Publications by authors named "Tomohiro Sakamoto"

Background: Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) is a vital mechanical circulatory support for treating patients with refractory cardiogenic shock (CS). VA-ECMO can improve end-organ perfusion; however, it increases left ventricular (LV) afterload, resulting in further myocardial damage. ECPELLA, a combination of VA-ECMO and Impella (Abiomed Inc.

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  • * In a prospective study involving 95 subjects across 7 centers in Japan, the new system showed a high success rate in reducing MR and improving patient functional capacity.
  • * Results indicated durable outcomes with minimal adverse events, including a low one-year all-cause mortality rate of 9.5% and heart failure hospitalization at 18.9%.
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Background: Data on the impact of valve position on clinical outcomes in patients with atrial fibrillation (AF) and bioprosthetic valves (BPVs) are limited.

Methods And Results: The BPV-AF Registry was a multicenter, prospective, observational study involving 894 patients with BPVs and AF. In this post-hoc substudy, patients were classified according to BPV position: aortic (n=588; 65.

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Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) includes eosinophilic granulomatosis with polyangiitis, granulomatosis with polyangiitis, and microscopic polyangiitis. Pulmonary involvements such as interstitial pneumonia and alveolar hemorrhage are common in AAV, but pleuritis is rare. Here, we report a case of pleuritis associated with AAV.

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  • The study investigates the R-CHADS-VASc score's ability to predict cardiovascular events in atrial fibrillation (AF) patients post bioprosthetic valve replacement, using data from the BPV-AF registry with 766 participants.
  • Patients were classified into low, moderate, and high risk based on their R-CHADS-VASc scores, with results indicating that those with higher scores experienced significantly more cardiovascular events during the follow-up period.
  • The findings suggest that the R-CHADS-VASc score is an effective tool for assessing cardiovascular risk in AF patients who have undergone BPV replacement, with higher scores correlating to worse outcomes.
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Background: Because the clinical benefit of antiplatelet therapy (APT) for patients with nonsignificant coronary artery disease (CAD) remains poorly understood, we evaluated it in patients after fractional flow reserve (FFR)-guided deferral of revascularization.

Methods And Results: From the J-CONFIRM (Long-Term Outcomes of Japanese Patients with Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), we investigated 265 patients with deferred lesions who did not require APT for secondary prevention of cardiovascular disease. A 2-year landmark analysis assessed the relationship between APT at 2 years and 5-year major cardiac adverse events (MACE: composite of all-cause death, target vessel-related myocardial infarction, clinically driven target vessel revascularization).

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  • Current guidelines suggest using either DOACs or warfarin for patients with atrial fibrillation who have a bioprosthetic valve, but research on elderly patients (≥80 years) in this context is limited.
  • A study analyzed data from 752 patients, revealing that those aged ≥80 had a significantly higher risk of adverse outcomes than younger patients, with a hazard ratio of 2.04.
  • The findings indicate that both DOACs and warfarin have comparable efficacy and safety in managing elderly patients with bioprosthetic valves and atrial fibrillation.
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  • Subclinical leaflet thrombosis (SLT) can lead to failure of transcatheter heart valves (THV) after TAVI, prompting this study to investigate its formation and related thrombotic factors.
  • In a study of 26 patients treated with edoxaban for atrial fibrillation undergoing TAVI, SLT was observed in 16.7% of patients at one week, decreasing to 5.9% by three months.
  • It was found that patients with SLT at one week had reduced maximal leaflet thickness, while thrombogenicity initially dropped but began to rise again by three months post-TAVI, indicating complex dynamics in thrombus formation in the early recovery phase.
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Background: There is no established standard 3 line treatment for patients with advanced non-small cell lung cancer (NSCLC). Although cytotoxic chemotherapeutic agents that are not used as 1 or 2 line treatment are administrated as 3 line treatment, their anti-tumor efficacy is insufficient. Anti-programmed death ligand-1 (PD-L1)/programmed death-1 (PD1) treatment is more effective and less toxic than chemotherapy in anti-PD-L1/PD-1 treatment-naïve patients with NSCLC.

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  • The study focused on very elderly patients (aged 80 and above) with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), investigating their clinical outcomes over one year.
  • It included 1337 patients divided into four age groups, with findings showing that the very elderly had a higher rate of all-cause death compared to the sexagenarian group.
  • After accounting for various patient factors, there were no significant differences in the overall outcomes between the very elderly and sexagenarian groups, suggesting comparable results when adjusting for health conditions and characteristics.
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  • A study was conducted to improve the prediction of which coronary artery lesions could lead to acute coronary syndrome (ACS) by integrating artificial intelligence (AI) with traditional methods.
  • The research focused on patients who had undergone coronary CT angiography (CTA) before experiencing an ACS event, analyzing both culprit (problematic) and nonculprit lesions.
  • The new model incorporating AI features showed significantly better predictability for identifying high-risk lesions compared to standard methods, suggesting that AI can enhance cardiac risk assessment.
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  • Immune-related adverse events (irAEs) can influence the effectiveness of PD-L1 inhibitors in treating metastatic non-small cell lung cancer (NSCLC), but their impact on nonmetastatic NSCLC outcomes was previously unclear.
  • This study evaluated the relationship between irAEs and progression-free survival (PFS) in Stage III NSCLC patients undergoing treatment with the PACIFIC regimen, analyzing both mild and nonmild irAEs through robust statistical methods.
  • Findings indicated that patients with nonmild irAEs experienced poorer PFS compared to those with mild irAEs or none at all, suggesting that mild irAEs could indicate better survival outcomes while more severe reactions treated with steroids are linked to worse outcomes.
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Background: The 1-year clinical outcomes of the Absorb GT1 Japan post-market surveillance (PMS) suggested that an appropriate intracoronary imaging-guided bioresorbable vascular scaffold (BVS) implantation technique may reduce the risk of target lesion failure (TLF) and scaffold thrombosis (ST) associated with the Absorb GT1 BVS. The long-term outcomes through 5 years are now available.

Methods and results: This study enrolled 135 consecutive patients (n=139 lesions) with ischemic heart disease in whom percutaneous coronary intervention (PCI) with the Absorb GT1 BVS was attempted.

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Tepotinib is a highly selective MET tyrosine kinase inhibitor (TKI) that has demonstrated robust and durable clinical activity in patients with MET exon 14 (METex14) skipping non-small-cell lung cancer (NSCLC). In the Phase II VISION study, patients received oral tepotinib 500 mg once daily. The primary endpoint was an objective response by an independent review committee (IRC) according to RECIST v1.

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The relationship between sex differences and long-term outcomes after fractional flow reserve (FFR)- and instantaneous wave-free ratio (iFR)-guided deferral of revascularization has yet to be elucidated. From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on FFR in a multicenter registry), this study included 432 lesions from 385 patients (men, 323 lesions in 286 patients; women, 109 lesions in 99 patients) with paired data of FFR and iFR. The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), including cardiac death, target vessel-related myocardial infarction, and clinically driven target vessel revascularization.

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Purpose: Mechanical circulatory support (MCS) using a venoarterial extracorporeal membrane oxygenation (VA-ECMO) device or a catheter-type heart pump (Impella) is critical for the rescue of patients with severe cardiogenic shock. However, these MCS devices require large-bore cannula access (14-Fr and larger) at the femoral artery or vein, which often requires surgical decannulation.

Methods: In this retrospective study, we evaluated post-closure method using a percutaneous suture-mediated vascular closure system, Perclose ProGlide/ProStyle (Abbott Vascular, Lake Bluff, IL, Perclose), as an alternative procedure for MCS decannulation.

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  • - The study investigates the effectiveness and safety of combining bevacizumab with chemotherapy and atezolizumab in advanced non-small cell lung cancer (NSCLC) patients, building on the existing standard treatment protocols.
  • - Conducted as a phase 3 randomized clinical trial at 37 hospitals in Japan, it enrolled patients with advanced nonsquamous NSCLC between January 2019 and August 2020, focusing on those without genetic driver alterations or who had prior treatment with tyrosine kinase inhibitors.
  • - The primary outcome measured was progression-free survival (PFS), assessed by independent reviewers, with a total of 412 patients enrolled in two treatment groups: one receiving the standard regimen and the other receiving the combination with bev
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  • Biomarker testing for driver mutations in non-small cell lung cancer (NSCLC) is crucial for treatment selection, yet current practices in Japan reveal limitations.
  • The REVEAL cohort study involved data collection from 29 institutions, examining 1479 patients diagnosed with advanced or recurrent NSCLC to assess biomarker testing and treatment issues.
  • The study found that while 86.1% of patients had confirmed biomarker status, there were varying positivity rates among different gene tests, indicating challenges in effective treatment decisions based on biomarker testing.
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  • Non-small cell lung cancer (NSCLC) with uncommon EGFR mutations is a rare group, making up 14% of EGFR mutations, and this study examines the effectiveness of osimertinib in treating these patients.
  • The trial included 42 patients, with 40 eligible and received osimertinib at a dose of 80 mg daily, tracking outcomes like overall response rate (ORR) and progression-free survival (PFS).
  • Results showed a 55.0% ORR and a 90.0% disease control rate (DCR), with a median PFS of 9.4 months, highlighting the potential of osimertinib in this uncommon mutation category.
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  • - The study reviews the impact of computed tomography-derived fractional flow reserve (FFR) on the treatment of coronary artery disease in Japan, where it is reimbursed by insurance, assessing its clinical effectiveness and economic benefits.
  • - In a multicenter registry involving 410 patients, results showed that FFR usage significantly reduced the need for invasive coronary angiography (ICA) in 39.5% of cases and avoided unnecessary additional tests in patients with FFR values above 0.80.
  • - Overall, the introduction of FFR not only minimized unnecessary procedures but also led to an estimated 35% reduction in medical costs, highlighting its potential value in everyday clinical practice.
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  • * Analyzing 111 lesions from 168 patients, the research found three key geometric parameters—SB diameter, BP-CT length, and dPOC—that were significant predictors of SB compromise, with corresponding cutoff values established.
  • * The results revealed that as the OCT risk score increased based on these parameters, the likelihood of SB compromise also increased significantly, demonstrating the predictive capability of OCT in this context.
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Background Chronic kidney disease (CKD) might influence fractional flow reserve (FFR) value, potentially attenuating its prognostic utility. However, few large-scale data are available regarding clinical outcomes after FFR-guided deferral of revascularization in patients with CKD. Methods and Results From the J-CONFIRM registry (Long-Term Outcomes of Japanese Patients With Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), 1218 patients were divided into 3 groups according to renal function: (1) non-CKD (estimated glomerular filtration rate ≥60 mL/min per 1.

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Background: Percutaneous left atrial appendage closure (LAAC) has increased for those who need alternative to long-term anticoagulation with non-valvular atrial fibrillation (NVAF).

Methods And Results: From September 2019, after initiating WATCHMAN (Boston Scientific, Maple Grove, MN, USA) device implantation, we established Transcatheter Modification of Left Atrial Appendage by Obliteration with Device in Patients from the NVAF (TERMINATOR) registry. Utilizing 729 patients' data until January 2022, we analyzed percutaneous LAAC data regarding this real-world multicenter prospective registry.

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