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In Japan, most HbA1c measurements by enzymatic assays or immunoassays represent the HbA1c levels in the blood cell fraction obtained after centrifugation of the blood samples. The present study investigated that the blood cell enzymatic HbA1c assay (EA-HbA1c) was compared with whole blood HbA1c in patients with iron deficiency anemia (IDA). Study 1: EA-HbA1c levels using blood cell samples (blood cell EA-HbA1c) and high-performance liquid chromatography (HPLC)-HbA1c levels using whole blood samples (whole blood HPLC-HbA1c) were measured in 15 IDA patients with Hb < 8 g/dL and transferrin saturation (TSAT) < 20%, and the correlations between the blood cell EA-HbA1c/whole blood HPLC-HbA1c ratio (%) and various IDA indicators [mean corpuscular hemoglobin concentration (MCHC), TSAT, and logarithmically transformed ferritin (log-FER)] were examined.

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Background And Aims: The association between periprocedural change in tricuspid regurgitation (TR) and outcomes in patients undergoing mitral transcatheter edge-to-edge repair (M-TEER) is unclear. This study aimed to examine the prognostic value of TR before and after M-TEER.

Methods: Patients in the OCEAN-Mitral registry were divided into four groups according to baseline and post-procedure echocardiographic assessments: no TR/no TR (no TR), no TR/significant TR (new-onset TR), significant TR/no TR (normalized TR), and significant TR/significant TR (residual TR) (all represents before/after M-TEER).

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We present a patient with type 2 diabetes mellitus and a variant hemoglobin whose HbA1c levels were falsely elevated regardless of the measurement method [high-performance liquid chromatography (HPLC), enzymatic, and immuno-assay] used. The causes of the falsely high HbA1c levels in this patient were investigated. The patient was a 73-year-old man with frequent hypoglycemia on self-monitoring of blood glucose, whose HbA1c level when measured by HPLC (standard mode) and immunoassay was substantially higher than that predicted by continuous blood glucose monitoring or from the patient's glycated albumin level.

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Background: Evidence regarding the incidence of prosthesis-patient mismatch (PPM) and long-term mortality after transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS) is scarce.

Objectives: This study sought to assess the incidence and prognostic impact of PPM after TAVR for bicuspid AS compared with that for tricuspid AS.

Methods: In total, 7,393 patients who underwent TAVR were prospectively enrolled in the OCEAN-TAVI (Optimized Catheter Valvular Intervention Transcatheter Aortic Valve Implantation) registry, an ongoing Japanese, multicenter registry.

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Introduction: Surgical site infection (SSI) is one of the most serious postoperative complications following instrumented spinal surgery. We previously reported the potential of continuous local antibiotic perfusion (CLAP) to retain implants for patients with SSI following instrumented spinal surgery. We conducted a retrospective multicenter study to elucidate the efficacy and limitations of CLAP for patients with SSI following instrumented spinal surgery.

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There is a scarcity of data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and chronic kidney disease (CKD). The Optimal Intravascular Ultrasound (OPTIVUS)-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1,015 patients who underwent multivessel IVUS-guided PCI including left anterior descending coronary artery target with an intention to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared the clinical outcomes between patients with and without CKD.

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Background: A small mitral valve area (MVA) is one of the challenging anatomies for transcatheter edge-to-edge repair (TEER) for mitral regurgitation, but the relationship between baseline MVA and clinical outcomes remains unknown. This study aimed to evaluate the association of baseline MVA with procedural and clinical outcomes in patients undergoing TEER with MitraClip from the OCEAN-Mitral registry (Optimized Catheter Valvular Intervention-Mitral).

Methods: A total of 1768 patients undergoing TEER were divided into 3 groups according to baseline MVA: group 1: <4.

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Background: Research on the impact of angiographically detected residual trabeculation after left atrial appendage closure (LAAC) is limited.

Objectives: To investigate the incidence, characteristics, and clinical implications of angiographically detected residual trabeculation after LAAC using the WATCHMAN device.

Methods: We analyzed 1350 consecutive patients with atrial fibrillation undergoing LAAC using the WATCHMAN device from the OCEAN-LAAC registry, which is a prospective ongoing, multicenter Japanese registry.

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Background: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) is of greater concern in Asians, considering their relatively smaller annular sizes compared with Westerners. However, the prognostic significance of PPM in Asian populations has not been demonstrated.

Objectives: This study aimed to elucidate the prognostic value of PPM after TAVR in Asian patients.

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Article Synopsis
  • - The study compares the hemodynamic performance and clinical outcomes of self-expandable valves (SEV) and balloon-expandable valves (BEV) in patients with small aortic annulus (SAA) undergoing transcatheter aortic valve replacement (TAVR).
  • - Results showed that SEV offered better hemodynamics, with a higher rate of severe prosthesis-patient mismatch and a greater mean pressure gradient in patients receiving BEV, while BEV had lower incidences of paravalvular leakage and new permanent pacemaker implantation.
  • - Overall, both valve types had similar device success rates, indicating that SEV is superior in hemodynamic outcomes but BEV has advantages in reducing certain complications. *
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Article Synopsis
  • This study explores the relationship between handgrip strength and all-cause mortality in patients undergoing transcatheter edge-to-edge repair (TEER) for heart issues, suggesting that weaker grip strength could indicate a higher risk of death post-procedure.
  • It includes data from the OCEAN-Mitral Registry, which analyzed handgrip tests of 2077 patients before TEER, with follow-ups showing varied changes in strength based on the success of the procedure.
  • The findings suggest that improving mitral regurgitation (MR) post-TEER can positively impact frailty and resilience, making this research a significant insight into patient outcomes in heart-related treatments.
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Article Synopsis
  • This study examined how left ventricular ejection fraction (LVEF) changes after a specific heart valve repair procedure called transcatheter edge-to-edge valve repair (TEER) in patients with mitral regurgitation (MR).
  • Findings revealed that 32% of patients experienced worsened LVEF after the procedure, linked to increased end-systolic volumes in the heart and certain predictors like higher LVEF and levels of B-type natriuretic peptide.
  • Despite the LVEF worsening, long-term outcomes (like death or hospitalization for heart failure) were similar for both patients with worsened and preserved LVEF, indicating that LVEF change might not significantly impact overall health results post-TEER
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Background: The prognosis of patients with lung cancer and malignant pleural effusion (MPE) caused by carcinomatous pleurisy is poor. Chemical pleurodesis is commonly performed clinically, however, often has a high failure rate. Furthermore, prolonged sustained drainage and delayed introduction of systemic chemotherapy could increase the risk of worsening the Eastern Cooperative Oncology Group Performance Status (ECOG PS) in the treatment of patients with non-small cell lung cancer (NSCLC).

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Background: The Direct Oral Anticoagulant (DOAC) Score can predict bleeding risk in patients with atrial fibrillation taking DOACs; however, it lacks external validation. Therefore, this study aimed to assess the association between the DOAC Score and bleeding events in patients with atrial fibrillation who underwent transcatheter aortic valve replacement.

Methods And Results: This retrospective multicenter cohort study included patients with atrial fibrillation who underwent transcatheter aortic valve replacement, as registered in a Japanese multicenter registry.

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Objectives: Colorectal cancer is the most prevalent malignant disease in Japan. This study aimed to publish data on colorectal cancer cases registered in 2023, involving initial treatments in 2015.

Methods: Participating facilities of the Japanese Society for Cancer of the Colon and Rectum (JSCCR) registered cases treated in 2015 according to the 8th edition of the Japanese Classification of Colorectal Carcinoma.

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Background: Provisional single stenting strategy (PSS) is a default strategy for percutaneous coronary intervention (PCI) of unprotected left main distal bifurcation lesions (ULMD). Previous study reported that a bifurcation angle change (BAC) between end diastole and systole was associated with outcomes after PCI with double stent strategy (DSS) for ULMD. However, there are no data comparing outcomes after PCI with PSS versus DSS according the degree of BAC.

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Data concerning the clinical effect of the latest-generation self-expandable transcatheter heart valve (Evolut FX) remain limited. We aimed to assess the in-hospital outcomes of 3 bioprosthetic valves (Evolut EPO, PRO+, and FX). We analyzed data from a Japanese multicenter registry involving 634 consecutive patients who underwent transcatheter aortic valve replacement with Evolut FX up until October 2023.

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Article Synopsis
  • Percutaneous left atrial appendage closure (LAAC) helps reduce stroke and bleeding events in patients with non-valvular atrial fibrillation, particularly those who cannot take anticoagulants, but patients with heart failure remain at risk.
  • In a study involving 937 patients, researchers evaluated the effect of baseline plasma B-type natriuretic peptide (BNP) levels on outcomes after LAAC, with 98% of the procedures being successfully completed.
  • Results showed that higher baseline plasma BNP levels were linked to an increased risk of stroke, bleeding events, and mortality, indicating the need for further research to optimize treatment strategies for these patients.
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Background: The Clinical Frailty Scale (CFS) is a useful frailty marker for predicting clinical outcomes in patients undergoing invasive therapy. However, the clinical impact of CFS after transcatheter edge-to-edge repair in patients with mitral regurgitation (MR) remains unclear. This study aimed to elucidate the association between the baseline frail status defined by the CFS and clinical outcomes with or without postprocedural MR ≥2+ (post-MR ≥2+) after transcatheter edge-to-edge repair.

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Article Synopsis
  • East Asians typically have smaller aortic valve complexes compared to Western populations, and there’s limited data on TAVI outcomes in Asian patients with large annuli.
  • This study analyzes TAVI results in Asian patients, comparing outcomes between balloon-expandable valves (BEVs) and self-expandable valves (SEVs) by examining data from the OCEAN-TAVI registry.
  • Findings show no significant differences in 3-year all-cause mortality, heart failure rehospitalization rates, or valve function after 2 years between BEV and SEV groups, although SEVs had higher rates of paravalvular leakage and pacemaker implantation.
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We encountered a case of a large hematoma developing with perforation shortly after a cold snare polypectomy for a colorectal adenoma. The patient underwent cold snare polypectomy for a 3-mm type Is lesion in the transverse colon at another facility. Two hours later, she visited the emergency room due to abdominal pain.

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Background: Intraplaque delivery of contrast has been utilized during percutaneous coronary interventions (PCI) of chronic total occlusions (CTO) to delineate anatomy and to facilitate wire crossing. Its utility as a tool to accomplish primary crossing of CTOs has not been described or validated.

Aims: We describe a new technique leveraging the diagnostic and therapeutic roles of intraplaque contrast injection to accomplish primary crossing of CTOs: HydroDynamic contrast Recanalization (HDR).

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Article Synopsis
  • * Out of 1474 patients analyzed, 18.4% received higher doses of beta-blockers one month post-surgery, showing a significant association with lower risks of all-cause and cardiovascular mortality.
  • * The findings suggest that adjusting beta-blocker therapy after M-TEER can lead to improved outcomes, particularly for patients with a low left ventricular ejection fraction (LVEF) of 40% or less.
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Article Synopsis
  • - The study investigates how mismatched residual mitral regurgitation (MR) and left atrial pressure (LAP) after a specific heart procedure (TEER) can negatively impact clinical outcomes in patients with severe MR and heart failure.
  • - Researchers categorized 1,477 patients into three groups based on their MR and LAP levels, finding that those with mismatched or poor conditions faced higher risks of death and heart failure hospitalization compared to those in an optimal state.
  • - Six key factors were identified as predictors of hemodynamic mismatch after TEER, including body mass index and pre-procedural pressures, suggesting that monitoring these could help improve patient outcomes.
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Article Synopsis
  • The study evaluates the outcomes of mitral transcatheter edge-to-edge repair (M-TEER) in patients with severe mitral regurgitation, focusing on the impact of body mass index (BMI) on mortality rates.
  • Researchers analyzed data from 2,149 M-TEER patients, categorizing them as underweight, normal weight, or overweight/obese, finding that underweight individuals had significantly higher rates of all-cause, cardiovascular, and non-cardiovascular mortality.
  • The findings suggest that underweight status is a critical risk factor for worse outcomes post-M-TEER, highlighting the importance of thorough risk assessment and management in these patients.
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