Publications by authors named "Yoshio Tahara"
Background: The Society of Cardiovascular Angiography and Intervention (SCAI) has defined 5 stages of cardiogenic shock (CS). In patients with acute myocardial infarction (AMI) who initially present in stable hemodynamic condition (SCAI CS stage: A or B), CS stages could deteriorate despite therapeutic management. However, deterioration of SCAI CS stages after AMI remains to be fully characterized.
View Article and Find Full Text PDFArticle Synopsis
- ECPR has enabled previously ineligible patients with refractory out-of-hospital cardiac arrest (OHCA) from acute myocardial infarction (AMI) to undergo primary percutaneous coronary intervention (PCI).
- A study examined 671 patients over five years, finding that 37% of them had refractory cardiac arrest despite ECPR, with about 65% achieving return of spontaneous circulation (ROSC) post-PCI and 21% surviving to discharge.
- Key factors influencing survival included having prehospital ROSC, quicker ECPR initiation, and achieving a high TIMI flow grade after the procedure.
Article Synopsis
- Acute autoimmune pericarditis (AAP) is a rare condition with varied causes, and this study aimed to understand its diagnosis and outcomes compared to acute idiopathic pericarditis (AIP).
- Out of 20,469 patients analyzed, 170 had AAP with diagnoses including systemic lupus erythematosus and rheumatoid arthritis, while 1.8% of AAP patients died during hospitalization and 8.8% experienced cardiac tamponade.
- The research found that AAP patients had a higher risk of cardiac tamponade compared to AIP patients, but both groups had similar rates of rehospitalization, highlighting the diagnostic diversity in AAP.
Background: Our study investigated the prognostic impacts of the interval between collapse and the initiation of cardiopulmonary resuscitation (CPR), and subsequent intervals to defibrillation or epinephrine administration, on 30-day favorable neurological outcomes following out-of-hospital cardiac arrest (OHCA).
Methods And Results: This nationwide population-based cohort study used the All Japan Utstein Registry, encompassing OHCA patients in Japan between January 2006 and December 2021. The primary outcome was 30-day favorable neurological outcomes, defined as Cerebral Performance Category 1 or 2.
Background: Possible etiologies of out-of-hospital cardiac arrest (OHCA), including aortic dissection, ruptured aortic aneurysms, and pulmonary embolism, may be classified as non-cardiac causes. We investigated whether cardiac and non-cardiac OHCAs increased following the Kumamoto earthquake and whether the impact on OHCAs extended to regions far from the epicenter.
Methods And Results: We prospectively analyzed a nationwide registry of patients who experienced OHCAs between January 2013 and December 2019.
Article Synopsis
- The study examines the left-digit bias (LDB) and its potential influence on decision-making during out-of-hospital cardiac arrests (OHCA) among medical professionals and the general public.
- Researchers analyzed data from nearly 384,200 cases of OHCA witnessed by family members to see if age thresholds (60, 70, 80, and 90 years) impacted the rates of bystander CPR and advanced cardiac life support.
- The findings revealed no significant changes in CPR or medical intervention rates at any of the age thresholds, indicating that age-related LDB does not seem to affect medical decision-making in these situations.
Article Synopsis
- The study explores the relationship between COVID-19 and the severity of acute myocardial infarction (AMI) in Japan, using data from the JROAD-DPC study covering April 2019 to March 2021.
- Researchers identified an increase in patients with cardiogenic shock (Killip class IV) during the pandemic, with 15.7% vs. 14.5% in the pre-pandemic period, and a slight rise in 30-day mortality rates (9.6% vs. 9.2%).
- Despite these findings, the adjusted 30-day mortality rates for different Killip classes remained consistent before and during the pandemic, indicating that the overall severity of AMI managed during this period did not affect
Aim: To develop a new scoring model for patients with cardiogenic out-of-hospital cardiac arrest (OHCA) to facilitate neurological prognosis prediction upon hospital arrival by using prehospital resuscitation features alone.
Methods: Between 2005 and 2019, we enrolled 942,891 adult patients with OHCA of presumed cardiac aetiology from the All-Japan Utstein Registry. Scoring models applied prehospital resuscitation features a priori from the variables the American College of Cardiology algorithm including age, duration to return of spontaneous circulation (ROSC) or hospital arrival, no bystander cardiopulmonary resuscitation (CPR), unwitnessed arrest, and nonshockable rhythm (R-EDByUS score) to predict unfavorable neurological outcomes defined as Cerebral Performance Category 3, 4, or 5 at 1 month.
This study investigates the impact of the COVID-19 pandemic on pediatric out-of-hospital cardiac arrest (OHCA) outcomes in Japan, aiming to address a critical research gap. Analyzing data from the All-Japan Utstein registry covering pediatric OHCA cases from 2018 to 2021, the study observed no significant changes in one-month survival, neurological outcomes, or overall performance when comparing the pre-pandemic (2018-2019) and pandemic (2020-2021) periods among 6765 cases. However, a notable reduction in pre-hospital return of spontaneous circulation (ROSC) during the pandemic (15.
View Article and Find Full Text PDFAim: The optimal timing of adrenaline administration after defibrillation in patients with out-of-hospital cardiac arrest (OHCA) and an initial shockable rhythm is unknown. We investigated the association between the defibrillation-to-adrenaline interval and clinical outcomes.
Methods: Between 2011 and 2020, we enrolled 1,259,960 patients with OHCA into a nationwide prospective population-based registry in Japan.
Background: International consensus on cardiopulmonary resuscitation (CPR) and emergency cardiovascular care science and treatment recommendations (CoSTR) have reported updates on CPR maneuvers every 5 years since 2000. However, few national population-based studies have investigated the comprehensive effectiveness of those updates for out-of-hospital cardiac arrest due to shockable rhythms. The primary objective of the present study was to determine whether CPR based on CoSTR 2005 or 2010 was associated with improved outcomes in Japan, as compared with CPR based on Guidelines 2000.
View Article and Find Full Text PDFObjective Earlobe crease (ELC) is an easily detectable physical sign of cardiovascular risk and coronary artery disease (CAD). However, the relationship between ELC and CAD severity in patients with ST-segment elevation myocardial infarction (STEMI) requiring urgent clinical judgment is unknown. Using the residual synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score, we investigated the relationship between ELC and anatomical severity of CAD.
View Article and Find Full Text PDFTemperature perception is essential for humans to discern the environment and maintain homeostasis. However, some individuals experience cold hypersensitivity, characterized by a subjective feeling of coldness despite ambient environmental temperatures being normal, the underlying mechanisms of which are unknown. In this study, we aimed to investigate the relationship between subjective cold symptoms and somatic burden or single nucleotide polymorphisms to understand the causes of cold hypersensitivity.
View Article and Find Full Text PDFBackground: The impact of a national initiative to provide cardiopulmonary resuscitation (CPR) education to the public on the rates of citizen-initiated CPR and survival following out-of-hospital cardiac arrest (OHCA) remains uncertain.
Methods: We examined 358,025 cases of citizen-witnessed OHCA with presumed cardiac origin, recorded in the Japanese nationwide registry from 2005 to 2020. We assessed the relationship between the number of individuals certified in CPR courses, citizen interventions, and neurologically favorable survival at one month.
Background: While internal mammary artery (IMA) has become a major conduit of coronary artery bypass graft (CABG) surgery, subclavian artery stenosis (SAS) could cause subsequent coronary events due to ischemia of myocardial territory supplied by IMA. Clinical characteristics and cardiovascular outcomes of SAS-related IMA failure (SAS-IMAF) remain to be fully determined yet. Therefore, the current study was designed to characterize SAS-IMAF in patients receiving CABG with IMA.
View Article and Find Full Text PDFBackground: Gasping during resuscitation has been reported as a favorable factor for out-of-hospital cardiac arrest. We examined whether gasping during resuscitation is independently associated with favorable neurological outcomes in patients with refractory ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) undergoing extracorporeal cardiopulmonary resuscitation ECPR.
Methods: Data from a 2014 study on advanced cardiac life support for ventricular fibrillation with extracorporeal circulation in Japan (SAVE-J), which examined the efficacy of ECPR for refractory VF/pVT, were analyzed.
Article Synopsis
- The study investigates the influence of prehospital factors on neurological outcomes for patients experiencing witnessed out-of-hospital cardiac arrest (OHCA) with a shockable rhythm, aiming to clarify existing uncertainties.
- Researchers analyzed data from over 1.9 million patients using a nationwide registry, focusing specifically on 86,495 individuals fitting the study's criteria, and developed a decision tree model to evaluate outcomes.
- Key findings indicate that the return of spontaneous circulation, lack of adrenaline administration, and patient age are significant predictors of favorable neurological survival, with probabilities of survival ranging from 5.7% to 70.8% and validation assessments showing strong predictive performance.
Aim: Omega-3 fatty acids have emerged as a new option for controlling the residual risk for coronary artery disease (CAD) in the statin era. Eicosapentaenoic acid (EPA) is associated with reduced CAD risk in the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention trial, whereas the Statin Residual Risk with Epanova in High Cardiovascular Risk Patients with Hypertriglyceridemia trial that used the combination EPA/docosahexaenoic acid (DHA) has failed to derive any clinical benefit. These contradictory results raise important questions about whether investigating the antiatherosclerotic effect of omega-3 fatty acids could help to understand their significance for CAD-risk reduction.
View Article and Find Full Text PDFNitroglycerin dilates the radial artery and prevents spasm, which increases the success rate of sheath cannulation through the conventional transradial approach. However, the effects of nitroglycerin on distal radial approach (DRA) procedures are not known. The aim of this study is to elucidate whether a transdermal nitroglycerin patch improves the rate of successful DRA cannulation.
View Article and Find Full Text PDFArticle Synopsis
- Younger females experiencing out-of-hospital cardiac arrest (OHCA) in public settings are less likely to receive critical interventions like public access defibrillation and bystander CPR, which could negatively impact their neurological outcomes.
- A study using data from the All-Japan Utstein Registry analyzed over 354,000 cases of OHCA from 2005 to 2020, revealing significant disparities in treatment rates and outcomes based on age and sex.
- The findings showed that males were more likely to receive life-saving interventions compared to females, highlighting the need for targeted efforts to improve responses for younger women in cardiac emergencies.
Background: There is growing interest in the indirect negative effects of coronavirus disease 2019 (COVID-19) on mortality. We aimed to assess its indirect effect on out-of-hospital cardiac arrest (OHCA) outcomes.
Methods: We analysed a prospective nationwide registry of 506,935 patients with OHCA between 2017 and 2020.
Article Synopsis
- Defibrillation is key in improving survival rates and spontaneous circulation in out-of-hospital cardiac arrest cases with shockable rhythms, and prehospital adrenaline can boost the chances of early recovery.
- A study analyzed over 1.8 million OHCA cases in Japan, focusing on 81,056 patients with witnessed cardiac arrest and a shockable rhythm, to assess how the number of defibrillation attempts influenced survival and neurological outcomes.
- While more defibrillation attempts generally led to lower neurological survival rates for most, the trend flipped for patients given adrenaline, where up to four shocks improved outcomes.