基本情報
研究キーワード
4研究分野
1委員歴
5-
2012年 - 2014年
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2014年
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2014年
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2014年
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2012年
受賞
7-
2010年3月
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2009年5月
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2006年11月
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2002年7月
論文
965-
Journal of the American Heart Association 14(2) e034627 2025年1月21日BACKGROUND: The effect of worsening renal function and baseline chronic kidney disease (CKD) on outcomes in patients with chronic coronary syndrome in the setting of optimal medical therapy remains unknown. METHODS AND RESULTS: The REAL-CAD (Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy With Pitavastatin in Coronary Artery Disease) study is a prospective, multicenter, randomized trial of high-dose (pitavastatin 4 mg/day) or low-dose (pitavastatin 1 mg/day) statin therapy in 12 118 patients with chronic coronary syndrome. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, stroke, or unstable angina requiring hospitalization (major adverse cardiac and cerebral events [MACCE]). CKD was defined as an estimated glomerular filtration rate [eGFR] <60 mL/min per 1.73 m2. WRF was defined as a decrease in eGFR ≥20% in the initial year; borderline renal function was an annual decrease of 0%<eGFR<20%, and stable renal function was no decrease. Of 12 118 patients, 4340 had baseline CKD and 7778 did not. The rate of MACCE at 5 years was significantly lower in those without (5.5%) versus with CKD (9.5%) (P<0.0001). After excluding 1247 patients who had MACCE, were censored, or missing eGFR within 1 year, 10 871 patients were included. Of these, 3885 were baseline CKD and the remaining 6986 did not have baseline CKD. Of the 10 871 patients, 577 patients had WRF, 6014 patients showed borderline renal function, and the remaining 4280 patients maintained stable renal function. In patients with CKD, WRF was an independent predictor for MACCE at 4 years as compared with stable renal function (hazard ratio [HR]: 1.67; [95% CI, 1.03-2.73; P=0.039]). In patients without CKD, borderline renal function was a significant predictor for MACCE at 4 years compared with stable renal function (HR: 1.40 [95% CI, 1.03-1.91; P=0.032]). CONCLUSIONS: Baseline CKD was an independent predictor for MACCE in patients with CCS. WRF was a significant predictor for MACCE in patients with CKD. Because borderline renal function was an independent predictor for MACCE even in patients without CKD, mild-to-moderate annual declines of eGFR should be carefully monitored (NCT01042730). REGISTRATION: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01042730.
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International Journal of Molecular Sciences 26(2) 556-556 2025年1月10日 査読有り
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IJC Heart & Vasculature 54 101507-101507 2024年10月
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Hypertension research : official journal of the Japanese Society of Hypertension 2024年9月19日The Japanese Society of Hypertension have established a blood pressure (BP) target of 130/80 mmHg for patients with coronary artery disease (CAD). We evaluated the data of 8793 CAD patients in the Clinical Deep Data Accumulation System database who underwent cardiac catheterization at six university hospitals and the National Cerebral and Cardiovascular Center (average age 70 ± 11 years, 78% male, 43% with acute coronary syndrome [ACS]). Patients were divided into two groups based on whether or not they achieved the guideline-recommended BP of <130/80 mmHg. We analyzed the relationship between BP classification and major adverse cardiac and cerebral event (MACCE) separately in two groups: those with ACS and those with chronic coronary syndrome (CCS). During an average follow-up period of 33 months, 710 MACCEs occurred. A BP below 130/80 mmHg was associated with fewer MACCEs in both the overall (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-1.00, p = 0.048) and the ACS group (HR 0.67, 95%CI 0.51-0.88, p = 0.003). In particular, stroke events were also lower among those with a BP below 130/80 mmHg in both the overall (HR 0.69, 95%CI 0.53-0.90, p = 0.006) and ACS groups (HR 0.44, 95%CI 0.30-0.67, p < 0.001). In conclusion, the achievement of BP guidelines was associated with improved outcomes in CAD patients, particularly in reducing stroke risk among those with ACS.
MISC
1913-
Circulation journal : official journal of the Japanese Circulation Society 71 165-166 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 154-154 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 163-163 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 458-458 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 459-459 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 333-333 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 339-339 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 194-194 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 13-13 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 318-318 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 307-307 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 419-419 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 183-183 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 240-240 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 235-235 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 44-44 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 51-52 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 52-52 2007年3月1日
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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 49(9) 210A-210A 2007年3月
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JOURNAL OF HEART AND LUNG TRANSPLANTATION 26(2) S112-S112 2007年2月
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日本組織細胞化学会総会プログラムおよび抄録集 (48) 119-119 2007年
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日本組織細胞化学会総会プログラムおよび抄録集 (48) 99-99 2007年
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JOURNAL OF PHARMACOLOGICAL SCIENCES 103 25P-25P 2007年
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Circulation Journal 71(12) 1835-1840 2007年Background: Actual data regarding coronary artery disease (CAD) patients in Japan is scarce, so in the present study a large database of Japanese patients with significant CAD was constructed for analysis of the relationship between medical treatments and outcomes in this cohort. Methods and Results: The present study enrolled 15,628 patients who underwent coronary angiography and were diagnosed as having significant stenosis in at least 1 coronary artery. Of these, 13,812 patients were followed up and included in the analysis: 10,626 (77%) men and 3,186 (23%) women. Diagnosis at the time of registration was acute myocardial infarction (AMI) for 2,955 patients, old myocardial infarction for 3,913 patients and unstable angina pectoris for 2,049 patients. Patients were followed up for an average of 2.7 years. At the start of the follow-up, 37.4% of the patients were prescribed statins, 50.2% calcium-channel blockers (CCB), 31.6% angiotensin-converting enzyme inhibitors (ACEI), 13.5% angiotensin II receptor blockers (ARB) and 60.2% nitrates. Univariate Cox regression model analysis showed that the hazard ratio (HR) of statins was 0.780 (95% confidence intervals (CI), 0.710-0.856 p< 0.001) fibrates, 0.580 (95%CI, 0.425-0.790 p=0.001) CCB, 1.067 (95%CI, 0.976-1.166 p=0.153) ACEI, 1.062 (95%CI, 0.968-1.166 p=0.202) ARB, 1.036 (95%CI, 0.914-1.174 p=0.581) nitrates, 1.147 (95%CI, 1.043-1.260 p=0.005). When the data were adjusted for background data and all cardiovascular medications, the HR of statins was 0.809 (95%CI, 0.726-0.901 p< 0.001), CCB 1.031 (95%CI, 0.937-1.135 p=0.535), ACEI 1.023 (95%CI, 0.924-1.132 p=0.663), ARB 0.991 (95%CI, 0.867-1.132 p=0.890), nitrates 1.074 (95%CI, 0.973-1.186 p=0.155). For patients presenting with AMI at the time of registration, the HR of CCB was 1.340 (95%CI, 1.084-1.655 p=0.007) and that of nitrates was 0.862 (95%CI, 0.703-1.059 p=0.157). Conclusion: In a cohort of CAD patients in Japan, the prescription pattern differed from that of Western studies. Statins and fibrates were shown to be significantly beneficial in the whole cohort. In the AMI subgroup, CCB showed a deleterious effect and nitrates showed a non-significant tendency for beneficial effect, which should be investigated in future randomized control trials.
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JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY 41(6) 1068-1069 2006年12月
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JOURNAL OF HYPERTENSION 24 95-95 2006年12月
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JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY 41(6) 1045-1046 2006年12月
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JOURNAL OF HYPERTENSION 24 289-289 2006年12月
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JOURNAL OF MOLECULAR AND CELLULAR CARDIOLOGY 41(6) 1063-1063 2006年12月
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JOURNAL OF HYPERTENSION 24 392-392 2006年12月
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JOURNAL OF HYPERTENSION 24 187-187 2006年12月
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Circulation journal : official journal of the Japanese Circulation Society 70 1247-1299 2006年11月20日
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Circulation journal : official journal of the Japanese Circulation Society 70 1190-1190 2006年10月20日
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Circulation journal : official journal of the Japanese Circulation Society 70 2006年10月20日
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Circulation journal : official journal of the Japanese Circulation Society 70 2006年10月20日
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日本血栓止血学会誌 = The Journal of Japanese Society on Thrombosis and Hemostasis 17(5) 550-550 2006年10月1日
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CIRCULATION 114(18) 192-192 2006年10月
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Cardiovascular drugs and therapy 20(5) 377-86 2006年10月 査読有りINTRODUCTION: Recent advances in our understanding of the pathophysiological and molecular mechanisms involved in pulmonary arterial hypertension have led to the development of novel and rational pharmacological therapies. In addition to conventional therapy (i.e., supplemental oxygen and calcium channel blockers), prostacyclin or endothelin receptor antagonists have been recommended as a first-line therapy for pulmonary arterial hypertension. However, these treatments have potential limitations with regard to their long-term efficacy and improvement in survival. Furthermore, intravenous prostacyclin (epoprostenol) therapy, which is recommended by most experts for patients with New York Heart Association (NYHA) functional class IV, is complicated, uncomfortable for patients, and expensive because of the cumbersome administration system. Considering these circumstances, it is necessary to develop additional novel therapeutic approaches that target the various components of this multifactorial disease. CASE REPORT: In this short review, we present an overview of the current treatment options for pulmonary arterial hypertension and describe a case report with primary pulmonary hypertension. A male patient with NYHA functional class IV and showing no response to calcium channel blockers and prostacyclin exhibited significantly improved exercise tolerance and hemodynamics and long-term survival for more than 2.5 years after receiving an oral combination therapy of a phosphodiesterase type 5 inhibitor (sildenafil), phosphodiesterase type 3 inhibitor (pimobendan), and nicorandil. FUTURE PERSPECTIVE: We also discuss the background and plausible potential mechanisms involved in this case, as well as future perspectives in the treatment of pulmonary arterial hypertension.
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CIRCULATION 114(18) 327-327 2006年10月
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Atherosclerosis 188(2) 265-273 2006年10月Statins not only reduce serum cholesterol but they also improve vascular endothelial function independent of their lipid-lowering effects. However, except for the mechanism of nitric oxide induction via calveolin, the physiologic basis for the pleiotropic effect of statins remains unknown. In the present study, we investigated the relationship between the effects of statins on vascular endothelial cell function and heat shock proteins. We found that, in vascular endothelial cells, simvastatin increased the steady-state levels of heat shock proteins 90 and 70, and heme oxygenase-1 and caused the nuclear translocation of heat shock factor 1. A decoy oligonucleotide encoding the heat shock element inhibited statin-induced expression of heat shock protein 70, endothelial nitric oxide synthase, and thrombomodulin. This decoy oligonucleotide also inhibited the ability of statin to reduce endothelin-1 and plasminogen activator inhibitor-1 expression. These results indicate that statins improve vascular endothelial function via heat shock factor 1, which may contribute to their ability to improve cardiovascular disease. © 2005 Elsevier Ireland Ltd. All rights reserved.
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Journal of Cardiology 48(Suppl.I) 469-469 2006年9月
書籍等出版物
21-
Springer 2009年 (ISBN: 9784431877745)
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Signal Transduction and Cardiac Hypertrophy (Naranjan S. Dhalla, Larry Hryshko, Elissavet Kardami, Pawan K. Singal, KLUWER ACADEMIC PUBLISHERS) 2003年
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Signal Transduction and Cardiac Hypertrophy (Naranjan S. Dhalla, Larry Hryshko, Elissavet Kardami, Pawan K. Singal, KLUWER ACADEMIC PUBLISHERS) 2003年
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Rapid Cycle Real-Time PCR : methods and applications 2001年
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in"The Hypertrophied Heart" 2000年
共同研究・競争的資金等の研究課題
91-
日本学術振興会 科学研究費助成事業 2023年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 2020年7月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2019年4月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2019年4月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2018年6月 - 2023年3月