims: Increased arterial stiffness is associated with the severity of cerebral small-vessel disease (SVD) and may predict incident dementia. This study investigated the predictive value of brachial-ankle pulse wave velocity (ba-PWV) for dementia and cognitive decline.

Methods: Data were obtained from a Japanese cohort of 478 patients who underwent ba-PWV measurement.

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Background: We aimed to clarify the predictive value of cerebral small-vessel disease and intracranial large artery disease (LAD) observed in magnetic resonance imaging of the brain and magnetic resonance angiography on future vascular events and cognitive impairment.

Methods And Results: Data were derived from a Japanese cohort with evidence of cerebral vessel disease on magnetic resonance imaging. This study included 862 participants who underwent magnetic resonance angiography after excluding patients with a modified Rankin Scale score >1 and Mini-Mental State Examination score <24.

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Purpose: In the present trial, the 24-month safety and effectiveness of the TCD-17187 drug-coated balloon (DCB) for the treatment of atherosclerotic lesions in the superficial femoral artery (SFA) and proximal popliteal artery (PA) were evaluated in Japanese patients.

Methods: This was a prospective, multicenter, core laboratory-adjudicated, single-arm trial. From 2019 to 2020, 121 patients with symptomatic peripheral artery disease were enrolled.

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Article Synopsis
  • This study evaluated the impact of left ventricular diastolic dysfunction (LVDD) on vascular outcomes in patients who suffered from strokes that were not caused by heart issues, involving 563 participants aged around 68 years.
  • The findings revealed that 23.1% of patients had LVDD, which significantly increased their risk of serious cardiovascular events within a year, compared to those without LVDD (20.9% versus 10.8%).
  • The study concluded that LVDD should be included in risk assessments and prevention strategies for individuals who experience noncardioembolic strokes, as its severity correlates with the likelihood of future vascular incidents.
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Background: CD34 is a transmembrane phosphoglycoprotein and a marker of hematopoietic and nonhematopoietic stem/progenitor cells. In experimental studies, CD34+ cells are rich sources of endothelial progenitor cells and can promote neovascularization and endothelial repair. The potential role of CD34+ cells in stroke patients remains unclear.

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Background: It remains unclear whether changes in the venous circulation contribute to cognitive decline.

Objective: This study aimed to clarify whether the spontaneous jugular vein reflux (JVR) is associated with cognitive impairment and incident dementia.

Methods: Patients with any evidence of cerebral vessel disease on magnetic resonance imaging (MRI) were consecutively enrolled between October 2015 to July 2019.

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Article Synopsis
  • * In a study involving 648 patients, researchers found that a higher total SVD score was linked to lower scores on cognitive tests like the MMSE and MoCA-J, indicating impaired global cognitive function and attention.
  • * The findings suggest that addressing SVD burden could help prevent cognitive decline in affected individuals, highlighting the importance of managing hypertension and other vascular risk factors.
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We report a case of vasospastic angina (VSA) following COVID-19 mRNA vaccination. Despite the widespread occurrence of myocarditis, there have been few reports of post-vaccinal VSA. A 41-year-old male patient was referred for chest pain at rest following mRNA vaccination; he had never experienced chest pain prior to vaccination.

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Background: Triglyceride-glucose (TyG) index has been proposed as a simple and credible surrogate for insulin resistance and an independent predictor of cardiovascular outcomes. Due to lack of data on TyG index in stroke, we aimed to evaluate the predictive value of the index for recurrent vascular event risk among stroke patients.

Methods: This was a prospective observational study, in which 866 patients (mean age, 70.

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Article Synopsis
  • - Remote ischemic conditioning (RIC) shows promise as a method to protect the heart and brain during ischemia, potentially increasing collateral circulation and reducing brain damage after a stroke in mice.
  • - In experiments, RIC was found to improve blood flow, decrease early ischemic lesions, and lessen the overall damage to the brain compared to a sham procedure, suggesting its effectiveness in stroke recovery.
  • - The beneficial effects of RIC may involve the nitric oxide synthase (NOS) and Akt pathways, as inhibitors of these pathways reversed RIC's positive impacts on circulation and brain injury outcomes.
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Article Synopsis
  • The study evaluated how high homocysteine levels (hyperhomocysteinemia, or HHcy) affect the risk of recurring vascular events in stroke patients, particularly focusing on those with chronic kidney disease (CKD).
  • A total of 621 patients with ischemic strokes or transient ischemic attacks were followed for one year, finding that 18.5% had elevated homocysteine levels and were more likely to have artery stenosis.
  • Results indicated that HHcy significantly increased the risk of major adverse cardiovascular events (MACEs) in patients with CKD, but did not have the same predictive value for those without CKD.
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Purpose: The aim of this preapproval trial was to evaluate the 12-month safety and effectiveness of the TCD-17187 drug-coated balloon (DCB) for the treatment of atherosclerotic lesions in the superficial femoral artery (SFA) and/or proximal popliteal artery (PA).

Methods: This was a prospective, multicenter, core laboratory adjudicated, single-arm trial. From October 2019 to November 2020, a total of 121 symptomatic peripheral artery disease patients with SFA and/or proximal PA lesions were enrolled.

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Background: Remote ischemic conditioning (RIC) refers to the application of repeated short periods of ischemia intended to protect remote areas against tissue damage during and after prolonged ischemia.

Aim: We aim to evaluate the efficacy of RIC, determined by the modified Rankin Scale (mRS) score at 90 days after stroke onset.

Design And Methods: This study is an investigator-initiated, multicenter, prospective, randomized, open-label, parallel-group clinical trial.

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Here, we report a case of an 85-year-old man who presented sudden onset of diplopia, dysarthria, and gait disturbance. On admission, he exhibited bilateral adduction palsy, convergence palsy, and binocular exotropia in the forward gaze showing wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome. He had a history of chronic nonvalvular atrial fibrillation.

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Background: This study aimed to identify the association between long term functional outcomes and acute ischemic stroke (AIS) in patients with heart failure (HF) in Japan and whether 1-year event risks can be related to these patients.

Methods and results: This was a prospective observational study, and 651 patients registered in the Tokyo Women's Medical University Stroke Registry were classified into the HF and non-HF groups. Functional outcome at 1 year after stroke onset was defined as either good (modified Rankin Scale [mRS] score of 0-2) or poor (mRS score of 3-6).

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Article Synopsis
  • Common vascular diseases like atherosclerosis, small-vessel disease (SVD), and heart issues can be found in patients with embolic stroke of undetermined source (ESUS), although they don't directly cause the strokes.* -
  • A study involving 221 ESUS patients found that those with moderate to severe atherosclerosis (grades A2 or A3) faced a higher risk of subsequent vascular events compared to those with no atherosclerosis (grade A0).* -
  • The findings suggest that using the ASCOD classification to assess the severity of vascular diseases in ESUS patients can help predict risk and improve management strategies.*
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Background And Objectives: Hypertriglyceridemia is perceived to promote atherosclerotic pathology, but its role in stroke has not been well defined. Our aim was to assess the contribution of hypertriglyceridemia to residual vascular risk in patients with atherothrombotic stroke.

Methods: The Tokyo Women's Medical University Stroke Registry is an ongoing prospective, observational registry in which 870 patients with acute ischemic stroke or TIA within 1 week of onset were consecutively enrolled and followed up for 1 year.

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Aims: We aimed to determine the characteristics and vascular outcomes of stroke in renal transplant (RT) recipients and compare them with those in patients on hemodialysis (HD) and those with no renal replacement therapy (RRT).

Methods: In this prospective observational study, 717 patients (mean age, 70.8 years; male, 60.

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