Ô e+¶q¶ [ Bq - 東京都CCUネットワーク¬¬2日目第79 回日本循環器学会学術集会 3 ポスター会場5（グランフロント大阪北館B1 階イベントラボ）

MyAbstracts

会長小川久雄熊本大学大学院生命科学研究部循環器内科学教授

国立循環器病研究センター副院長

第79回日本循環器学会学術集会The 79th Annual Scientific Meeting of the Japanese Circulation Society

2015年4月24日（金）～26日（日）〈中之島会場〉大阪国際会議場

リーガロイヤルホテル大阪堂島リバーフォーラムABCホール

〈グランフロント大阪会場〉ナレッジキャピタルコングレコンベンションセンター

イベントラボカンファレンスルーム

JCS2015

プログラム第79回日本循環器学会学術集会

第２日目

第 79 回日本循環器学会学術集会 2

4月 24日（金）第 2日目

第 15会場（リーガロイヤルホテル大阪ウエストウイング 2階ペリドット）

[OE05] Oral Presentation (English) 5　ACS/AMI (Clinical/Diagnosis) 8:30-10:00

座長：Minoru Yoshiyama（Department of Internal Medicine and Cardiology, Osaka City University School of Medicine,Osaka）座長：Hideaki Yoshino（Department of Internal Medicine II, Kyorin University, Mitaka）

OE-027 Can In-hospital Mortality by the GRACE Score Relate to That of Japanese NSTEMI?; Analysis from Tokyo CCUNetwork Database ··························································································································· 12

Kota Komiyama（Tokyo CCU network Scientific Committee, Metropolitan Hiroo Hospital, Tokyo）

第 20会場（グランフロント大阪北館 B2階ナレッジキャピタルコングレコンベンションセンターホール A）

[RT05] ラウンドテーブルディスカッション 5　日本の循環器救急疾患の現状 16:30-18:00

座長：Tetsuya Sumiyoshi（榊原記念病院循環器内科）座長：Satoshi Yasuda（国立循環器病研究センター心臓血管内科）

RT05-3 Circadian Variation of a Cardiogenic Shock Complicating Acute Myocardial Infarction ····························· 7Makoto Suzuki（Department of Cardiovascular Medicine, Sakakibara Heart Institute, Tokyo）

第 25会場（グランフロント大阪北館タワー C 8階ナレッジキャピタルカンファレンスルーム C03＋ 04）

[OJ17] 一般演題口述（日本語） 17　ACS/AMI (Clinical/Diagnosis) 16:30-18:00

座長：Katsumi Saito（西新井ハートセンター病院循環器内科）座長：Kenei Shimada（大阪市立大学循環器病態内科学）

OJ-102 Prognostic Impact of Anemia on Admission in Japanese Patients with Acute Myocardial Infarction: A Multi-CenterCohort Study of Tokyo CCU Network ································································································ 16

Mikio Kishi（Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, NTT Medical CenterTokyo, Tokyo）

ポスター会場 1（大阪国際会議場 3階イベントホール）

[PE029] Poster Session (English) 29　ACS/AMI (Clinical/Diagnosis) 2 15:30-16:20

座長：Hideki Okayama（Department of Cardiology, Ehime Prefectural Central Hospital, Matsuyama）

PE-173 Impact of Occluded Culprit Arteries on Short-term Mortality in Non-ST Elevation Myocardial Infarction: MulticenterRegistry from Tokyo CCU Network Database ······················································································ 18

Mizuki Miura（Tokyo CCU Network Scientific Committee, Department of Cardiovascular Medicine, The Universityof Tokyo Hospital, Tokyo）

第２日目


ポスター会場 5（グランフロント大阪北館 B1階イベントラボ）

[PJ013] ポスターセッション（日本語） 13　Shock/Transplantation/LVAD 10:10-11:00

座長：Hirotsugu Fukuda（獨協医科大学心臓・血管外科）

PJ-072 Emergency Coronary Revascularization for Cardiogenic Shock or Post Cardiac Arrest Syndrome Complicating AcuteMyocardial Infarction ······················································································································· 19

Eizo Tachibana（Tokyo CCU Network Scientific Committee, Tokyo）

[PJ014] ポスターセッション（日本語） 14　Cardiomyopathy/Hypertrophy (Clinical) 1 10:10-11:00

座長：Akiyoshi Ogimoto（愛媛大学循環器・呼吸器・腎高血圧内科）

PJ-079 Divergent Clinical Features of Takotsubo Cardiomyopathy by the Type of Preceding Stress ······················ 20Tsutomu Murakami（Tokyo CCU network Scientific Committee, Tokyo）

第３日目


4月 25日（土）第 3日目

第 17会場（リーガロイヤルホテル大阪ウエストウイング 2階山楽 2）

[OE45] Oral Presentation (English) 45　ACS/AMI (Clinical/Treatment) 1 17:20-18:50

座長：Akira Sato（Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba）座長：Taizo Kondo（Department of Cardiology, Gifu Prefectural Tajimi Hospital, Gifu）

OE-266 Prognosis of Young Patients with Acute Myocardial Infarction: A Multi-Center Cohort Study of Tokyo CCU Network······················································································································································ 13


第 22会場（グランフロント大阪北館 B2階ナレッジキャピタルコングレコンベンションセンタールーム 2）

[FS34] ファイアサイドセミナー 34　JAMIR-KAMIR Joint Symposium in JCS 2015 抗血栓療法の国際比較を目指して 19:00-20:30

講演 1～5 座長：安田聡（国立循環器病研究センター）講演 1～5 座長：Young Jo Kim（Yeungnam University Hospital）パネルディスカッション座長：木村一雄（横浜市立大学附属市民総合医療センター）パネルディスカッション座長：Myung Ho Jeong（Chonnam National University Hospital）

公益財団法人循環器病研究振興財団

FS34 Latest Characteristics and Management of ST Elevation and Non-ST Elevation Myocardial Infarction in the TokyoMetropolitan Area ··························································································································· 9高山守正（榊原記念病院循環器内科）

ポスター会場 5（グランフロント大阪北館 B1階イベントラボ）

[PJ053] ポスターセッション（日本語） 53　Heart Failure (Pathophysiology) 1 10:10-11:00

座長：Akihisa Hanatani（大阪市立大学循環器内科学）

PJ-319 Prevalence and Combined Influence on In-hospital Mortality of Acute Heart Failure with Atrial Fibrillation······················································································································································ 21

Takamichi Miyamoto（Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, Musashino RedCross Hospital, Musashino）

第４日目


4月 26日（日）第 4日目

第 10会場（リーガロイヤルホテル大阪タワーウイング 3階光琳 2）

[OE68] Oral Presentation (English) 68　Diabetes 15:30-17:00

座長：Shoichi Yamagishi（Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, KurumeUniversity School of Medicine, Kurume）座長：Michio Shimabukuro（Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School ofHealth Biosciences, Tokushima）

OE-400 Prognostic Impact of Hyperglycemia in Japanese Patients with Acute Myocardial Infarction: A Multi-Center CohortStudy of Tokyo CCU Network ··········································································································· 15


第 12会場（リーガロイヤルホテル大阪タワーウイング 3階ロイヤルホール）

[FRS25] Featured Research Session 25　ACS 15:20-17:00

座長：David Brieger（Coronary Care and Coronary Interventions, Concord Hospital, Australia）座長：Masaharu Ishihara（Devision of Coronary Heart Diesease, Hyogo College of Medicine, Nishinomiya）

FRS-124 Trend of Revascularization, and Short-term Outcome of the Elderly Non-ST Elevation Myocardial Infarction Patients―Tokyo CCU Network Cohort Analysis― ··························································································· 8

Hajime Fujimoto（Tokyo CCU network Scientific Committee/Department of Cardiology, Tokyo MetropolitanGeriatric Hospital, Tokyo）

第 17会場（リーガロイヤルホテル大阪ウエストウイング 2階山楽 2）

[OE62] Oral Presentation (English) 62　Thromboembolism/Antithrombotic Therapy/Thrombolysis 2 13:30-15:00

座長：Mashio Nakamura（Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu）座長：Takeshi Ogo（Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita）

OE-368 Differences of Systemic Thrombolysis Effect on Each Severity of Acute Pulmonary Embolism (APE): Data fromthe Tokyo CCU Network ·················································································································· 14

Yasuhiro Tanabe（Tokyo CCU network Scientific Committee, Tokyo）

第 19会場（ABCホール）

[LBCS4] Late Breaking Cohort Studies 4 10:40-11:55

座長：Hisayoshi Fujiwara（兵庫県立尼崎病院）座長：Masatsugu Hori（大阪府立成人病センター）

LBCS4-2 Circadian Variation of a Cardiogenic Shock Complicating Acute Myocardial Infarction ····························· 11Makoto Suzuki（Tokyo CCU network Scientific Committee/Department of Cardiology, Sakakibara Heart Institute,Tokyo）

抄録第79回日本循環器学会学術集会

Round Table DiscussionFeatured Research Sessionファイアサイドセミナー

RoundTable

Discussion


[RT05] ラウンドテーブルディスカッション 5　日本の循環器救急疾患の現状

2015年 4月 24日（金） 16:30-18:00　第 20 会場（グランフロント大阪北館 B2 階ナレッジキャピタルコングレコンベンションセンターホール A）

座長：Tetsuya Sumiyoshi（榊原記念病院循環器内科）座長：Satoshi Yasuda（国立循環器病研究センター心臓血管内科）

Disease registries, containing systematic records of cases, have been valuable in exploring and understanding variousaspects of cardiology. This is particularly true for the clinical entities of acute coronary syndromes (ACS) includingST-segment elevation myocardial infarction (STEMI), non-STEMI, unstable angina and sudden death. Registries haveprovided both epidemiological and clinical information that was not readily available from randomized controlled trialsin highly-selected populations. Registries, whether mandated or voluntary, prospective or retrospective in their analysis,have generally a common study population and common data definitions. In this session, we highlight how registriesprovide insight into the demographics and treatment of ACS, and diversify to offer information on quality improvementand original research-through data mining.

RT05-3Circadian Variation of a Cardiogenic Shock Complicating Acute Myocardial Infarction

Makoto Suzuki 1、Tetsuya Sumiyoshi 1、Hideki Miyachi 2、Jun Yamashita 2、Masao Yamasaki 2、Katsumi Miyauchi 2、Takeshi Yamamoto 2、Ken Nagao 2、Hitonobu Tomoike 1、Morimasa Takayama 1

1:Department of Cardiovascular Medicine, Sakakibara Heart Institute, Tokyo、2:Tokyo CCU Network Council, Tokyo

Background To characterize fatal clinical features of a cardiogenic shock complicating acute myocardial infarction (AMI),we investigated whether there are any circadian variations in this critical disorder. Methods Of 6,773 patients with AMIregistered in the Tokyo CCU Network Council between 2010 and 2012 in whom onset time was available, a total of 463consecutive patients (358 male, mean age of 70 years) with a cardiogenic shock complicating AMI were identified. Thecircadian distribution of the onset and also in-hospital mortality were evaluated in those with overall AMI and a cardiogenicshock complicating AMI. Results of overall patients with AMI, 4648 (69%) were Killip class I, 89% percutaneous coronaryintervention (PCI), and 7.3% in-hospital death. Of those with cardiogenic shock, 82% underwent PCI, and 43% in-hospitaldeath. The frequency of onset of AMI was significantly increased during the period from 7 a.m. to 10 a.m. in both overalland cardiogenic shock (p=0.0001 and 0.0163 vs. average, respectively). Overall in-hospital mortality did not show theperiodic structure, whereas that in cardiogenic shock revealed serious high during the morning periods compared with theother periods (53% vs. 40%, p=0.0171). A logistic regression analysis demonstrated that onset during the morning periods(p=0.008), complications of cardiac arrest (p=0.001), and serum levels of creatinine (p=0.014) are highly associated within-hospital mortality in those with cardiogenic shock. Conclusion A noteworthy circadian variation was presented in thefrequency of onset and that was also deemed to associate with high in-hospital mortality in those with a cardiogenic shockcomplicating AMI.

[Keywords] acute coronary syndrome / circadian rhythm

FeaturedResearch

Session


[FRS25] Featured Research Session 25　ACS

2015年 4月 26日（日） 15:20-17:00　第 12会場（リーガロイヤルホテル大阪タワーウイング 3階ロイヤルホール）

座長：David Brieger（Coronary Care and Coronary Interventions, Concord Hospital, Australia）座長：Masaharu Ishihara（Devision of Coronary Heart Diesease, Hyogo College of Medicine, Nishinomiya）

FRS-124Trend of Revascularization, and Short-term Outcome of the Elderly Non-ST Elevation Myocardial In-farction Patients―Tokyo CCU Network Cohort Analysis―

Hajime Fujimoto 1、Kohta Komiyama 2、Keiko Oikawa 2、Hidenari Hozawa 2、Kazumasa Harada 1、Masato Nakamura 2、Hiroyuki Daida 2、Takeshi Yamamoto 2、Ken Nagao 2、Morimasa Takayama 2

1:Tokyo CCU network Scientific Committee/Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo、2:Tokyo CCU networkScientific Committee, Tokyo

Background. Recently, aging of Japanese population israpidly proceeding. The best strategy for the elderly non-ST elevation myocardial infarction (NSTEMI) patients isnot established. Method. We retrospectively investigatedthe trend of revascularization, and the 30-days mortality ofthe NSTEMI patients of 80 years old or more, who wereadmitted to the 50 hospitals participating in Tokyo CCUnetwork since 2007 to 2012. Results. In total, 569 patientswere enrolled. The mean age was 85.1±4.2 years old. Therates of the patients who underwent emergent revasculariza-tion, including PCI and CABG, and that of deferred revas-cularization, and the 30-days mortality are shown in Figure.Conclusion. In Tokyo, the rate of the elderly NSTEMI pa-tients who undergo emergent revascularization has graduallyincreased, and the 30-days mortality has decreased during

the last 6 years.

[Keywords] geriatrics / acute coronary syndrome

ファイアサイドセミナー


[FS34] ファイアサイドセミナー 34　JAMIR-KAMIR Joint Symposium in JCS 2015 抗血栓療法の国際比較を目指して

2015年 4月 25日（土） 19:00-20:30　第 22 会場（グランフロント大阪北館 B2 階ナレッジキャピタルコングレコンベンションセンタールーム 2）

講演 1～5 座長：安田聡（国立循環器病研究センター）講演 1～5 座長：Young Jo Kim（Yeungnam University Hospital）パネルディスカッション座長：木村一雄（横浜市立大学附属市民総合医療センター）パネルディスカッション座長：Myung Ho Jeong（Chonnam National University Hospital）

FS34Latest Characteristics and Management of ST Elevation and Non-ST Elevation Myocardial Infarction inthe Tokyo Metropolitan Area

高山守正 1

1:榊原記念病院循環器内科

No abstract provided.


Late Breaking Cohort StudiesOral Presentation (English)

Oral Presentation (Japanese)

LateBreaking

CohortStudies


[LBCS4] Late Breaking Cohort Studies 42015年 4月 26日（日） 10:40-11:55　第 19会場（ABCホール）

座長：Hisayoshi Fujiwara（兵庫県立尼崎病院）座長：Masatsugu Hori（大阪府立成人病センター）

LBCS4-2Circadian Variation of a Cardiogenic Shock Complicating Acute Myocardial Infarction

Makoto Suzuki 1、Morimasa Takayama 2、Hideki Miyachi 2、Jun Yamashita 2、Masao Yamasaki 2、Katsumi Miyauchi 2、Hiroyuki Tanaka 2、Mizuki Miura 2、Masatomo Yoshikawa 2、Mikio Kishi 2、Takeshi Yamamoto 2、Ken Nagao 2、Tetsuya Sumiyoshi 3

1:Tokyo CCU network Scientific Committee/Department of Cardiology, Sakakibara Heart Institute, Tokyo、2:Tokyo CCU network ScientificCommittee, Tokyo、3:Department of Cardiology, Sakakibara Heart Institute, Tokyo

Background To characterize fatal clinical features of a cardiogenic shock complicating acute myocardial infarction (AMI),we investigated whether there are any circadian variations in this critical disorder. Methods Of 6,773 patients with AMIregistered in the Tokyo CCU Network Council between 2010 and 2012 in whom onset time was available, a total of 463consecutive patients (358 male, mean age of 70 years) with a cardiogenic shock complicating AMI were identified. Thecircadian distribution of the onset and also in-hospital mortality were evaluated in those with overall AMI and a cardiogenicshock complicating AMI. Results Of overall patients with AMI, 4648 (69%) were Killip class I, 89% percutaneous coronaryintervention (PCI), and 7.3% in-hospital death. Of those with cardiogenic shock, 82% underwent PCI, and 43% in-hospitaldeath. The frequency of onset of AMI was significantly increased during the period from 7 a.m. to 10 a.m. in both overalland cardiogenic shock (p=0.0001 and 0.0163 vs. average, respectively). Overall in-hospital mortality did not show theperiodic structure, whereas that in cardiogenic shock revealed serious high during the morning periods compared with theother periods (53% vs. 40%, p=0.0171). A logistic regression analysis demonstrated that onset during the morning periods(p=0.008), complications of cardiac arrest (p=0.001), and serum levels of creatinine (p=0.014) are highly associated with in-hospital mortality in those with cardiogenic shock.Conclusion A noteworthy circadian variation was presented in the frequencyof onset and that was also deemed to associate with high in-hospital mortality in those with a cardiogenic shock complicatingAMI.

[Keywords] circadian rhythm / acute coronary syndrome

OralPresentation

(English)


[OE05] Oral Presentation (English) 5　ACS/AMI (Clinical/Diagnosis)

2015年 4月 24日（金） 8:30-10:00　第 15会場（リーガロイヤルホテル大阪ウエストウイング 2階ペリドット）

座長：Minoru Yoshiyama（Department of Internal Medicine and Cardiology, Osaka City University School of Medicine,Osaka）座長：Hideaki Yoshino（Department of Internal Medicine II, Kyorin University, Mitaka）

OE-027Can In-hospital Mortality by the GRACE Score Relate to That of Japanese NSTEMI?; Analysis fromTokyo CCU Network Database

Kota Komiyama 1、Masato Nakamura 2、Kei Sato 2、Hajime Fujimoto 2、Keiko Oikawa 2、Hidenari Hohzawa 2、Hiroyuki Daida 2、Takeshi Yamamoto 2、Ken Nagao 2、Morimasa Takayama 2

1:Tokyo CCU network Scientific Committee, Metropolitan Hiroo Hospital, Tokyo、2:Tokyo CCU network Scientific Committee, Tokyo

<Background> The GRACE score can be calculated in-hospital mortality by 8 independent factors at hospitaliza-tion. However, this score was derived from abroad large reg-istry of acute coronary syndrome. According to the guide-lines of the Japanese Circulation Society, GRACE scorehad not yet used in widespread because the frequency ofvasospasm was higher in Japan. <Method> 1250 non-ST-segment Elevation Myocardial Infarction (NSTEMI) pa-tients who were hospitalization at 67 multicenter TokyoCCUs during January, 2007 - December, 2012 were scoredin accordance with GRACE method. The in-hospital mor-tality was retrospectively evaluated of each scores. <Re-sult> The significant strong correlation was revealed be-tween in-hospital mortality of GRACE score and that of

Tokyo CCU network database (r=0.836, p<0.001). <Con-clusion> GRACE score of Japanese NSTEMI can help clin-icians stratify risk for optimal triage and management.

[Keywords] mortality / acute coronary syndrome

OralPresentation

(English)


[OE45] Oral Presentation (English) 45　ACS/AMI (Clinical/Treatment) 1

2015年 4月 25日（土） 17:20-18:50　第 17会場（リーガロイヤルホテル大阪ウエストウイング 2階山楽 2）

座長：Akira Sato（Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba）座長：Taizo Kondo（Department of Cardiology, Gifu Prefectural Tajimi Hospital, Gifu）

OE-266Prognosis of Young Patients with Acute Myocardial Infarction: A Multi-Center Cohort Study of TokyoCCU Network

Mikio Kishi 1、Masao Yamasaki 2、Jun Yamashita 2、Hideki Miyauchi 2、Masatomo Yoshikawa 2、Hiroyuki Tanaka 2、Katsumi Miyauchi 2、Atsushi Takagi 2、Ken Nagao 2、Morimasa Takayama 2

1:Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, NTT Medical Center Tokyo, Tokyo、2:Tokyo CCU networkScientific Committee, Tokyo

Background: Data concerning prognosis in young patientswith acute myocardial infarction (AMI) is still limited.Methods and Results: We evaluated a total of 10783Japanese AMI patients using Tokyo CCU network Database2009-2012. A total of 9.8% patients were younger than 50years old. Those patients showed less 30-day mortality ratethan older patients. (10.0% versus 12.9%) In the subgroupanalysis of young AMI patients, higher Killip stage and CKDwere strong predictors of all-cause mortality. Gender para-dox which was seen in the mortality among all AMI patientsdisappeared in the subgroup of young AMI patients. Con-clusions: From the present study, young Japanese patientswith AMI might have favorable outcome. Higher Killip stageand CKD might contribute to the worse outcome.

[Keywords] epidemiology / prognosis

OralPresentation

(English)


[OE62] Oral Presentation (English) 62　Thromboembolism/Antithrombotic Therapy/Thrombolysis 2

2015年 4月 26日（日） 13:30-15:00　第 17会場（リーガロイヤルホテル大阪ウエストウイング 2階山楽 2）

座長：Mashio Nakamura（Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu）座長：Takeshi Ogo（Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita）

OE-368Differences of Systemic Thrombolysis Effect on Each Severity of Acute Pulmonary Embolism (APE):Data from the Tokyo CCU Network

Yasuhiro Tanabe 1、Atsushi Mizuno 1、Kei Mabuchi 1、Takeshi Yamamoto 1、Toru Obayashi 1、Morimasa Takayama 1、Ken Nagao 1

1:Tokyo CCU network Scientific Committee, Tokyo

[Background] Systemic intravenous thrombolysis is less-invasive and easy to perform; however, its role for APE, particularlyfor intermediate-risk APE, is controversial. [Objective] To elucidate the differences in the effect of systemic thrombolysis oneach severity of APE. [Methods] This retrospective investigation included 1,064 cases of APE reported between 2005 and 2012.[Results] Of these, the numbers of non-massive, sub-massive, massive and collapse cases were 514 (48.3%), 368 (34.6%), 118(11.1%), and 64 (6.0%); 548 cases were administered anticoagulant alone (51.4%), 404 cases received systemic thrombolysis(38.0%), 52 cases received pulmonary artery injection (4.9%), 51 cases received catheter treatment (4.8%), and 9 cases receivedsurgical embolectomy (0.8%). The comparison between the anticoagulant alone and systemic thrombolysis groups accordingto the severity of APE resulted in no differences in blood pressure or oxygen saturation at baseline; however, the systemicthrombolysis group showed younger age (62.0±15.9 vs. 68.2±16.9, P=0.001) and lower female proportion (49.3% vs. 67.2%,P=0.001) than the anticoagulant alone group in the sub-massive cases. In the massive cases, acute mortality showed lowertrend in the systemic thrombolysis than anticoagulant alone group (17.9% vs. 33.3%, P=0.089), whereas no difference wasobserved in the sub-massive cases (3.4% vs. 4.4%, P=0.85). [Conclusion] Systemic thrombolysis seemed to be effective onreducing acute mortality in massive APE, although, it might be less effective in sub-massive APE.

[Keywords] pulmonary embolism / thrombolysis

OralPresentation

(English)


[OE68] Oral Presentation (English) 68　Diabetes

2015年 4月 26日（日） 15:30-17:00　第 10会場（リーガロイヤルホテル大阪タワーウイング 3階光琳 2）

座長：Shoichi Yamagishi（Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, KurumeUniversity School of Medicine, Kurume）座長：Michio Shimabukuro（Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School ofHealth Biosciences, Tokushima）

OE-400Prognostic Impact of Hyperglycemia in Japanese Patients with Acute Myocardial Infarction: A Multi-Center Cohort Study of Tokyo CCU Network

Mikio Kishi 1、Masao Yamasaki 2、Jun Yamashita 2、Hideki Miyachi 2、Masatomo Yoshikawa 2、Hiroyuki Tanaka 2、Katsumi Miyauchi 2、Atsushi Takagi 2、Ken Nagao 2、Morimasa Takayama 2


Background: Hyperglycemia on admission is a predictorof an unfavorable prognosis in patients with Acute My-ocardial Infarction (AMI). However few data are avail-able in Japanese patients with AMI. Methods and Results:A total of 8527 AMI patients with admission blood glu-cose level (ABGL) analysis were evaluated using TokyoCCU Network Database 2009-2012. A total of 28.7%patients had ABGL>200mg/dL and those hyperglycemiagroup showed higher 30-day mortality than the other group.The result of Cox-regression analysis revealed that hy-perglycemia was a strong predictor of short-term mortal-ity. In the subgroup analysis of diabetic patients, hy-perglycemia was still a predictor of short-term mortalityin both poor-controlled patients (HbA1c>6.5%) and well-controlled patients (6.5%≥HbA1c) Conclusions: From thepresent study, hyperglycemia was associated with worse

prognosis in Japanese AMI patients, even in diabetic pa-tients.

[Keywords] acute coronary syndrome / prognosis

OralPresentation

(Japanese)


[OJ17] 一般演題口述（日本語） 17　ACS/AMI (Clinical/Diagnosis)

2015年 4月 24日（金） 16:30-18:00　第 25会場（グランフロント大阪北館タワー C 8階ナレッジキャピタルカンファレンスルーム C03＋ 04）

座長：Katsumi Saito（西新井ハートセンター病院循環器内科）座長：Kenei Shimada（大阪市立大学循環器病態内科学）

OJ-102Prognostic Impact of Anemia on Admission in Japanese Patients with Acute Myocardial Infarction: AMulti-Center Cohort Study of Tokyo CCU Network

Mikio Kishi 1、Masao Yamasaki 2、Jun Yamashita 2、Hideki Miyachi 2、Masatomo Yoshikawa 2、Hiroyuki Tanaka 2、Katsumi Miyauchi 2、Atsushi Takagi 2、Ken Nagao 2、Morimasa Takayama 2


Background: Anemia has been previously reported as a pre-dictor of short-term mortality in patients with acute my-ocardial infarction (AMI). However, few data are availablein Japanese patients with AMI. Methods and Results: Weevaluated 30-day mortality in Japanese AMI patients usingTokyo CCU Network Database 2009-2012 (n=10783) andclassified these patients into 3 groups those were non-anemiagroup whose serum hemoglobin (Hb) concentration >12.0g/dL on admission, mild anemia group (12.0 g/dL≥Hb>10.0g/dL) and severe anemia group (10.0 g/dL≥Hb). The re-sult of Cox-regression analysis showed that even mild anemiawas a predictor of short-term mortality. Kaplan-meier curvefor short-term mortality revealed gradual increase among 3groups. Conclusions: The present study showed that ane-mia was associated with short-term mortality in Japanese

patients with AMI.

[Keywords] acute coronary syndrome / prognosis


Poster Session (English)Poster Session (Japanese)

PosterSession(English)


[PE029] Poster Session (English) 29　ACS/AMI (Clinical/Diagnosis) 2

2015年 4月 24日（金） 15:30-16:20　ポスター会場 1（大阪国際会議場 3階イベントホール）

座長：Hideki Okayama（Department of Cardiology, Ehime Prefectural Central Hospital, Matsuyama）

PE-173Impact of Occluded Culprit Arteries on Short-term Mortality in Non-ST Elevation Myocardial Infarction:Multicenter Registry from Tokyo CCU Network Database

Mizuki Miura 1、Masao Yamasaki 1、Masatomo Yoshikawa 1、Katsumi Miyauchi 1、Hiroyuki Tanaka 1、Hideki Miyachi 1、Jun Yamashita 1、Takeshi Yamamoto 1、Ken Nagao 1、Morimasa Takayama 1

1:Tokyo CCU Network Scientific Committee, Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo

Background: Some studies have suggested that occluded culprit artery was independently associated with worse outcomesin patients with non-ST elevation myocardial infarction (NSTEMI). However there are few reports evaluating the differencesof mortality between ST elevation myocardial infarction (STEMI) patients and NSTEMI patients who had occluded culpritarteries.Methods: Coronary angiography in acute phase were checked 9822 in 10,842 acute myocardial infarction patients in68 centers in Tokyo CCU Network Registry in 2009-2012. There were 5450 STEMI patients (TIMI 0-3) and 439 NSTEMIpatients with occluded culprit arteries (TIMI 0). We assessed all-cause in-hospital mortality and cardiovascular in-hospitalmortality within 30 days.Results: All-cause mortality was significantly lower in NSTEMI patients who had occluded culpritarteries than STEMI patients (14.1% vs 9.3%, p=0.016). Cardiovascular mortality was similar among two groups (10.2% vs7.4%, p=0.313). In multivariate cox regression analysis, age (HR 1.006, p<0.001, 95% CI: 1.003 - 1.010), killip class (HR2.077, p<0.001, 95% CI: 1.385 – 3.114), percutaneous coronary intervention (HR 0.669, p=0.013, 95% CI: 0.487 – 0.919),anterior infarction (HR 1.539, p=0.002, 95% CI: 1.175 – 2.015) and statin (HR 0.305, p<0.001, 95% CI: 0.229 – 0.407) wereindependent predictors for all-cause mortality.Conclusion: NSTEMI patients who had occluded culprit arteries had lowermortality than STEMI patients within 30days.

[Keywords] angiography / myocardial infarction

PosterSession(Japanese)


[PJ013] ポスターセッション（日本語） 13　Shock/Transplantation/LVAD

2015年 4月 24日（金） 10:10-11:00　ポスター会場 5（グランフロント大阪北館 B1階イベントラボ）

座長：Hirotsugu Fukuda（獨協医科大学心臓・血管外科）

PJ-072Emergency Coronary Revascularization for Cardiogenic Shock or Post Cardiac Arrest Syndrome Compli-cating Acute Myocardial Infarction

Eizo Tachibana 1、Ken Nagao 1、Tadateru Takayama 1、Yusuke Hosokawa 1、Takeshi Yamamoto 1

1:Tokyo CCU Network Scientific Committee, Tokyo

BACKGROUND:The 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care recom-mended that not only patients with cardiogenic shock complicating AMI but also post cardiac arrest syndrome due to presumedAMI should undergo emergency coronary angiography and subsequent coronary reperfusion therapy if needed. However, thereare few comparative studies of Emergency Coronary Revascularizations (ECR) of those two groups.METHODS: We comparedthe effects of ECR (except for CABG alone) between the AMI patients with cardiogenic shock and those with post cardiacarrest syndrome from the data of Tokyo CCU Network Registry, a prospective, multicenter observation registry of emergencycardiovascular care. The primary endpoint was survival to hospital discharge.RESULTS: Of the 17,076 AMI patients whowere admitted to CCU in the Tokyo CCU Network, 1,381 were enrolled in this study; 872 were cardiogenic shock patients(Shock group), and 509 were post cardiac arrest patients (PCAS group). No significant differences were seen between theShock group and the PCAS group in the whole cohort (57% vs. 61%, p=NS). In addition, the survival rate was higher in thepatients who received ECR than in those who no ECR in each group (The Shock group; 64%vs.32%, p<0.001, The PCASgroup; 66% vs.38%, p<0.001, respectively). CONCLUSION:Emergency Coronary Revascularization for cardiogenic shock isequivalent to that for post cardiac arrest syndrome in terms of survival benefits.

[Keywords] shock / emergency care



[PJ014] ポスターセッション（日本語） 14　Cardiomyopathy/Hypertrophy (Clinical) 1

2015年 4月 24日（金） 10:10-11:00　ポスター会場 5（グランフロント大阪北館 B1階イベントラボ）

座長：Akiyoshi Ogimoto（愛媛大学循環器・呼吸器・腎高血圧内科）

PJ-079Divergent Clinical Features of Takotsubo Cardiomyopathy by the Type of Preceding Stress

Tsutomu Murakami 1、Tsutomu Yoshikawa 1、Yuichiro Maekawa 1、Toshiaki Isogai 1、Tetsuo Yamaguchi 1、Tetsuro Ueda 1、Konomi Sakata 1、Takeshi Yamamoto 1、Ken Nagao 1、Morimasa Takayama 1

1:Tokyo CCU network Scientific Committee, Tokyo

Background: It is well known that takotsubo cardiomyopathy (TC) is commonly preceded by emotional or physical stress.However, clinical features by type of preceding stress remain to be determined so far.Methods: We investigated 368 patientsof TC from Tokyo CCU Network database, comprising of 71 cardiovascular centers in the metropolitan area during 3 years.We attempted to characterize the clinical profiles during hospitalization by comparing patients with emotional stress (n=104),physical stress (n=131) and those without preceding stress (n=131).Results: There were no differences in apical ballooningtype (91.3% vs. 92.3% vs. 91.6%, p=0.96), peak creatinine kinase level (414±439 IU/l vs. 846±2055 IU/l vs. 454±544IU/l, p=0.84) and cardiac death (1.9% vs. 1.5% vs. 2.3%, p=0.91). There were differences in age (70.7±11.4 vs. 76.0±10.0vs. 73.3±13.1, p<0.01), female gender (84.6% vs. 68.0% vs. 80.5%, p<0.01), brain natriuretic peptide (471±970 pg/mlvs. 846±2055 pg/ml vs. 454±544 pg/ml, p<0.01), ejection fraction on echocardiogram (53.8±13.3% vs. 46.4±13.7% vs.51.6±14.0%, p<0.01), pump failure (Killip grade≥III, 4.6% vs. 19.9% vs. 12.0%, p<0.01), respiratory supportive therapies(8.7% vs. 26.7% vs. 12.0%, p<0.01) and all cause death (2.9% vs. 11.5% vs. 3.8%, p<0.01), respectively.Conclusion: In thedatabase, TC preceded by physical stress seems to be more serious. Differential underlying disorders may be responsible forthe divergent clinical features.

[Keywords] cardiomyopathy / stress



[PJ053] ポスターセッション（日本語） 53　Heart Failure (Pathophysiology) 1

2015年 4月 25日（土） 10:10-11:00　ポスター会場 5（グランフロント大阪北館 B1階イベントラボ）

座長：Akihisa Hanatani（大阪市立大学循環器内科学）

PJ-319Prevalence and Combined Influence on In-hospital Mortality of Acute Heart Failure with Atrial Fibrillation

Takamichi Miyamoto 1

1:Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, Musashino Red Cross Hospital, Musashino

BackgroundAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia. AF is a risk factor for heart failure.This study is undertaken to determine the prevalence and the combined influence on in-hospital mortality of acute heartfailure (AHF) accompanying with AF. on the causes of death after an admission of AHF. Methods and ResultsPatients whowere admitted with AHF were enrolled using Tokyo CCU Network Database from 2010 to 2012. 9564 patients (male; n=4003,age; 75±13 years old) have were examined. The mortality (8.3% vs. 8.9%) of AF group (n=2093, 33.1%) was as same as thatof Non-AF group (n=4230, 66.9%).

[Keywords] emergency care / atrial fibrillation

Documents

Ô e+¶q¶ [ Bq - 東京都CCUネットワーク¬¬2日目 第79 回日本循環器学会学術集会 3 ポスター会場5（グランフロント大阪北館B1 階イベントラボ）

Ô e+¶q¶ [ Bq - 東京都CCUネットワーク¬¬2日目第79 回日本循環器学会学術集会 3 ポスター会場5（グランフロント大阪北館B1 階イベントラボ）