日本循環器学会学術集会

JCS2015
第79回
日本循環器学会学術集会
The 79th Annual Scientiﬁc Meeting of the Japanese Circulation Society
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
2015年4月24日（金）∼ 26日（日）
〈中之島会場〉
〈グランフロント大阪会場〉
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
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
My Abstracts
プログラム
第 79 回日本循環器学会学術集会
第 79 回日本循環器学会学術集会
2
第２日目
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 CCU
12
Network Database ···························································································································
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（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 ·····························
7
Makoto 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-Center
Cohort Study of Tokyo CCU Network ································································································
16
Mikio Kishi（Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, NTT Medical Center
Tokyo, 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: Multicenter
Registry from Tokyo CCU Network Database ······················································································
18
Mizuki Miura（Tokyo CCU Network Scientific Committee, Department of Cardiovascular Medicine, The University
of Tokyo Hospital, Tokyo）
第 79 回日本循環器学会学術集会
3
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 Acute
Myocardial 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 ······················
Tsutomu Murakami（Tokyo CCU network Scientific Committee, Tokyo）
20
第 79 回日本循環器学会学術集会
4
4 月 25 日（土）
第 3 日目
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
Mikio Kishi（Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, NTT Medical Center
Tokyo, Tokyo）
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 Tokyo
Metropolitan Area ···························································································································
9
高山守正（
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
······················································································································································
Takamichi Miyamoto（Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, Musashino Red
Cross Hospital, Musashino）
21
第 79 回日本循環器学会学術集会
5
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
OE-400
第４日目
座長：Shoichi Yamagishi（Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume
University School of Medicine, Kurume）
座長：Michio Shimabukuro（Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School of
Health Biosciences, Tokushima）
Prognostic Impact of Hyperglycemia in Japanese Patients with Acute Myocardial Infarction: A Multi-Center Cohort
Study of Tokyo CCU Network ···········································································································
15
Mikio Kishi（Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, NTT Medical Center
Tokyo, Tokyo）
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 Metropolitan
Geriatric 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 from
the 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 ·····························
Makoto Suzuki（Tokyo CCU network Scientific Committee/Department of Cardiology, Sakakibara Heart Institute,
Tokyo）
11
抄録
第 79 回日本循環器学会学術集会
Round Table Discussion
Featured Research Session
ファイアサイドセミナー
第 79 回日本循環器学会学術集会
7
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（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 various
aspects of cardiology. This is particularly true for the clinical entities of acute coronary syndromes (ACS) including
ST-segment elevation myocardial infarction (STEMI), non-STEMI, unstable angina and sudden death. Registries have
provided both epidemiological and clinical information that was not readily available from randomized controlled trials
in 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 registries
provide insight into the demographics and treatment of ACS, and diversify to oﬀer information on quality improvement
and original research-through data mining.
RT05-3
Circadian 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 AMI
registered in the Tokyo CCU Network Council between 2010 and 2012 in whom onset time was available, a total of 463
consecutive patients (358 male, mean age of 70 years) with a cardiogenic shock complicating AMI were identified. The
circadian distribution of the onset and also in-hospital mortality were evaluated in those with overall AMI and a cardiogenic
shock complicating AMI. Results of overall patients with AMI, 4648 (69%) were Killip class I, 89% percutaneous coronary
intervention (PCI), and 7.3% in-hospital death. Of those with cardiogenic shock, 82% underwent PCI, and 43% in-hospital
death. The frequency of onset of AMI was significantly increased during the period from 7 a.m. to 10 a.m. in both overall
and cardiogenic shock (p=0.0001 and 0.0163 vs. average, respectively). Overall in-hospital mortality did not show the
periodic structure, whereas that in cardiogenic shock revealed serious high during the morning periods compared with the
other 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
frequency of onset and that was also deemed to associate with high in-hospital mortality in those with a cardiogenic shock
complicating AMI.
[Keywords] acute coronary syndrome / circadian rhythm
Round Table 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
第 79 回日本循環器学会学術集会
8
[FRS25] Featured Research Session 25 ACS
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―
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 network
Scientific Committee, Tokyo
Background.
Recently, aging of Japanese population is
the last 6 years.
rapidly proceeding. The best strategy for the elderly nonST elevation myocardial infarction (NSTEMI) patients is
not established. Method. We retrospectively investigated
the trend of revascularization, and the 30-days mortality of
the NSTEMI patients of 80 years old or more, who were
admitted to the 50 hospitals participating in Tokyo CCU
network since 2007 to 2012. Results. In total, 569 patients
were enrolled. The mean age was 85.1±4.2 years old. The
rates of the patients who underwent emergent revascularization, including PCI and CABG, and that of deferred revascularization, and the 30-days mortality are shown in Figure.
Conclusion. In Tokyo, the rate of the elderly NSTEMI patients who undergo emergent revascularization has gradually
increased, and the 30-days mortality has decreased during
[Keywords] geriatrics / acute coronary syndrome
Featured Research Session
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）
第 79 回日本循環器学会学術集会
9
[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
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）
FS34
Latest Characteristics and Management of ST Elevation and Non-ST Elevation Myocardial Infarction in
the Tokyo Metropolitan Area
高山守正
1
1: 原記念病院循環器内科
No abstract provided.
ファイアサイドセミナー
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）
抄録
第 79 回日本循環器学会学術集会
Late Breaking Cohort Studies
Oral Presentation (English)
Oral Presentation (Japanese)
第 79 回日本循環器学会学術集会
11
[LBCS4] Late Breaking Cohort Studies 4
2015 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）
Circadian 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 Scientific
Committee, 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 AMI
registered in the Tokyo CCU Network Council between 2010 and 2012 in whom onset time was available, a total of 463
consecutive patients (358 male, mean age of 70 years) with a cardiogenic shock complicating AMI were identified. The
circadian distribution of the onset and also in-hospital mortality were evaluated in those with overall AMI and a cardiogenic
shock complicating AMI. Results Of overall patients with AMI, 4648 (69%) were Killip class I, 89% percutaneous coronary
intervention (PCI), and 7.3% in-hospital death. Of those with cardiogenic shock, 82% underwent PCI, and 43% in-hospital
death. The frequency of onset of AMI was significantly increased during the period from 7 a.m. to 10 a.m. in both overall
and cardiogenic shock (p=0.0001 and 0.0163 vs. average, respectively). Overall in-hospital mortality did not show the
periodic structure, whereas that in cardiogenic shock revealed serious high during the morning periods compared with the
other 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 inhospital mortality in those with cardiogenic shock.Conclusion A noteworthy circadian variation was presented in the frequency
of onset and that was also deemed to associate with high in-hospital mortality in those with a cardiogenic shock complicating
AMI.
[Keywords] circadian rhythm / acute coronary syndrome
Late Breaking Cohort Studies
LBCS4-2
第 79 回日本循環器学会学術集会
12
[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）
Can In-hospital Mortality by the GRACE Score Relate to That of Japanese NSTEMI?; Analysis from
Tokyo 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-
Tokyo CCU network database (r=0.836, p<0.001). <Con-
hospital mortality by 8 independent factors at hospitaliza-
clusion> GRACE score of Japanese NSTEMI can help clin-
tion. However, this score was derived from abroad large reg-
icians stratify risk for optimal triage and management.
istry of acute coronary syndrome. According to the guidelines of the Japanese Circulation Society, GRACE score
had not yet used in widespread because the frequency of
vasospasm was higher in Japan.
<Method> 1250 non-
ST-segment Elevation Myocardial Infarction (NSTEMI) patients who were hospitalization at 67 multicenter Tokyo
CCUs during January, 2007 - December, 2012 were scored
in accordance with GRACE method. The in-hospital mortality was retrospectively evaluated of each scores. <Result> The significant strong correlation was revealed between in-hospital mortality of GRACE score and that of
[Keywords] mortality / acute coronary syndrome
Oral Presentation (English)
OE-027
第 79 回日本循環器学会学術集会
13
[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）
Prognosis of Young Patients with Acute Myocardial Infarction: A Multi-Center Cohort Study of Tokyo
CCU 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 network
Scientific Committee, Tokyo
Background: Data concerning prognosis in young patients
with acute myocardial infarction (AMI) is still limited.
Methods and Results:
We evaluated a total of 10783
Japanese AMI patients using Tokyo CCU network Database
2009-2012. A total of 9.8% patients were younger than 50
years old. Those patients showed less 30-day mortality rate
than older patients. (10.0% versus 12.9%) In the subgroup
analysis of young AMI patients, higher Killip stage and CKD
were strong predictors of all-cause mortality. Gender paradox which was seen in the mortality among all AMI patients
disappeared in the subgroup of young AMI patients. Conclusions: From the present study, young Japanese patients
with AMI might have favorable outcome. Higher Killip stage
and CKD might contribute to the worse outcome.
[Keywords] epidemiology / prognosis
Oral Presentation (English)
OE-266
第 79 回日本循環器学会学術集会
14
[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）
Diﬀerences 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, particularly
for intermediate-risk APE, is controversial. [Objective] To elucidate the diﬀerences in the eﬀect of systemic thrombolysis on
each 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 received
surgical embolectomy (0.8%). The comparison between the anticoagulant alone and systemic thrombolysis groups according
to the severity of APE resulted in no diﬀerences in blood pressure or oxygen saturation at baseline; however, the systemic
thrombolysis 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 lower
trend in the systemic thrombolysis than anticoagulant alone group (17.9% vs. 33.3%, P=0.089), whereas no diﬀerence was
observed in the sub-massive cases (3.4% vs. 4.4%, P=0.85). [Conclusion] Systemic thrombolysis seemed to be eﬀective on
reducing acute mortality in massive APE, although, it might be less eﬀective in sub-massive APE.
[Keywords] pulmonary embolism / thrombolysis
Oral Presentation (English)
OE-368
第 79 回日本循環器学会学術集会
15
[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, Kurume
University School of Medicine, Kurume）
座長：Michio Shimabukuro（Department of Cardio-Diabetes Medicine, The University of Tokushima Graduate School of
Health Biosciences, Tokushima）
Prognostic Impact of Hyperglycemia in Japanese Patients with Acute Myocardial Infarction: A MultiCenter 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
1:Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, NTT Medical Center Tokyo, Tokyo、2:Tokyo CCU network
Scientific Committee, Tokyo
Background: Hyperglycemia on admission is a predictor
prognosis in Japanese AMI patients, even in diabetic pa-
of an unfavorable prognosis in patients with Acute My-
tients.
ocardial Infarction (AMI). However few data are available in Japanese patients with AMI. Methods and Results:
A total of 8527 AMI patients with admission blood glucose level (ABGL) analysis were evaluated using Tokyo
CCU Network Database 2009-2012.
A total of 28.7%
patients had ABGL>200mg/dL and those hyperglycemia
group showed higher 30-day mortality than the other group.
The result of Cox-regression analysis revealed that hyperglycemia was a strong predictor of short-term mortality.
In the subgroup analysis of diabetic patients, hy-
perglycemia was still a predictor of short-term mortality
in both poor-controlled patients (HbA1c>6.5%) and wellcontrolled patients (6.5%≥HbA1c) Conclusions: From the
present study, hyperglycemia was associated with worse
[Keywords] acute coronary syndrome / prognosis
Oral Presentation (English)
OE-400
第 79 回日本循環器学会学術集会
16
[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）
Prognostic Impact of Anemia on Admission 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
1:Tokyo CCU network Scientific Committee, Tokyo/Division of Cardiology, NTT Medical Center Tokyo, Tokyo、2:Tokyo CCU network
Scientific Committee, Tokyo
Background: Anemia has been previously reported as a pre-
patients with AMI.
dictor of short-term mortality in patients with acute myocardial infarction (AMI). However, few data are available
in Japanese patients with AMI. Methods and Results: We
evaluated 30-day mortality in Japanese AMI patients using
Tokyo CCU Network Database 2009-2012 (n=10783) and
classified these patients into 3 groups those were non-anemia
group whose serum hemoglobin (Hb) concentration >12.0
g/dL on admission, mild anemia group (12.0 g/dL≥Hb>10.0
g/dL) and severe anemia group (10.0 g/dL≥Hb). The result of Cox-regression analysis showed that even mild anemia
was a predictor of short-term mortality. Kaplan-meier curve
for short-term mortality revealed gradual increase among 3
groups. Conclusions: The present study showed that anemia was associated with short-term mortality in Japanese
[Keywords] acute coronary syndrome / prognosis
Oral Presentation (Japanese)
OJ-102
抄録
第 79 回日本循環器学会学術集会
Poster Session (English)
Poster Session (Japanese)
第 79 回日本循環器学会学術集会
18
[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-173
Impact of Occluded Culprit Arteries on Short-term Mortality in Non-ST Elevation Myocardial Infarction:
Multicenter Registry from Tokyo CCU Network Database
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 outcomes
in patients with non-ST elevation myocardial infarction (NSTEMI). However there are few reports evaluating the diﬀerences
of mortality between ST elevation myocardial infarction (STEMI) patients and NSTEMI patients who had occluded culprit
arteries.Methods: Coronary angiography in acute phase were checked 9822 in 10,842 acute myocardial infarction patients in
68 centers in Tokyo CCU Network Registry in 2009-2012. There were 5450 STEMI patients (TIMI 0-3) and 439 NSTEMI
patients with occluded culprit arteries (TIMI 0). We assessed all-cause in-hospital mortality and cardiovascular in-hospital
mortality within 30 days.Results: All-cause mortality was significantly lower in NSTEMI patients who had occluded culprit
arteries than STEMI patients (14.1% vs 9.3%, p=0.016). Cardiovascular mortality was similar among two groups (10.2% vs
7.4%, p=0.313). In multivariate cox regression analysis, age (HR 1.006, p<0.001, 95% CI: 1.003 - 1.010), killip class (HR
2.077, 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) were
independent predictors for all-cause mortality.Conclusion: NSTEMI patients who had occluded culprit arteries had lower
mortality than STEMI patients within 30days.
[Keywords] angiography / myocardial infarction
Poster Session (English)
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
第 79 回日本循環器学会学術集会
19
[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-072
Emergency Coronary Revascularization for Cardiogenic Shock or Post Cardiac Arrest Syndrome Complicating 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
mended that not only patients with cardiogenic shock complicating AMI but also post cardiac arrest syndrome due to presumed
AMI should undergo emergency coronary angiography and subsequent coronary reperfusion therapy if needed. However, there
are few comparative studies of Emergency Coronary Revascularizations (ECR) of those two groups.METHODS: We compared
the eﬀects of ECR (except for CABG alone) between the AMI patients with cardiogenic shock and those with post cardiac
arrest syndrome from the data of Tokyo CCU Network Registry, a prospective, multicenter observation registry of emergency
cardiovascular care. The primary endpoint was survival to hospital discharge.RESULTS: Of the 17,076 AMI patients who
were 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 the
Shock group and the PCAS group in the whole cohort (57% vs. 61%, p=NS). In addition, the survival rate was higher in the
patients who received ECR than in those who no ECR in each group (The Shock group; 64%vs.32%, p<0.001, The PCAS
group; 66% vs.38%, p<0.001, respectively). CONCLUSION:Emergency Coronary Revascularization for cardiogenic shock is
equivalent to that for post cardiac arrest syndrome in terms of survival benefits.
[Keywords] shock / emergency care
Poster Session (Japanese)
BACKGROUND:The 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care recom-
第 79 回日本循環器学会学術集会
20
[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-079
Divergent 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
However, clinical features by type of preceding stress remain to be determined so far.Methods: We investigated 368 patients
of 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 ballooning
type (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±544
IU/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±10.0
vs. 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/ml
vs. 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 the
database, TC preceded by physical stress seems to be more serious. Diﬀerential underlying disorders may be responsible for
the divergent clinical features.
[Keywords] cardiomyopathy / stress
Poster Session (Japanese)
Background: It is well known that takotsubo cardiomyopathy (TC) is commonly preceded by emotional or physical stress.
第 79 回日本循環器学会学術集会
21
[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-319
Prevalence 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
This study is undertaken to determine the prevalence and the combined influence on in-hospital mortality of acute heart
failure (AHF) accompanying with AF. on the causes of death after an admission of AHF. Methods and ResultsPatients who
were 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 that
of Non-AF group (n=4230, 66.9%).
[Keywords] emergency care / atrial fibrillation
Poster Session (Japanese)
BackgroundAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia. AF is a risk factor for heart failure.

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