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Hematologogical and Sonological Studies on Mechanisms of Thromboembolism in Non-Valvular Atrial Fibrillation

Research Project

Project/Area Number 11670645
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Neurology
Research InstitutionTokyo Women's Medical University

Principal Investigator

UCHIYAMA Shinichiro  Tokyo Women's Medical University, Department of Neurology, Professor, 医学部, 教授 (50119905)

Co-Investigator(Kenkyū-buntansha) KASANUKI Hiroshi  Tokyo Women's Medical University, Department of Neurology, Professor, 医学部, 教授 (40096574)
Project Period (FY) 1999 – 2001
Project Status Completed (Fiscal Year 2001)
Budget Amount *help
¥3,600,000 (Direct Cost: ¥3,600,000)
Fiscal Year 2001: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 2000: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 1999: ¥1,500,000 (Direct Cost: ¥1,500,000)
KeywordsATRIAL FIBRILLATION / CEREBRAL INFARCTION / BLOOD COAGULATION MARKERS / RISK FACTORS / ANTITHROMBOTIC THERAPY / WARFARIN / INR / PROGNOSIS / 転帰 / 血液凝血マーカー / 経食道エコー / ワルファリン / 出血合併症 / 血液凝固 / アスピリン / チクロピジン / 重症度 / 非弁膜症性心房細動 / 脳梗栓症 / 血小板フィブノゲン結合 / 血小板Pセレクチン発現 / 網状血小板 / ワーファリン療法
Research Abstract

In patients with non-valvular atrial fibrillation (NVAF), who had cerebral embolism, beta-thromboglobulin, platelet factor 4, and thrombin-antithrombin-III (TAT) were increased in acute phase, while fibrin monomer and D-dimer (DD) were most increased in subacute phase. Platelet p-selectin expression and reticulated platelets were more frequently increased than platelet fibrinogen binding, and they were corrected by warfarin alone or with antiplatelet agents. Large infarcts and poor outcome at discharge were more frequent in patients with age more than 75 years, congestive heart failure, left atrial dilatation, and increased TAT and DD than in those without them. Large infarcts were more frequent in patients not treated with any antithrombotic agent than in those treated with warfarin. Among patients treated with warfarin, large infarcts were more frequent in INR below 2.0 than over 2.0, while major hemorrhage was more frequent in INR over 2.5 than below 2.5 among patients aged over 75 years. These results indicate that platelet and coagulation activation occur in acute phase followed by fibrinolysis activation in aubacute phase, platelet release and consumption occurs more easily than platelet aggregation, and aging, congestive heart failure, left atrial dilatation, coagulation-fibrinolysis activation, and no treatment with antithrombotic agents are risk factors for large infarcst and poor outocme, and optimal INR with warfarin treatmentm is 2.0 to 3.0 in patients aged below 75 years, while it is 2.0 to 3.0 in those aged over 75 years.

Report

(4 results)
  • 2001 Annual Research Report   Final Research Report Summary
  • 2000 Annual Research Report
  • 1999 Annual Research Report
  • Research Products

    (21 results)

All Other

All Publications (21 results)

  • [Publications] 内山 真一郎: "再発予知.リスクファクターからみた脳卒中"Progress in Medicine. 21巻5号. 1272-1277 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 内山 真一郎: "抗血栓療法.脳血管障害の臨床"神経研究の進歩. 45巻3号. 427-436 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 内山 真一郎: "脳塞栓症.EBMに基く臨床データブック"臨床医. 27巻増刊号. 1547-1552 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 内山 真一郎: "閉塞性脳血管障害への抗血小板薬と抗凝固薬"臨床成人病. 31巻7号. 897-906 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 内山 真一郎: "抗血栓療法とEBM.脳卒中診療におけるEBM"脳と循環. 6巻3号. 223-230 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] Shinichiro Uchiyama: "Risk of ischemic stroke and hemorrhagic complications in warfarinized patients with non-valuular atrial fibrillation"Internal Medicine. 40巻12号. 1166-1167 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 内山 真一郎: "今日の治療指針"医学書院. 1527 (2002)

    • Related Report
      2001 Annual Research Report
  • [Publications] 内山真一郎: "脳卒中の治療と予後"日本内科学会雑誌. 89・3. 31-39 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] 内山真一郎: "抗血栓療法による脳梗塞再発予防"神経治療学. 17・2. 119-130 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] 内山真一郎: "血栓の形成される病態"Medicina. 37・7. 1048-1051 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] 内山真一郎: "心房細動と脳梗塞"Heart Nursing. 13・13. 1620-1627 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] 内山真一郎: "Cochrane Stroke Review Groupによる抗血栓療法のメタアナリシス"東京女子医科大学雑誌. 70・9. 551-564 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] 内山真一郎: "心房細動の脳塞栓予防"現代医療. 33(増刊II). 632-638 (2001)

    • Related Report
      2000 Annual Research Report
  • [Publications] 内山真一郎: "Annual Review神経"脳卒中の二次予防. 344 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] 内山真一郎: "血小板活性化と血液凝血学的異常"神経内科. 52・1. 10-17 (2000)

    • Related Report
      1999 Annual Research Report
  • [Publications] 内山真一郎: "心疾患と脳血管障害"日本内科学会雑誌. 88・5. 851-857 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 内山真一郎: "心原性脳塞栓症"日本臨床領域別症候群シリーズ. No.26. 158-161 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 内山真一郎: "虚血性脳血管の抗凝固療法"医学のあゆみ. 別冊ver1. 354-357 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 内山真一郎他: "虚血性脳血管障害における血小板活性化とその制御"脳卒中. 21・4(印刷中). (2000)

    • Related Report
      1999 Annual Research Report
  • [Publications] 内山真一郎: "脳血管障害の治療"現代医療社. 256 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 内山真一郎,山崎昌子: "ブレインアタック超急性期の脳卒中診療"中山書店. 386 (1999)

    • Related Report
      1999 Annual Research Report

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Published: 1999-04-01   Modified: 2016-04-21  

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