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Serum High-Density Lipoprotein Cholesterol Levels and the Risk of Kidney Function Decline: The Japan Specific Health Checkups (J‑SHC) Study. 血清高密度脂蛋白胆固醇水平与肾功能衰退的风险:日本特定健康检查(J-SHC)研究》。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-21 DOI: 10.5551/jat.65107
Takaaki Kosugi, Masahiro Eriguchi, Hisako Yoshida, Hiroyuki Tamaki, Takayuki Uemura, Hikari Tasaki, Riri Furuyama, Fumihiro Fukata, Masatoshi Nishimoto, Masaru Matsui, Ken-Ichi Samejima, Kunitoshi Iseki, Shouichi Fujimoto, Tsuneo Konta, Toshiki Moriyama, Kunihiro Yamagata, Ichiei Narita, Masato Kasahara, Yugo Shibagaki, Masahide Kondo, Koichi Asahi, Tsuyoshi Watanabe, Kazuhiko Tsuruya

Aims: Both low and high serum levels of high-density lipoprotein cholesterol (HDL-C) were reported to be associated with adverse kidney outcomes. However, this association has not been well investigated in the general Japanese population.

Methods: This nationwide longitudinal study used data from the Japan Specific Health Checkups Study conducted between 2008-2014. The association between serum HDL-C levels and 40% decline in estimated glomerular filtration rate (eGFR) was analyzed using Cox regression analysis. Trajectories of eGFR were compared using mixed-effects model.

Results: Among 768,495 participants, 6,249 developed 40% decline in eGFR during the median follow-up period of 34.6 (interquartile range: 14.8-48.4) months. Using serum HDL-C levels of 40-59 mg/dL as a reference, the adjusted hazard ratios (95% confidence intervals) for the kidney outcome of serum HDL-C levels of <40, 60-79 and ≥ 80 mg/dL were 1.26 (1.14-1.39), 0.91 (0.86-0.96), and 0.86 (0.78-0.93), respectively. Restricted cubic spline analysis showed that HDL-C levels of less than approximately 60 mg/dL were associated with an increased risk of kidney outcomes. Subgroup analysis showed that baseline eGFR and proteinuria modified the effects of serum HDL-C levels on kidney outcomes. The mixed-effects model showed that the lower category of HDL-C level was associated with a higher eGFR decline rate (p for interaction <0.001).

Conclusions: Low HDL-C levels were associated with kidney function decline; however, high HDL-C levels were not associated with adverse kidney outcomes in the general Japanese population.

目的:据报道,血清中高密度脂蛋白胆固醇(HDL-C)水平过低或过高都与肾脏的不良预后有关。方法:这项全国性纵向研究使用了日本特定人群的数据:这项全国性纵向研究使用了 2008-2014 年间进行的日本特定健康检查研究的数据。采用 Cox 回归分析法分析了血清 HDL-C 水平与估计肾小球滤过率(eGFR)下降 40% 之间的关系。采用混合效应模型比较了 eGFR 的变化轨迹:结果:在 768 495 名参与者中,有 6 249 人在 34.6 个月(四分位间范围:14.8-48.4 个月)的中位随访期间 eGFR 下降了 40%。以血清 HDL-C 水平 40-59 mg/dL 为参考,血清 HDL-C 水平<40、60-79 和≥80 mg/dL 肾脏结局的调整危险比(95% 置信区间)分别为 1.26(1.14-1.39)、0.91(0.86-0.96)和 0.86(0.78-0.93)。限制性立方样条分析表明,HDL-C 水平低于约 60 mg/dL 与肾脏疾病风险增加有关。亚组分析显示,基线 eGFR 和蛋白尿改变了血清 HDL-C 水平对肾脏预后的影响。混合效应模型显示,较低类别的 HDL-C 水平与较高的 eGFR 下降率相关(交互作用 p <0.001):结论:在日本普通人群中,低 HDL-C 水平与肾功能下降有关;但高 HDL-C 水平与不良肾脏结果无关。
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引用次数: 0
Assessment of Low-density Lipoprotein Cholesterol Levels and Non-invasive Vascular Health in School-aged Children: A Study in Ogasa District, Shizuoka Prefecture. 学龄儿童低密度脂蛋白胆固醇水平和无创血管健康评估:静冈县小笠地区研究》。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-19 DOI: 10.5551/jat.64795
Nanaho Hasegawa, Satoru Iwashima, Yuri Furusawa, Akinari Hayakawa, Junichiro Katuki, Satoshi Hayano, Keigo Seki, Soichiro Yata, Kenichi Kinjo, Shinichiro Sano

Aim: The present study assessed low-density lipoprotein cholesterol (LDL-C) levels in school-aged children from the Ogasa District of Shizuoka Prefecture and evaluated the utility of non-invasive vascular tests, namely flow-mediated dilation (FMD) and intima-media thickness (IMT), in pediatric patients with familial hypercholesterolemia (FH).

Method: We analyzed the lipid test results of 8,568 students screened for prevention of lifestyle-related diseases and 78 children under 15 years old with cholesterol levels exceeding 220 mg/dL who visited Chutoen General Medical Center. We examined the LDL-C distribution from school-age screenings and conducted FMD and IMT assessments on those meeting the 2022 Pediatric FH Guidelines criteria.

Results: Among the screened students, 186 (2.2%) exhibited LDL-C levels above 140 mg/dL, including 123 fourth-graders (2.8%) and 63 first-year junior high students (1.5%). The mean LDL-C level across all students was 90.0 mg/dL (standard deviation: 21.3 mg/dL), with the 95th percentile at approximately 125.0 mg/dL. Of the 78 children who visited the hospital, 65 met the FH diagnostic criteria. In children ≥ 10 years old, no significant IMT differences were observed between the Definitive and Probable FH groups and the Possible FH group; however, a significant difference in the FMD percentage was noted between these groups (9.9% [8.1%-11.9%] vs. 14.2% [11.6%-16.3%], P=0.003).

Conclusions: Our findings highlight the LDL-C distribution in FH screening and suggest a potential reduction in FMD in pediatric FH patients ≥ 10 years old. These results emphasize the importance of initiating pharmacological interventions in school-aged children to maintain optimal LDL-C levels for lifelong cardiovascular health.

目的:本研究评估了静冈县小笠地区学龄儿童的低密度脂蛋白胆固醇(LDL-C)水平,并评估了非侵入性血管检测(即血流介导扩张(FMD)和血管内中膜厚度(IMT))在家族性高胆固醇血症(FH)儿科患者中的实用性:我们分析了为预防生活方式相关疾病而接受筛查的 8568 名学生的血脂检测结果,以及在 Chutoen 综合医疗中心就诊的 78 名胆固醇水平超过 220 mg/dL 的 15 岁以下儿童的血脂检测结果。我们检查了学龄筛查中低密度脂蛋白胆固醇的分布情况,并对符合《2022 年儿科 FH 指南》标准的学生进行了 FMD 和 IMT 评估:在接受筛查的学生中,有 186 人(2.2%)的低密度脂蛋白胆固醇水平超过 140 mg/dL,其中包括 123 名四年级学生(2.8%)和 63 名初中一年级学生(1.5%)。所有学生的平均低密度脂蛋白胆固醇水平为 90.0 毫克/分升(标准差:21.3 毫克/分升),第 95 百分位数约为 125.0 毫克/分升。在到医院就诊的 78 名儿童中,有 65 名符合 FH 诊断标准。在年龄≥10 岁的儿童中,确定和可能的 FH 组与可能的 FH 组之间未观察到明显的 IMT 差异;但是,这些组之间的 FMD 百分比存在显著差异(9.9% [8.1%-11.9%] vs. 14.2% [11.6%-16.3%],P=0.003):我们的研究结果突显了 FH 筛查中低密度脂蛋白胆固醇的分布情况,并表明≥ 10 岁的儿童 FH 患者的 FMD 可能会降低。这些结果强调了在学龄儿童中启动药物干预以维持最佳低密度脂蛋白胆固醇水平对终生心血管健康的重要性。
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引用次数: 0
Development and Validation of a Cardiovascular Disease Risk Prediction Model for the Japanese Working Population: The Japan Epidemiology Collaboration on Occupational Health Study. 日本职业人群心血管疾病风险预测模型的开发与验证:日本职业健康流行病学合作研究》。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-19 DOI: 10.5551/jat.64919
Huan Hu, Tohru Nakagawa, Toru Honda, Shuichiro Yamamoto, Takeshi Kochi, Hiroko Okazaki, Toshiaki Miyamoto, Takayuki Ogasawara, Naoki Gommori, Makoto Yamamoto, Maki Konishi, Yosuke Inoue, Isamu Kabe, Seitaro Dohi, Tetsuya Mizoue

Aims: This study aimed to develop a cardiovascular disease (CVD) risk model using data from a large occupational cohort.

Methods: A risk prediction model was developed using the routine health checkup data of 96,117 Japanese employees (84.0% men) who were 30-64 years of age and had no CVD at baseline. Cox proportional hazards regression models were employed to develop a risk model for assessing the 10-year CVD risk. Measures of discrimination and calibration were used to assess the predictive performance of the model and internal validation was used to examine potential overfitting.

Results: During a mean follow-up period of 6.7 years (range, 0.1-11.0 years), 422 cases of incident CVD were confirmed. The final model, which included predictor variables of age, smoking, diabetes, systolic blood pressure, and low- and high-density lipoprotein cholesterol levels, demonstrated a good predictive ability (Harrell's C-statistic, 0.796; 95% confidence interval, 0.775-0.817) with excellent calibration between observed and predicted values. Internal validation revealed minimal overfitting.

Conclusions: The developed model can accurately predict the 10-year CVD risk. Because it is based on routine health checkup data, the prediction model can be easily implemented in the workplace. Further studies are required to assess the external validity and transferability of the proposed CVD risk model.

目的:本研究旨在利用一个大型职业队列的数据建立心血管疾病(CVD)风险模型:方法:利用 96,117 名日本员工(84.0% 为男性)的常规健康检查数据建立了一个风险预测模型,这些员工的年龄在 30-64 岁之间,基线时没有心血管疾病。采用 Cox 比例危险回归模型建立了评估 10 年心血管疾病风险的风险模型。使用辨别度和校准度来评估模型的预测性能,并使用内部验证来检查潜在的过度拟合:结果:在平均 6.7 年(0.1-11.0 年)的随访期间,共确诊 422 例心血管疾病。最终模型包括年龄、吸烟、糖尿病、收缩压、低密度和高密度脂蛋白胆固醇水平等预测变量,显示出良好的预测能力(哈雷尔 C 统计量,0.796;95% 置信区间,0.775-0.817),观察值和预测值之间的校准效果极佳。内部验证显示过拟合程度极低:结论:所开发的模型可准确预测 10 年心血管疾病风险。结论:所开发的模型可准确预测 10 年心血管疾病风险,由于该模型基于常规健康检查数据,因此可在工作场所轻松实施。还需要进一步的研究来评估所提出的心血管疾病风险模型的外部有效性和可转移性。
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引用次数: 0
Adequate Vegetable Intake Improves Metabolic Indices in Healthy Japanese Participants: A Randomized Crossover Study. 充足的蔬菜摄入可改善健康日本人的代谢指标:一项随机交叉研究。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-10 DOI: 10.5551/jat.64509
Yuka Kawakami-Shinoda, Megumi Sato, Alima Bao, Xiangna Zheng, Mana Kamiya, Ge Li, Toshio Hosaka, Toshinao Goda, Hidekazu Arai

Aim: We aimed to elucidate the effect of a healthy diet containing adequate amounts of protein and vegetables on metabolic indices.

Methods: In this randomized crossover study, twenty-two healthy Japanese participants ingested two different test meals: fish diet (F) or fish diet with adequate vegetable content (FV). Each 5-day diet load test was separated by a washout period of at least seven days. Metabolic indices were measured in fasting blood and 24-h urine samples.

Results: The delta (Δ) plasma glucose and Δserum low-density lipoprotein (LDL) cholesterol concentrations were significantly larger in the participants in group FV than in group F (p=0.042, p=0.013, respectively). The urinary pH in participants in group F on day 6 was significantly lower than on day 1 (p=0.008), and the Δurinary pH and Δnet gastrointestinal absorption of alkali of participants in group FV tended to be smaller than in group F (p=0.070, p=0.075, respectively).

Conclusions: This study showed that a healthy diet containing adequate protein and vegetables reduced the dietary acid load and improved plasma glucose and serum LDL concentrations in healthy Japanese participants.

目的:我们旨在阐明含有足量蛋白质和蔬菜的健康饮食对代谢指数的影响:在这项随机交叉研究中,22 名健康的日本参与者摄入了两种不同的测试膳食:鱼类膳食(F)或含有足量蔬菜的鱼类膳食(FV)。每次为期 5 天的饮食负荷试验之间都有至少 7 天的缓冲期。通过空腹血液和 24 小时尿液样本测量代谢指数:结果:FV 组参与者的血浆葡萄糖δ和血清低密度脂蛋白胆固醇δ浓度明显高于 F 组(分别为 p=0.042 和 p=0.013)。F组参与者第6天的尿液pH值明显低于第1天(p=0.008),FV组参与者的Δ尿液pH值和Δ净胃肠道碱吸收量往往小于F组(分别为p=0.070和p=0.075):本研究表明,含有充足蛋白质和蔬菜的健康饮食可降低膳食酸负荷,改善日本健康参与者的血糖和血清低密度脂蛋白浓度。
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引用次数: 0
Impact of Changes in Lifestyle and Psychological Factors on the Incidence of Metabolic Syndrome after the Great East Japan Earthquake: Follow-up of the Fukushima Health Management Survey. 东日本大地震后生活方式和心理因素的变化对代谢综合征发病率的影响:福岛健康管理调查的后续研究。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-10 DOI: 10.5551/jat.64923
Atsushi Takahashi, Fumikazu Hayashi, Tetsuya Ohira, Michio Shimabukuro, Akira Sakai, Masaharu Maeda, Mitsuaki Hosoya, Junichiro J Kazama, Koichi Hashimoto, Shiho Sato, Hironori Nakano, Masanori Nagao, Kanako Okazaki, Hitoshi Ohto, Seiji Yasumura, Hiromasa Ohira

Aim: The Fukushima Daiichi Nuclear Power Plant accident caused lifestyle changes and psychological distress in residents living near the plant. This study clarified the associations between changes in residents' lifestyles and psychological factors with the onset of metabolic syndrome (METs) after the accident.

Methods: This longitudinal study included 10,373 residents who underwent the Comprehensive Health Check and Mental Health and Lifestyle Survey in Fiscal Year (FY) 2013. Follow-up surveys were conducted between FY 2014 and FY 2017. Lifestyle changes and the METs incidence were evaluated using a logistic regression model.

Results: METs developed in 14.0% of subjects. In addition to metabolic factors, such as the body mass index, hypertension, dyslipidemia, and diabetes mellitus, there were differences in physical activity, fast walking, eating fast, eating habits before bedtime, skipping breakfast, current smoking, and alcohol intake between subjects with and without new-onset METs. Eating fast, current smoking, and drinking alcohol were positively associated with new-onset METs, whereas starting physical activity and fast walking were inversely associated with new-onset METs.

Conclusions: Disaster-related lifestyle changes, such as eating fast, starting to smoke, and continued alcohol intake, were risk factors for new-onset METs after the Fukushima Daiichi Nuclear Power Plant accident.

目的:福岛第一核电站事故导致核电站附近居民的生活方式发生变化,并引发心理困扰。本研究阐明了事故后居民生活方式和心理因素的变化与代谢综合征(METs)发病之间的关系:这项纵向研究包括 10,373 名在 2013 财政年度(FY)接受了全面健康检查和心理健康与生活方式调查的居民。在 2014 财年至 2017 财年期间进行了跟踪调查。采用逻辑回归模型对生活方式改变和 METs 发生率进行了评估:结果:14.0%的受试者出现了 METs。除了体重指数、高血压、血脂异常和糖尿病等代谢因素外,有和没有新发 METs 的受试者在体力活动、快走、快餐、睡前饮食习惯、不吃早餐、当前吸烟和酒精摄入量方面也存在差异。快餐、当前吸烟和饮酒与新发 METs 呈正相关,而开始体力活动和快走与新发 METs 呈反相关:结论:与灾难相关的生活方式改变,如快速进食、开始吸烟和持续饮酒,是福岛第一核电站事故后新发 METs 的风险因素。
{"title":"Impact of Changes in Lifestyle and Psychological Factors on the Incidence of Metabolic Syndrome after the Great East Japan Earthquake: Follow-up of the Fukushima Health Management Survey.","authors":"Atsushi Takahashi, Fumikazu Hayashi, Tetsuya Ohira, Michio Shimabukuro, Akira Sakai, Masaharu Maeda, Mitsuaki Hosoya, Junichiro J Kazama, Koichi Hashimoto, Shiho Sato, Hironori Nakano, Masanori Nagao, Kanako Okazaki, Hitoshi Ohto, Seiji Yasumura, Hiromasa Ohira","doi":"10.5551/jat.64923","DOIUrl":"https://doi.org/10.5551/jat.64923","url":null,"abstract":"<p><strong>Aim: </strong>The Fukushima Daiichi Nuclear Power Plant accident caused lifestyle changes and psychological distress in residents living near the plant. This study clarified the associations between changes in residents' lifestyles and psychological factors with the onset of metabolic syndrome (METs) after the accident.</p><p><strong>Methods: </strong>This longitudinal study included 10,373 residents who underwent the Comprehensive Health Check and Mental Health and Lifestyle Survey in Fiscal Year (FY) 2013. Follow-up surveys were conducted between FY 2014 and FY 2017. Lifestyle changes and the METs incidence were evaluated using a logistic regression model.</p><p><strong>Results: </strong>METs developed in 14.0% of subjects. In addition to metabolic factors, such as the body mass index, hypertension, dyslipidemia, and diabetes mellitus, there were differences in physical activity, fast walking, eating fast, eating habits before bedtime, skipping breakfast, current smoking, and alcohol intake between subjects with and without new-onset METs. Eating fast, current smoking, and drinking alcohol were positively associated with new-onset METs, whereas starting physical activity and fast walking were inversely associated with new-onset METs.</p><p><strong>Conclusions: </strong>Disaster-related lifestyle changes, such as eating fast, starting to smoke, and continued alcohol intake, were risk factors for new-onset METs after the Fukushima Daiichi Nuclear Power Plant accident.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
NIRS-IVUS Assessment of OCT-Derived Healed Coronary Plaques. 对 OCT 导出的愈合冠状动脉斑块进行 NIRS-IVUS 评估。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-07 DOI: 10.5551/jat.64781
Kosei Terada, Takashi Kubo, Amir Kh M Khalifa, Wei-Ting Wang, Suwako Fujita, Ryan D Madder

Aims: Healed plaque (HP) is associated with rapid plaque growth and luminal narrowing. Thin-cap fibroatheroma (TCFA) is recognized as a precursor lesion to plaque rupture. The aim of the present study was to compare the lipid size among optical coherence tomography (OCT)-derived HP, TCFA, and thick-cap fibroatheroma (ThCFA) using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS).

Methods: The present study included 173 patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention. Non-culprit lesions with angiographically intermediate stenosis were assessed by both OCT and NIRS-IVUS.

Results: The frequency of TCFA, HP, and ThCFA was 35 (20%), 53 (30%), and 85 (49%), respectively. Minimum lumen area was not significantly different between TCFA and HP, but was smaller in TCFA and HP than in ThCFA (4.6 [interquartile range {IQR}: 3.5-6.4] mm2 vs. 4.3 [3.4-5.3] mm2 vs. 6.5 [4.8-8.6] mm2, P<0.001). Plaque burden was not significantly different between TCFA and HP, but was larger in TCFA and HP than in ThCFA (72 [IQR: 66-80] % vs. 75 [67-80] % vs. 62 [54-69] %, P<0.001). Maximum lipid core burden index in 4mm (maxLCBI4mm) was largest in TCFA, followed by HP and ThCFA (493 [IQR: 443-606] vs. 446 [347-520] vs. 231 [161-302], P<0.001). The frequency of lipid rich plaque with maxLCBI4mm >400 was highest in TCFA, followed by HP and ThCFA (89% vs. 60% vs. 7%, P<0.001).

Conclusions: Based on NIRS-IVUS findings, non-culprit coronary HP in AMI was associated with vulnerable plaque characteristics, but not as much as TCFA.

目的:愈合斑块(HP)与斑块快速生长和管腔狭窄有关。薄帽纤维血管瘤(TCFA)被认为是斑块破裂的前兆病变。本研究旨在使用近红外光谱血管内超声(NIRS-IVUS)比较光学相干断层扫描(OCT)得出的 HP、TCFA 和厚盖纤维斑块(ThCFA)的脂质大小:本研究纳入了173名接受经皮冠状动脉介入治疗的急性心肌梗死(AMI)患者。通过 OCT 和 NIRS-IVUS 对血管造影中度狭窄的非冠状动脉病变进行评估:结果:TCFA、HP 和 ThCFA 的发生率分别为 35(20%)、53(30%)和 85(49%)。TCFA和HP的最小管腔面积无明显差异,但TCFA和HP的最小管腔面积小于ThCFA(4.6 [四分位间范围{IQR}:3.5-6.4] mm2 vs. 4.3 [3.4-5.3] mm2 vs. 6.5 [4.8-8.6] mm2,P<0.001)。TCFA和HP的斑块负荷无明显差异,但TCFA和HP的斑块负荷大于ThCFA(72 [IQR: 66-80] % vs. 75 [67-80] % vs. 62 [54-69] %,P<0.001)。TCFA 的 4mm 最大脂质核心负荷指数(maxLCBI4mm)最大,其次是 HP 和 ThCFA(493 [IQR: 443-606] vs. 446 [347-520] vs. 231 [161-302],P<0.001)。在TCFA中,maxLCBI4mm>400的富脂斑块频率最高,其次是HP和ThCFA(89% vs. 60% vs. 7%,P<0.001):结论:根据 NIRS-IVUS 的研究结果,AMI 非冠状动脉 HP 与易损斑块特征相关,但不如 TCFA 相关。
{"title":"NIRS-IVUS Assessment of OCT-Derived Healed Coronary Plaques.","authors":"Kosei Terada, Takashi Kubo, Amir Kh M Khalifa, Wei-Ting Wang, Suwako Fujita, Ryan D Madder","doi":"10.5551/jat.64781","DOIUrl":"https://doi.org/10.5551/jat.64781","url":null,"abstract":"<p><strong>Aims: </strong>Healed plaque (HP) is associated with rapid plaque growth and luminal narrowing. Thin-cap fibroatheroma (TCFA) is recognized as a precursor lesion to plaque rupture. The aim of the present study was to compare the lipid size among optical coherence tomography (OCT)-derived HP, TCFA, and thick-cap fibroatheroma (ThCFA) using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS).</p><p><strong>Methods: </strong>The present study included 173 patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention. Non-culprit lesions with angiographically intermediate stenosis were assessed by both OCT and NIRS-IVUS.</p><p><strong>Results: </strong>The frequency of TCFA, HP, and ThCFA was 35 (20%), 53 (30%), and 85 (49%), respectively. Minimum lumen area was not significantly different between TCFA and HP, but was smaller in TCFA and HP than in ThCFA (4.6 [interquartile range {IQR}: 3.5-6.4] mm<sup>2</sup> vs. 4.3 [3.4-5.3] mm<sup>2</sup> vs. 6.5 [4.8-8.6] mm<sup>2</sup>, P<0.001). Plaque burden was not significantly different between TCFA and HP, but was larger in TCFA and HP than in ThCFA (72 [IQR: 66-80] % vs. 75 [67-80] % vs. 62 [54-69] %, P<0.001). Maximum lipid core burden index in 4mm (maxLCBI<sub>4mm</sub>) was largest in TCFA, followed by HP and ThCFA (493 [IQR: 443-606] vs. 446 [347-520] vs. 231 [161-302], P<0.001). The frequency of lipid rich plaque with maxLCBI<sub>4mm</sub> >400 was highest in TCFA, followed by HP and ThCFA (89% vs. 60% vs. 7%, P<0.001).</p><p><strong>Conclusions: </strong>Based on NIRS-IVUS findings, non-culprit coronary HP in AMI was associated with vulnerable plaque characteristics, but not as much as TCFA.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmacokinetics and Safety of Pemafibrate in Patients with both Dyslipidemia and Severe Renal Impairment: A Phase 4 Study. 同时患有血脂异常和严重肾功能损害的患者服用培马贝特的药代动力学和安全性:4 期研究。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-05 DOI: 10.5551/jat.64887
Shun Ishibashi, Hidenori Arai, Koutaro Yokote, Eiichi Araki, Mao Watanabe, Michiko Nakanishi, Yuichi Makinose, Hideki Suganami, Yuji Kurihara, Shizuya Yamashita

Aims: Per the package insert, pemafibrate was contraindicated for use in patients with severe renal impairment despite its biliary excretion. To validate this, we evaluated the pharmacokinetics and safety of pemafibrate for 12 weeks in patients with hypertriglyceridemia and renal impairment.

Methods: In this phase 4, multicenter, placebo-controlled, double-blind, parallel-group, comparative study, 21 patients were randomly assigned to pemafibrate 0.2 mg/day or placebo within Groups A (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73m2 without hemodialysis; pemafibrate n=4; placebo, n=2), B (hemodialysis; pemafibrate, n=4; placebo, n=1), and C (eGFR ≥ 30 and <60 mL/min/1.73m2 without hemodialysis; pemafibrate, n=8; placebo, n=2) for 12 weeks. Area under the concentration vs time curve within the dosing interval (τ) (AUCτ) of pemafibrate was measured after 12-week administration.

Results: The AUCτ (geometric mean) of pemafibrate was 7.333 and 7.991 ng·h/mL in Groups A+B and C, respectively; in Groups A+B to C at 12 weeks, the geometric mean ratio of pemafibrate AUCτ was 0.92 (90% confidence interval [CI]: 0.62, 1.36). The upper limit of the 90% CI was ≤ 2.0 (predetermined criterion). There was no consistent trend in the AUCτ and maximum plasma concentration of pemafibrate with/without statin use. Renal impairment degree did not affect the incidence of adverse events. No safety concerns were observed.

Conclusion: Pemafibrate repeated administration in patients with severe renal impairment did not increase pemafibrate exposure.

目的:根据包装说明书,尽管培马贝特可通过胆汁排泄,但严重肾功能损害患者禁用培马贝特。为了验证这一点,我们对高甘油三酯血症和肾功能损害患者服用培马贝特 12 周的药代动力学和安全性进行了评估:在这项 4 期、多中心、安慰剂对照、双盲、平行组比较研究中,21 名患者被随机分配到 A 组(估计肾小球滤过率 [eGFR] <30 mL/min/1.B 组(血液透析;培马贝特,n=4;安慰剂,n=1)和 C 组(eGFR ≥ 30 和 < 60 毫升/分钟/1.73 平方米,无血液透析;培马贝特,n=8;安慰剂,n=2),为期 12 周。服用 12 周后,测量了培马贝特在给药间隔 (τ) 内的浓度与时间曲线下的面积(AUCτ):A+B组和C组的培马贝特AUCτ(几何平均)分别为7.333和7.991纳克-小时/毫升;12周时,A+B组与C组的培马贝特AUCτ几何平均比为0.92(90%置信区间[CI]:0.62,1.36)。90%置信区间的上限≤2.0(预定标准)。使用/不使用他汀类药物时,培马贝特的AUCτ和最大血浆浓度没有一致的趋势。肾功能损害程度不影响不良事件的发生率。结论严重肾功能损害患者重复服用培马贝特不会增加培马贝特的暴露量。
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引用次数: 0
Cerebral Small Vessel Disease is Associated with Prehospital Delay in Acute Ischemic Stroke. 脑小血管疾病与急性缺血性卒中的院前延误有关。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-05 DOI: 10.5551/jat.64968
Marina Masui, Takeo Sato, Motohiro Okumura, Takahiro Ishikawa, Kenichi Sakuta, Tatsushi Kokubu, Junichiro Takahashi, Tomomichi Kitagawa, Maki Tanabe, Asako Onda, Teppei Komatsu, Kenichiro Sakai, Tadashi Umehara, Hidetaka Mitsumura, Yasuyuki Iguchi

Aim: To determine whether the severity of cerebral small vessel disease (SVD) is associated with prehospital delay in acute ischemic stroke.

Methods: Consecutive patients with ischemic stroke were included in this study. We evaluated the SVD burden using the total SVD score. Patients were divided into 2 groups: onset-to-door time within 4.5 hours (early arrival group) and onset-to-door time over 4.5 hours (delayed arrival group). First, we assessed whether the total SVD score was related to prehospital delay using a logistic regression analysis. Second, we assessed which item of the score was independently associated with delays. Finally, we determined whether the item had a linear association with the delay.

Results: Of the 2,112 screened patients, 1,754 were enrolled in the study (1,253 males [71%]; median age, 69 years). There were 1,105 patients (63%) in the delayed arrival group. The total SVD score was independently associated with delay (OR 1.11, 95% CI 1.01-1.21, p=0.025). Among the 4 items of the score, only enlarged perivascular spaces (EPVS) in the basal ganglia was independently associated with delay (OR 1.37, 95% CI 1.05-1.80, p=0.022). A linear trend was observed between EPVS grade and delay with reference to EPVS grade 0-1 (EPVS grade 2: OR 1.22, 95% CI 0.92-1.62, p=0.170, EPVS grade 3: OR 1.69, 95% CI 1.20-2.38, p=0.002, EPVS grade 4: OR 2.17, 95% CI 1.37-3.44, p=0.001).

Conclusions: Prehospital delay in acute ischemic stroke could be associated with the severity of SVD, particularly EPVS in the basal ganglia.

目的:确定脑小血管疾病(SVD)的严重程度是否与急性缺血性卒中的院前延误有关:本研究纳入了连续的缺血性脑卒中患者。我们使用 SVD 总分评估 SVD 负担。患者分为两组:从发病到到达医院的时间在 4.5 小时之内(早期到达组)和从发病到到达医院的时间超过 4.5 小时(延迟到达组)。首先,我们使用逻辑回归分析评估了 SVD 总分是否与院前延误有关。其次,我们评估了得分中与延误独立相关的项目。最后,我们确定该项目是否与延误呈线性关系:在 2,112 名接受筛查的患者中,1,754 人被纳入研究(1,253 名男性[71%];中位年龄 69 岁)。延迟到达组有 1,105 名患者(63%)。SVD 总分与延误有独立关联(OR 1.11,95% CI 1.01-1.21,P=0.025)。在该评分的 4 个项目中,只有基底节血管周围间隙增大(EPVS)与延迟独立相关(OR 1.37,95% CI 1.05-1.80,p=0.022)。EPVS等级与延迟之间呈线性趋势,参考EPVS等级0-1(EPVS等级2:OR 1.22,95% CI 0.92-1.62,p=0.170;EPVS等级3:OR 1.69,95% CI 1.20-2.38,p=0.002;EPVS等级4:OR 2.17,95% CI 1.37-3.44,p=0.001):急性缺血性卒中的院前延迟可能与 SVD 的严重程度有关,尤其是基底节的 EPVS。
{"title":"Cerebral Small Vessel Disease is Associated with Prehospital Delay in Acute Ischemic Stroke.","authors":"Marina Masui, Takeo Sato, Motohiro Okumura, Takahiro Ishikawa, Kenichi Sakuta, Tatsushi Kokubu, Junichiro Takahashi, Tomomichi Kitagawa, Maki Tanabe, Asako Onda, Teppei Komatsu, Kenichiro Sakai, Tadashi Umehara, Hidetaka Mitsumura, Yasuyuki Iguchi","doi":"10.5551/jat.64968","DOIUrl":"https://doi.org/10.5551/jat.64968","url":null,"abstract":"<p><strong>Aim: </strong>To determine whether the severity of cerebral small vessel disease (SVD) is associated with prehospital delay in acute ischemic stroke.</p><p><strong>Methods: </strong>Consecutive patients with ischemic stroke were included in this study. We evaluated the SVD burden using the total SVD score. Patients were divided into 2 groups: onset-to-door time within 4.5 hours (early arrival group) and onset-to-door time over 4.5 hours (delayed arrival group). First, we assessed whether the total SVD score was related to prehospital delay using a logistic regression analysis. Second, we assessed which item of the score was independently associated with delays. Finally, we determined whether the item had a linear association with the delay.</p><p><strong>Results: </strong>Of the 2,112 screened patients, 1,754 were enrolled in the study (1,253 males [71%]; median age, 69 years). There were 1,105 patients (63%) in the delayed arrival group. The total SVD score was independently associated with delay (OR 1.11, 95% CI 1.01-1.21, p=0.025). Among the 4 items of the score, only enlarged perivascular spaces (EPVS) in the basal ganglia was independently associated with delay (OR 1.37, 95% CI 1.05-1.80, p=0.022). A linear trend was observed between EPVS grade and delay with reference to EPVS grade 0-1 (EPVS grade 2: OR 1.22, 95% CI 0.92-1.62, p=0.170, EPVS grade 3: OR 1.69, 95% CI 1.20-2.38, p=0.002, EPVS grade 4: OR 2.17, 95% CI 1.37-3.44, p=0.001).</p><p><strong>Conclusions: </strong>Prehospital delay in acute ischemic stroke could be associated with the severity of SVD, particularly EPVS in the basal ganglia.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Non-HDL-C, Symptomatic Intracranial Arterial Stenosis, and Recurrent Vascular Risk in Minor Stroke. 非高密度脂蛋白胆固醇、症状性颅内动脉狭窄与轻微中风的复发性血管风险。
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-04 DOI: 10.5551/jat.64987
Haimei Fan, Tingting Liu, Kaili Zhang, Yongle Wang, Rong Wang, Fei Yang, Feifei Chen, Yanli Zhang, Huaai Guo, Xinyi Li, Xuemei Wu, Xiaoyuan Niu

Aim: We aimed to assess the association between non-high-density lipoprotein cholesterol (non-HDL-C) and symptomatic intracranial artery stenosis (sICAS), as well as the impact of non-HDL-C on recurrent vascular events in patients with mild ischemic stroke ( NIHSS score ≤ 5).

Methods: This prospective study was based on data from patients presenting within 72 hours of stroke occurrence. We included patients admitted to 8 Chinese hospitals between September 2019 and November 2021. The associations of non-HDL-C with sICAS and recurrent vascular risk were assessed using multivariate regression models and a restricted cubic spline analysis.

Results: Among the 2,544 patients analyzed at 12 months, 652 (25.6%) were diagnosed with sICAS. Elevated non-HDL-C was linked to a higher incidence of sICAS, and the adjusted odd ratios for quintile variables and continuous variables were 1.36 ([95% CI, 1.01-1.81]) and 1.14 ([95% CI, 1.04-1.24). In comparison to those in the first quintile, the adjusted hazard ratio of the fifth quintile of non-HDL-C was 1.19 ([95% CI 0.78-1.80]) for recurrent ischemic stroke and was 0.39 ([95% CI, 0.17-0.91]) for intracranialhemorrhage.

Conclusions: The non-HDL-C level may be a useful predictor of sICAS. Higher non-HDL-C levels may be associated with a lower risk of intracranial hemorrhage in mild, noncardiogenic stroke, but not a higher risk of recurrent ischemic stroke.

目的:我们旨在评估非高密度脂蛋白胆固醇(non-HDL-C)与无症状性颅内动脉狭窄(sICAS)之间的关系,以及非高密度脂蛋白胆固醇对轻度缺血性卒中患者(NIHSS评分≤5分)复发性血管事件的影响:这项前瞻性研究基于脑卒中发生后 72 小时内就诊患者的数据。我们纳入了 2019 年 9 月至 2021 年 11 月期间 8 家中国医院收治的患者。采用多变量回归模型和限制性立方样条分析评估了非高密度脂蛋白胆固醇与sICAS和复发性血管风险的关系:结果:在分析的 2544 名患者中,有 652 人(25.6%)在 12 个月后被确诊为 sICAS。非高密度脂蛋白胆固醇升高与sICAS的高发病率有关,五分位变量和连续变量的调整奇异比分别为1.36([95% CI, 1.01-1.81])和1.14([95% CI, 1.04-1.24))。与第一五分位数的患者相比,非高密度脂蛋白胆固醇第五五分位数的患者复发缺血性卒中的调整后危险比为 1.19([95% CI 0.78-1.80]),颅内出血的调整后危险比为 0.39([95% CI, 0.17-0.91]):结论:非 HDL-C 水平可能是预测 sICAS 的有效指标。结论:非 HDL-C 水平可能是预测 sICAS 的有用指标,非 HDL-C 水平越高,轻度非心源性卒中发生颅内出血的风险越低,但发生复发性缺血性卒中的风险并不高。
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引用次数: 0
FIB-4 Index and Liver Stiffness Measurement are Potential Predictors of Atherosclerosis in Metabolic Dysfunction-Associated Steatotic Liver Disease. FIB-4指数和肝脏硬度测量是代谢功能障碍相关性脂肪肝动脉粥样硬化的潜在预测指标
IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-09-04 DOI: 10.5551/jat.64809
Yoshihito Kubotsu, Yoshiko Sakamoto, Motoko Tago, Atsuko Chihara, Misa Norita, Chika Inadomi, Kaori Inoue, Hiroki Takayanagi, Kenichi Tanaka, Hiroshi Isoda, Takuya Kuwashiro, Satoshi Oeda, Toshiyasu Shiratori, Keizo Anzai, Koichi Node, Hirokazu Takahashi

Aims: Cardiovascular disease (CVD) is a common cause of death in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Therefore, CVD surveillance is important, but it is not well established. We evaluated the association between liver fibrosis, carotid artery atherosclerosis, and coronary artery stenosis in patients with MASLD.

Methods: Overall, 153 patients with MASLD who underwent carotid artery ultrasound were enrolled. Maximum intima-media thickness including plaques (Max-IMT) was measured by ultrasound. To predict liver fibrosis, liver stiffness was measured by vibration-controlled transient elastography and the fibrosis 4 (FIB-4) index was calculated. Coronary computed tomography angiography was performed to detect coronary artery stenosis based on a Max-IMT of ≥ 1.1 mm.

Results: The median Max-IMT was 1.3 mm, and 63 patients (41.2%) had a Max-IMT of ≥ 1.5 mm. FIB-4 index and liver stiffness was significantly correlated with Max-IMT, respectively (ρ=0.356, p<0.001, ρ=0.25, p=0.002). Liver stiffness was significantly associated with a Max-IMT of ≥1.5 mm, independent of age. Individuals with higher FIB-4 index had moderate or severe coronary artery stenosis more frequently. Individuals with higher LSM level also had moderate or severe coronary artery stenosis more frequently, especially severe stenosis.

Conclusions: Liver fibrosis parameters were associated with carotid artery atherosclerosis and coronary artery stenosis. Evaluation of liver fibrosis may be useful to identify significant atherosclerosis and coronary artery stenosis in patients with MASLD.

目的:心血管疾病(CVD)是代谢功能障碍相关性脂肪性肝病(MASLD)患者的常见死因。因此,对心血管疾病的监测非常重要,但目前尚未得到很好的证实。我们评估了MASLD患者肝纤维化、颈动脉粥样硬化和冠状动脉狭窄之间的关联:方法:共招募了153名接受颈动脉超声检查的MASLD患者。超声波测量了包括斑块在内的最大内中膜厚度(Max-IMT)。为预测肝纤维化,通过振动控制瞬时弹性成像测量肝脏硬度,并计算纤维化4(FIB-4)指数。根据 Max-IMT ≥ 1.1 毫米的标准,进行冠状动脉计算机断层扫描以检测冠状动脉狭窄:中位 Max-IMT 为 1.3 毫米,63 名患者(41.2%)的 Max-IMT ≥ 1.5 毫米。FIB-4 指数和肝脏硬度分别与 Max-IMT 显著相关(ρ=0.356,p<0.001;ρ=0.25,p=0.002)。肝硬变与 Max-IMT ≥1.5 mm 显著相关,与年龄无关。FIB-4指数越高的人,冠状动脉中度或重度狭窄的发生率越高。LSM水平越高的人中度或重度冠状动脉狭窄的发生率也越高,尤其是重度狭窄:结论:肝纤维化参数与颈动脉粥样硬化和冠状动脉狭窄有关。评估肝纤维化可能有助于鉴别MASLD患者的明显动脉粥样硬化和冠状动脉狭窄。
{"title":"FIB-4 Index and Liver Stiffness Measurement are Potential Predictors of Atherosclerosis in Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Yoshihito Kubotsu, Yoshiko Sakamoto, Motoko Tago, Atsuko Chihara, Misa Norita, Chika Inadomi, Kaori Inoue, Hiroki Takayanagi, Kenichi Tanaka, Hiroshi Isoda, Takuya Kuwashiro, Satoshi Oeda, Toshiyasu Shiratori, Keizo Anzai, Koichi Node, Hirokazu Takahashi","doi":"10.5551/jat.64809","DOIUrl":"https://doi.org/10.5551/jat.64809","url":null,"abstract":"<p><strong>Aims: </strong>Cardiovascular disease (CVD) is a common cause of death in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Therefore, CVD surveillance is important, but it is not well established. We evaluated the association between liver fibrosis, carotid artery atherosclerosis, and coronary artery stenosis in patients with MASLD.</p><p><strong>Methods: </strong>Overall, 153 patients with MASLD who underwent carotid artery ultrasound were enrolled. Maximum intima-media thickness including plaques (Max-IMT) was measured by ultrasound. To predict liver fibrosis, liver stiffness was measured by vibration-controlled transient elastography and the fibrosis 4 (FIB-4) index was calculated. Coronary computed tomography angiography was performed to detect coronary artery stenosis based on a Max-IMT of ≥ 1.1 mm.</p><p><strong>Results: </strong>The median Max-IMT was 1.3 mm, and 63 patients (41.2%) had a Max-IMT of ≥ 1.5 mm. FIB-4 index and liver stiffness was significantly correlated with Max-IMT, respectively (ρ=0.356, p<0.001, ρ=0.25, p=0.002). Liver stiffness was significantly associated with a Max-IMT of ≥1.5 mm, independent of age. Individuals with higher FIB-4 index had moderate or severe coronary artery stenosis more frequently. Individuals with higher LSM level also had moderate or severe coronary artery stenosis more frequently, especially severe stenosis.</p><p><strong>Conclusions: </strong>Liver fibrosis parameters were associated with carotid artery atherosclerosis and coronary artery stenosis. Evaluation of liver fibrosis may be useful to identify significant atherosclerosis and coronary artery stenosis in patients with MASLD.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of atherosclerosis and thrombosis
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