Association between coronary plaque characteristics and sleep disordered breathing

• Project/Area Number: 16K19431
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Cardiovascular medicine
• Research Institution: Juntendo University
• Principal Investigator: Dohi Tomotaka 順天堂大学, 医学部, 准教授 (50771755)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000); Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2016: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: 睡眠呼吸障害 / 冠動脈硬化 / 血管内超音波 / 不安定プラーク / 残余リスク / 睡眠時無呼吸症候群 / 経鼻的持続陽圧呼吸療法 / 冠動脈プラーク / プラーク退縮 / 冠動脈疾患 / 栄養状態 / 循環器・高血圧 / 閉塞性睡眠時無呼吸症

Outline of Final Research Achievements

Our intravascular ultrasound analysis showed significant association between sleep-disordered breathing (SDB) and coronary plaque vulnerability. This study included 289 patients with coronary artery disease. Plaque characteristics of the culprit lesion were assessed by preintervention intravascular ultrasound. The presence of SDB was defined as a 3% oxygen desaturation index of >15 events per hour measured by nocturnal pulse oximetry. Attenuated plaque with a maximum attenuation angle >140 degree was more frequently observed in the SDB group compared with the no-SDB group (34.9% versus 22.6%; P=0.03). Multivariable logistic regression analysis showed that the presence of SDB was a significant predictor of a greater ultrasound attenuation angle (>140 degree) (odds ratio, 1.86; 95% confidence interval, 1.02 to 3.39; P=0.04). SDB was associated with larger atheroma plaque volume and a greater ultrasound attenuation, which are discriminators of plaque vulnerability.

Academic Significance and Societal Importance of the Research Achievements

睡眠呼吸障害の存在が、冠動脈疾患患者におけるプラークの不安定性に関わることを解明したことで、睡眠呼吸障害が冠動脈疾患リスクであることの再認識と治療介入への期待を示唆したと考える。つまり、高血圧症や脂質異常症などの古典的リスクだけでなく、睡眠呼吸障害のスクリーニングの重要性やそれに対する治療アプローチが厳格な冠動脈疾患2次予防戦略のひとつになる可能性があるからである。今後の課題として、睡眠呼吸障害への治療介入が冠動脈硬化の進展予防効果があるかどうか、心筋梗塞や狭心症の発症が抑制できるかなどが検証されるべきである。

Research Products

• [Journal Article] CPAP effects on atherosclerotic plaques in patients with sleep-disordered breathing and coronary artery disease: The ENTERPRISE trial (2019)
  • Author(s): Dohi Tomotaka、Kasai Takatoshi、Endo Hirohisa、Wada Hideki、Yanagisawa Naotake、Nojiri Shuko、Funamizu Takehiro、Shitara Jun、Doi Shinichiro、Kato Yoshiteru、Okai Iwao、Iwata Hiroshi、Isoda Kikuo、Okazaki Shinya、Miyauchi Katsumi、Daida Hiroyuki
  • Journal Title: Journal of Cardiology Volume: 73 Issue: 1 Pages: 89-93
  • DOI: 10.1016/j.jjcc.2018.07.002
  • Peer Reviewed
• [Journal Article] Clinical significance of non-culprit plaque regression following acute coronary syndrome: A serial intravascular ultrasound study (2019)
  • Author(s): Hirohisa Endo, Tomotaka Dohi , Katsumi Miyauchi et al.
  • Journal Title: Journal of Cardiology, Volume: 印刷中 Issue: 2 Pages: 102-108
  • DOI: 10.1016/j.jjcc.2018.12.023
  • Peer Reviewed
• [Journal Article] Culprit Plaque Characteristics in Patients With Sleep‐Disordered Breathing Undergoing Percutaneous Coronary Intervention: An Intravascular Ultrasound Study (2018)
  • Author(s): Wada Hideki、Dohi Tomotaka、Kasai Takatoshi、Yatsu Shoichiro、Naito Ryo、Kato Yoshiteru、Okai Iwao、Iwata Hiroshi、Isoda Kikuo、Okazaki Shinya、Miyauchi Katsumi、Daida Hiroyuki
  • Journal Title: Journal of the American Heart Association Volume: 7 Issue: 19
  • DOI: 10.1161/jaha.118.009826
  • Peer Reviewed / Open Access
• [Journal Article] Relationship between the prognostic nutritional index and long-term clinical outcomes in patients with stable coronary artery disease. (2018)
  • Author(s): Wada H, Dohi T, Miyauchi K, Jun S, Endo H, Doi S, Konishi H, Naito R, Tsuboi S, Ogita M, Kasai T, Okazaki S, Isoda K, Suwa S, Daida H.
  • Journal Title: Journal of Cardiology Volume: 印刷中 Issue: 2 Pages: 155-161
  • DOI: 10.1016/j.jjcc.2018.01.012
  • Peer Reviewed
• [Journal Article] Independent and Combined Effects of Serum Albumin and C-Reactive Protein on Long-Term Outcomes of Patients Undergoing Percutaneous Coronary Intervention (2017)
  • Author(s): Wada H, Dohi T, Miyauchi K, Doi S, Naito R, Konishi H, Tsuboi S, Ogita M, Kasai T, Okazaki S, Isoda K, Suwa S, Daida H.
  • Journal Title: Circulation Journal Volume: 81 Issue: 9 Pages: 1293-1300
  • DOI: 10.1253/circj.CJ-17-0124
  • NAID: 130006003913
  • ISSN: 1346-9843, 1347-4820
  • Peer Reviewed / Open Access
• [Journal Article] Prognostic Impact of the Geriatric Nutritional Risk Index on Long-Term Outcomes in Patients Who Underwent Percutaneous Coronary Intervention. (2017)
  • Author(s): Wada H, Dohi T, Miyauchi K, Doi S, Naito R, Konishi H, Tsuboi S, Ogita M, Kasai T, Hassan A, Okazaki S, Isoda K, Suwa S, Daida H.
  • Journal Title: American Journal of Cardiology Volume: 119 Issue: 11 Pages: 1740-1745
  • DOI: 10.1016/j.amjcard.2017.02.051
  • Peer Reviewed / Open Access
• [Journal Article] Prognostic impact of nutritional status assessed by the Controlling Nutritional Status score in patients with stable coronary artery disease undergoing percutaneous coronary intervention. (2017)
  • Author(s): Wada H, Dohi T, Miyauchi K, Doi S, Konishi H, Naito R, Tsuboi S, Ogita M, Kasai T, Okazaki S, Isoda K, Suwa S, Daida H.
  • Journal Title: Clin Res Cardiol. Volume: 106 Issue: 11 Pages: 875-883
  • DOI: 10.1007/s00392-017-1132-z
  • Peer Reviewed / Open Access
• [Journal Article] Preprocedural High-Sensitivity C-Reactive Protein Predicts Long-Term Outcome of Percutaneous Coronary Intervention (2017)
  • Author(s): Wada H, Dohi T, Miyauchi K, Shitara J, Endo H, Doi S, Naito R, Konishi H, Tsuboi S, Ogita M, Kasai T, Hassan A, Okazaki S, Isoda K, Shimada K, Suwa S, Daida H.
  • Journal Title: Circulation Journal Volume: 81 Issue: 1 Pages: 90-95
  • DOI: 10.1253/circj.CJ-16-0790
  • NAID: 130005252690
  • ISSN: 1346-9843, 1347-4820
  • Peer Reviewed / Open Access
• [Journal Article] Impact of gender difference on long-term outcomes of percutaneous coronary intervention for coronary artery disease in patients under statin treatment. (2017)
  • Author(s): Wada H, Ogita M, Miyauchi K, Shitara J, Endo H, Doi S, Naito R, Konishi H, Tsuboi S, Dohi T, Kasai T, Tamura H, Okazaki S, Isoda K, Suwa S, Daida H.
  • Journal Title: Heart Vessels. Volume: 32 Issue: 1 Pages: 16-21
  • DOI: 10.1007/s00380-016-0835-9
  • Peer Reviewed / Open Access
• [Journal Article] Impact of Lipoprotein(a) on Long-term Outcomes in Patients With Diabetes Mellitus Who Underwent Percutaneous Coronary Intervention. (2016)
  • Author(s): Konishi H, Miyauchi K, Shitara J, Endo H, Wada H, Doi S, Naito R, Tsuboi S, Ogita M, Dohi T, Kasai T, Okazaki S, Isoda K, Suwa S, Daida H.
  • Journal Title: American Journal of Cardiology Volume: 118 Issue: 12 Pages: 1781-1785
  • DOI: 10.1016/j.amjcard.2016.08.067
  • Peer Reviewed / Open Access
• [Journal Article] Prognostic impact of homocysteine levels and homocysteine thiolactonase activity on long-term clinical outcomes in patients undergoing percutaneous coronary intervention. (2016)
  • Author(s): Hassan A, Dohi T, Miyauchi K, Ogita M, Kurano M, Ohkawa R, Nakamura K, Tamura H, Isoda K, Okazaki S, Yatomi Y, Daida H.
  • Journal Title: Journal of Cadiology Volume: in press Issue: 6 Pages: 830-835
  • DOI: 10.1016/j.jjcc.2016.08.013
  • Peer Reviewed / Open Access
• [Journal Article] Combined Effect of Body Mass Index and Renal Function on Long-Term Clinical Outcomes in Elderly Adults After Percutaneous Coronary Intervention. (2016)
  • Author(s): Naito R, Miyauchi K, Konishi H, Tsuboi S, Ogita M, Dohi T, Tamura H, Kasai T, Okazaki S, Isoda K, Daida H.
  • Journal Title: Journal of the American Geriatrics Society Volume: 64 Issue: 9 Pages: 39-41
  • DOI: 10.1111/jgs.14223
  • Peer Reviewed / Open Access
• [Journal Article] Prognostic impact of circulating soluble LR11 on long-term clinical outcomes in patients with coronary artery disease (2016)
  • Author(s): Ogita M, Miyauchi K, Kasai T, Tsuboi S, Wada H, Naito R, Konishi H, Dohi T, Tamura H, Okazaki S, Yanagisawa N, Shimada K, Suwa S, Jiang M, Bujo H, Daida H
  • Journal Title: Atherosclerosis Volume: 244 Pages: 216-221
  • DOI: 10.1016/j.atherosclerosis.2015.11.004
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Temporal Trends in Clinical Outcomes Following Percutaneous Coronary Intervention in Patients with Renal Insufficiency (2016)
  • Author(s): Naito R, Miyauchi K, Shitara J, Endo H, Wada H, Doi S, Konishi H, Tsuboi S, Ogita M, Dohi T, Kasai T, Tamura H, Okazaki S, Isoda K, Daida H.
  • Journal Title: Journal of Atherosclerosis and Thrombosis Volume: 23 Issue: 9 Pages: 1080-1088
  • DOI: 10.5551/jat.34397
  • NAID: 130005261995
  • ISSN: 1340-3478, 1880-3873
  • Peer Reviewed / Open Access
• [Journal Article] Plasma lipoprotein(a) predicts major cardiovascular events in patients with chronic kidney disease who undergo percutaneous coronary intervention. (2016)
  • Author(s): Konishi H, Miyauchi K, Tsuboi S, Ogita M, Naito R, Dohi T, Kasai T, Tamura H, Okazaki S, Isoda K, Daida H.
  • Journal Title: International Journal of Cardiology Volume: 205 Pages: 50-53
  • DOI: 10.1016/j.ijcard.2015.12.007
  • Peer Reviewed / Open Access
• [Presentation] Culprit plaque characteristics in patients with sleep disorder breathing undergoing percutaneous coronary intervention: An intravascular ultrasound study (2018)
  • Author(s): Hideki Wada, Tomotaka Dohi
  • Organizer: 日本心血管インターベンション学会総会
• [Presentation] Impact of Serum Albumin Levels on Long-term Outcomes in Patients Undergoing Percutaneous Coronary Intervention (2016)
  • Author(s): Hideki Wada, Tomotaka Dohi, Katsumi Miyauchi
  • Organizer: American Heart Association’s Scientific Sessions
  • Place of Presentation: アメリカ・ニューオリンズ
  • Int'l Joint Research
• [Presentation] Synergistic Effect of BMI and eGFR on All-cause Mortality in the Elderly following Percutaneous Coronary Intervention (2016)
  • Author(s): R. Naito, K. Miyauchi, J. Shitara, H. Endo, H. Wada, S. Doi, H. Konishi, S. Tsuboi, M. Ogita, T. Dohi, T. Kasai1, H. Tamura, S. Okazaki, K. Isoda, H. Daida
  • Organizer: European Society of Cardiology
  • Place of Presentation: イタリア・ローマ
  • Int'l Joint Research
• [Presentation] Association between sustained increase of c-reactive protein (CRP) and long –term mortality in patients with coronary artery disease treated with percutaneous coronary intervention (2016)
  • Author(s): Shitara J, Ogita M, Miyauchi K, Wada H, Naito R, Konishi H, Tsuboi S, Dohi T, Kasai T, Tamura H, Okazaki S, Isoda K, Suwa S, Daida H
  • Organizer: European Society of Cardiology
  • Place of Presentation: イタリア・ローマ
  • Int'l Joint Research
• [Presentation] 冠動脈疾患患者の長期予後におけるhs-CRP値の性差について (2016)
  • Author(s): 西山大樹、土肥智貴、宮内克己、遠藤裕久、和田英樹、土井信一郎、小西宏和、内藤亮、坪井秀太、荻田学、華藤芳輝、葛西隆敏、田村浩、岡崎真也、磯田、菊生、代田浩之
  • Organizer: 第64回日本心臓病学会学術集会
  • Place of Presentation: 東京