Abstract:
:Direct oral anticoagulants (DOACs), such as rivaroxaban, reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). However, it is still unclear whether the stroke reduction benefit outweighs the bleeding risk in elderly Japanese patients with NVAF. The Xarelto Post-Authorization Safety and Effectiveness Study in Japanese Patients with Atrial Fibrillation (XAPASS) was a real-world, prospective observational, post-marketing surveillance study on the safety and effectiveness of rivaroxaban in Japanese clinical practice. This sub-analysis evaluated the clinical outcomes of elderly patients aged ≥ 75 years. At the 1-year follow-up, there were 4,685 (48.91%) and 4,893 (51.09%) patients aged ≥ 75 and < 75 years, respectively. Safety and effectiveness outcomes were compared between patients aged ≥ 75 years and those aged < 75 years, and among 3 elderly sub-populations (age ranges: 75-79, 80-84, and ≥ 85 years). Patients aged ≥ 75 years had higher rates of major bleeding [2.22 vs. 1.35 events per 100 patient-years, hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.17-2.28] and composite of stroke (ischemic or hemorrhagic)/non-central nervous system (non-CNS) systemic embolism (SE)/myocardial infarction (MI) (2.41 vs. 1.21 events per 100 patient-years, HR 1.97, 95% CI 1.40-2.77) compared to patients aged < 75 years. Intracranial hemorrhage rates were < 1 event per 100 patient-years in both groups (0.85 vs. 0.59 events per 100 patient-years, HR 1.43, 95% CI 0.85-2.40). Kaplan-Meier curves of major bleeding and stroke/non-CNS SE/MI showed that no significant differences of cumulative event rates were identified among the 3 elderly sub-populations. Stepwise Cox regression analyses revealed that creatinine clearance (CrCl) (<50 mL/min), hepatic impairment, and hypertension were specific predictors for major bleeding and no specific predictors were found for stroke/non-CNS SE/MI in patients aged ≥ 75 years. In conclusion, safety and effectiveness event rates were higher in patients aged ≥ 75 years compared with those aged < 75 years, yet, no distinct differences were observed among the 3 elderly sub-populations.
journal_name
Heart Vesselsjournal_title
Heart and vesselsauthors
Kitazono T,Ikeda T,Ogawa S,Nakagawara J,Minematsu K,Miyamoto S,Murakawa Y,Cavaliere M,Hayashi Y,Kidani Y,Okayama Y,Sunaya T,Sato S,Yamanaka Sdoi
10.1007/s00380-019-01487-xsubject
Has Abstractpub_date
2020-03-01 00:00:00pages
399-408issue
3eissn
0910-8327issn
1615-2573pii
10.1007/s00380-019-01487-xjournal_volume
35pub_type
杂志文章abstract::It is known that the heart of an athlete has been physiologically adapted by prolonged training. There are a large number of echocardiographic studies which have focused on left ventricular wall thickness and dilatation, but there are few studies concerning right heart function in the athlete's heart. The aim of this ...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s003800200018
更新日期:2002-07-01 00:00:00
abstract::Myocardial fibrosis and microvascular dysfunction are key determinants of outcome in heart failure (HF); we examined their relationship in patients with HF. Our study included 61 consecutive patients with HF but without coronary stenosis. All underwent gadolinium-enhanced cardiac magnetic resonance to evaluate late ga...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-016-0816-z
更新日期:2016-12-01 00:00:00
abstract::The efficacy of second-generation drug-eluting stent (DES) for the treatment of left main disease (LM) and/or three vessel disease (3VD) remains unclear. We compared 2-year outcomes of second- versus first -generation DES implantation among patients with LM and/or 3VD and to assess the differential of risk by complexi...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-016-0824-z
更新日期:2016-12-01 00:00:00
abstract::It is well known that patients with gastroesophageal reflux disease (GERD) experience GERD-related chest pain, but little is known about the relationship between GERD and coronary artery disease (CAD). We evaluated medical history of GERD in patients with suspected CAD and its association with types of CAD. We enrolle...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-019-01413-1
更新日期:2019-10-01 00:00:00
abstract::Subclavian artery stenosis can cause a flow reversal-so-called steal-not only in the ipsilateral vertebral artery, but also in the internal mammary artery in patients with a history of coronary-artery bypass grafting. Subclavian artery stenosis is also associated with peripheral artery disease elsewhere. We report a n...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-016-0821-2
更新日期:2016-11-01 00:00:00
abstract::It is well known that silent myocardial ischemia (SMI) often complicates patients with cerebral infarction and that stroke patients often die of ischemic heart disease. Therefore, it is considered important to treat myocardial ischemia in stroke patients. This study investigated SMI complicating Japanese patients with...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-011-0210-9
更新日期:2013-01-01 00:00:00
abstract::The role of inflammation in acute coronary syndrome (ACS) and the mechanism by which statin treats ACS is explored. Serum high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels were measured in 50 patients with ACS [including 30 cases with unstable angina (UA) and 20 patients with acute myocardia...
journal_title:Heart and vessels
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00380-004-0776-6
更新日期:2004-11-01 00:00:00
abstract::Cardiopulmonary polygraphy (PG) demonstrates not only parameters for sleep disordered breathing (SDB) but also hemodynamics. We previously developed a software that detects lung to fingertip circulation time (LFCT) derived from PG dataset and reported that those LFCT reflected the cardiac output. The purpose of this s...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-020-01657-2
更新日期:2021-01-01 00:00:00
abstract::We report the case of a newborn with an aneurysmal aorto-left ventricular tunnel causing significant paravalvular aortic regurgitation and obstruction of the right ventricular outflow tract (RVOT), coexisting with a bicuspid aortic valve. The coexistence of the two malformations together with the obstruction of the RV...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-013-0445-8
更新日期:2015-01-01 00:00:00
abstract::Due to the complex profile of atherosclerotic risk factors, an integrated analysis of a specific individual is difficult. Endothelial function reflects a composite of various risk factors, and may be used as an optimal tool to estimate the overall atherosclerotic risk. In this study, we investigated the value of digit...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-018-1118-4
更新日期:2018-07-01 00:00:00
abstract::MicroRNAs (miRNAs) are short non-coding RNAs that regulate gene expression. It seems that microRNA-21 (miR-21) and Visfatin, a novel adipocytokine, play roles in inflammation and atherosclerosis. The aim of this study was to investigate the association of miR-21 with Visfatin, inflammation, atherosclerosis and acute c...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-016-0913-z
更新日期:2017-05-01 00:00:00
abstract::Activation of mineralocorticoid receptor antagonists (MRAs) is cardioprotective; however, this property is lost upon blockade or inactivation of adenosine (ADO) receptor A2b. In this study, we investigated whether the effects of MRAs are mediated by an interaction between cardioprotective ADO receptors A1 and A3. Spir...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-019-01542-7
更新日期:2020-05-01 00:00:00
abstract::The hemodynamic load due to physical activity leads to structural and functional cardiac adaptations known as "Athlete's heart". We aimed to compare myocardial performance in different groups of trained athletes by means of 3D echocardiography and 3D speckle tracking echocardiography (3D-STE). 66 athletes [26 strength...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-014-0520-9
更新日期:2015-05-01 00:00:00
abstract::Peripartum cardiomyopathy (PPCM) is a rare but life-threatening cardiac disorder characterized by maternal systolic heart failure. Although PPCM is a major cause of maternal mortality, little is known about the acute-phase management of PPCM in real-world clinical settings. We retrospectively identified patients hospi...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-017-0958-7
更新日期:2017-08-01 00:00:00
abstract::Low levels of Soluble TNF-related apoptosis induced ligand (sTRAIL) seem to be related to worse prognosis after an acute coronary syndrome. PostConditioning (PostCond) may protect the heart from reperfusion injury. We sought to evaluate the impact of PostCond on sTRAIL in relationship to infarct size (area under the c...
journal_title:Heart and vessels
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00380-016-0851-9
更新日期:2017-02-01 00:00:00
abstract::Coronary artery spasm is involved in the pathogenesis of various cardiac disorders. We investigated patients with a history of syncope who underwent elective coronary angiography. We retrospectively analyzed 5781 consecutive patients who had diagnostic or follow-up angiography during a 26-year period. During this peri...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-017-1046-8
更新日期:2018-02-01 00:00:00
abstract::Studies have demonstrated that thyroid hormone (T3) can precondition the heart against ischaemic injury and improve post-ischaemic recovery. This study investigated whether the AT2 receptor (AT2R) is involved in cardioprotection and the potential molecular mechanism responsible for this effect. Hyperthyroidism was ind...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-017-1101-5
更新日期:2018-06-01 00:00:00
abstract::An unusual case of total occlusion of aorta just distal to the left subclavian artery, bicuspid aortic valve, and occluded left external iliac artery in a 21-year-old man who was admitted with headache and severe hypertension is presented. We wish to report this case because so far there have been none reported with s...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-006-0947-8
更新日期:2007-03-01 00:00:00
abstract::Both hypertension and hyperuricemia are closely associated with the morbidity and mortality of heart failure. This study was designed to evaluate the influences of long-term xanthine oxidase inhibitor (febuxostat) prescription on left ventricular hypertrophy (LVH), left ventricular (LV) diastolic function, and new-ons...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-020-01619-8
更新日期:2020-10-01 00:00:00
abstract::We studied the effects of cobalt-60 Gamma-radiation on the gene expression and secretion of adrenomedullin (Adm) and endothelin (ET) in cultured rat vascular smooth muscle cells (VSMCs). Rat VSMCs cultured in Dulbecoo's modified Eagle's medium containing 10% FBS were radiated with cobalt-60 Gamma-radiation at doses of...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-003-0709-9
更新日期:2003-09-01 00:00:00
abstract::Even though drug-coated balloon (DCB) angioplasty has emerged as a treatment option for drug-eluting stent in-stent restenosis (DES-ISR), the most effective treatment strategy for DES-ISR is still under debate. Therefore, we compared long-term clinical outcomes following DCB treatment of DES-ISR with those following 2...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-015-0741-6
更新日期:2016-09-01 00:00:00
abstract::We investigated the incidence of post-intubation hypotension (PIH) in hemodynamically stable patients with STEMI requiring rapid sequences intubation (RSI) and medicated with ketamine or midazolam as induction agent. STEMI patients admitted between 1st January 2009 and 1st January 2017 who did not receive any type of ...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-017-1049-5
更新日期:2018-03-01 00:00:00
abstract::Cross-sectional data suggest that the degree of coronary atherosclerosis is associated with aerobic fitness. However, there are limited longitudinal data addressing whether aerobic fitness is a predictor of coronary atherosclerosis progression. This study investigated whether peak oxygen consumption is related to a lo...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-015-0745-2
更新日期:2016-09-01 00:00:00
abstract::A 65-year-old man was admitted with chest pain. A diagnosis of spastic angina was made because of symptoms of recurrent anginal attacks associated with ST-segment elevations in the electrocardiogram. A selective coronary arteriogram revealed a 90% diameter narrowing of the proximal left anterior descending coronary ar...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/BF02058361
更新日期:1989-01-01 00:00:00
abstract::Thoracic outlet syndrome (TOS) is caused by compression of peripheral nerves and vascular structures along their course through the upper thoracic aperture to the axilla. The aim of our study was to analyze long-term outcomes of different treatments stratified by symptom severity. We performed a retrospective analysis...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-010-0112-2
更新日期:2011-11-01 00:00:00
abstract::The purpose of this study was to examine factors influencing readmission to hospital in patients with heart failure. This multicenter, retrospective cohort study analyzed 197 heart failure patients admitted to the research cooperation facilities between January 2017 and November 2017. We defined the readmission group ...
journal_title:Heart and vessels
pub_type: 杂志文章,多中心研究
doi:10.1007/s00380-019-01500-3
更新日期:2020-03-01 00:00:00
abstract::Atrial fibrillation (AF) is a complex disease with multiple inter-relating causes culminating in rapid atrial activation and atrial structural remodeling. The contribution of endoplasmic reticulum and mitochondria stress to AF has been highlighted. As the class III antiarrhythmic agent, ibutilide are widely used to AF...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-016-0891-1
更新日期:2017-02-01 00:00:00
abstract::Atrial fibrillation (AF) is the most common arrhythmia, characterized by a lack of atrial contraction and an irregular ventricular rhythm. We assessed the effect of fibrillatory wave amplitude on coronary blood flow in patients with AF using the thrombolysis in myocardial infarction (TIMI) frame count. Sixty-one patie...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-018-1121-9
更新日期:2018-07-01 00:00:00
abstract::Pleural effusions following coronary artery bypass grafting (CABG) have been reported in 65%-89% of the cases. The majority of pleural effusions are left-sided, of little significance, and resolve spontaneously. However, a few pleural effusions require specific therapeutics. We report clinical and pleural histologic f...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-006-0930-4
更新日期:2007-01-01 00:00:00
abstract::Wave intensity analysis is a method of studying intravascular flow wave propagation, calculated as the product of the rate of change in pressure (d P/ t) and the rate of change in velocity (d U/d t). The typical pattern of wave intensity seen during the cardiac cycle has two dominant peaks. The larger first peak (FP) ...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-003-0725-9
更新日期:2004-01-01 00:00:00