Is the secondary prevention strategy with the community-based clinical path effective for the suppression of cardiovascularevents in patients with myocardial infarction?
Project/Area Number |
22590611
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Single-year Grants |
Section | 一般 |
Research Field |
Public health/Health science
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Research Institution | Nippon Medical School |
Principal Investigator |
IBUKI Chikao 日本医科大学, 医学部, 講師 (80193639)
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Project Period (FY) |
2010 – 2012
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Project Status |
Completed (Fiscal Year 2012)
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Budget Amount *help |
¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2012: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2011: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2010: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
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Keywords | 心筋梗塞 / 冠動脈疾患 / 2次予防 / 地域連携 / クリニカルパス / コレステロール / 地域医療 / スタチン / 循環器 / 高血圧 |
Research Abstract |
We investigated whether the therapeutic system with ‘the community-based clinical path for patients with acute myocardial infarction’, based on the guideline for the secondary prevention of myocardial infarction, could contribute to the recurrence of cardiovascular events in coronary heart disease (CHD) patients. We have shown that among patients with CHD 47% cases achieved the target (<100mg/dL) of LDL-cholesterol (LDL-C) proposed by the guideline. In patients treated with percutaneous coronary intervention the % reduction in LDL-C level for the early period (3 months) of the statin treatment was prerequisite for the prevention of future (5 years) coronary events. In the following interventional study focusing on the pathological significance of low level of HDL-cholesterol (HDL-C), pitavastatin administration for patients with CHD with low (< 40mg/dL) HDL-C resulted in the improvement of the lipid profile (increase in HDL-C and decrease in LDL-C/HDL-C ratio) and the reduction of high sensitive troponin T (hsTnT), suggesting that the beneficial effect of the statin treatment against cardiovascular events should be attributable not only to the improvement of the lipid profile but also the alleviation of myocaridial damage. In conclusion our studies clarified the importance of the management of the lipid profile (LDL-C and HDL-C) and the statin treatment in terms of the secondary prevention of CHD. For efficacious management of the ’path’, we have created the educational DVD elucidating the standard care system for myocardial infarction patients, and the DVDs have being delivered to community-based physicians.
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Report
(4 results)
Research Products
(92 results)
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[Journal Article] Links betweensleep disordered breathing,coronaryAtherosclerotic burden, and cardiac biomarkers in patients with stable coronary artery disease2012
Author(s)
Inami T, Seino Y, Otuska T, Yamamoto M, Kimata N, Murakami D, Tkano M, Ohba T, Ibuki C, Mizuno K
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Journal Title
Journal of Cardiology
Volume: 60(3)
Pages: 180-186
Related Report
Peer Reviewed
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[Journal Article] Links between sleep disordered breathing, coronary atherosclerotic burden, and cardiac biomarkers in patients with stable coronary artery disease.2012
Author(s)
Inami T, Seino Y, Otsuka T, Yamamoto M, Kimata N, Murakami D, Takano M, Ohba T, Ibuki C, Mizuno K
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Journal Title
Journal of Cardiology
Volume: 60
Pages: 180-186
Related Report
Peer Reviewed
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[Journal Article] Atypical Exercise Stress Myocardial Perfusion SPECT Imaging in a Patient With Effort Angina Pectoris2011
Author(s)
Otsuka T, Miyauchi H, Ibuki C, Toba M, Tokuyama K, Ishii K, Kodani E, Kusama Y, Atarashi H, Kishida H, Mizuno K
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Journal Title
Circulation Journal
Volume: 75(1)
Pages: 218-220
NAID
URL
Related Report
Peer Reviewed
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[Journal Article] The possibility of delayed arterial healing 5 years after implantation of sirolimus-eluting stents: Serial observations by coronary angioscopy2011
Author(s)
Yamamoto M, Takano M, Murakami D, Inami T, Kobayashi N, Inami S, Okamatsu K, Ohba T, Ibuki C, Hata N, Mizuno K
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Journal Title
American Heart Journal
Volume: 161(6)
Pages: 1200-1206
URL
Related Report
Peer Reviewed
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[Journal Article] 急性心不全2011
Author(s)
雪吹周生,清野精彦
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Journal Title
救急医学救急薬剤プラクティカルガイド
Volume: 35(10)
Pages: 1245-1251
Related Report
Peer Reviewed
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[Journal Article] Secondary preventive effects of a calcium antagonist for ischemic heart attack: randomized parallel comparison with ss-blockers2011
Author(s)
Nakagomi A, Kodani E, Takano H, Uchida T, Sato N, Ibuki C, Kusama Y, Seino Y, Munakata K, Mizuno K, Takano T
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Journal Title
Circulation Journal
Volume: 75(7)
Pages: 1696-1705
URL
Related Report
Peer Reviewed
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[Journal Article] Atypical Exercise Stress Myocardial Perfusion SPECT Imaging in a Patient With Effort Angina Pectoris2011
Author(s)
Otsuka T, Miyauchi H, Ibuki C, Toba M, Tokuyama K, Ishii K, Kodani E, Kusama Y, Atarashi H, Kishida H, Mizuno K
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Journal Title
Circulation Journa
Volume: 75(1)
Pages: 218-220
NAID
Related Report
Peer Reviewed
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[Journal Article] The Possibility of delayed arterial healing 5 years after implantation of sirolimus-eluting stents : Serial observations by coronary angioscopy2011
Author(s)
Yamamoto M, Takano M, Murakami D, Inami T, Kobayashi N, Inami S, Okamatsu K, Ohba T, Ibuki C, Hata N, Mizuno K
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Journal Title
American Heart Journal
Volume: 161(6)
Pages: 1200-1206
Related Report
Peer Reviewed
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[Journal Article] Prevention of Cardiovascular events with calcium channel blocker-based combination therapies in patients with hypertension : a randomized controlled trial2011
Author(s)
Matsuzaki M, Ogihara T, Umemoto S, Rakugi H, Matsuoka H, Shimada K, Abe K, Suzuki N, Eto T, Higaki J, Ito S, Kamiya A, Kikuchi K, Suzuki H, Tei C, Ohashi Y, Saruta T, Combination of Hypertension to Prevent Cardiovascular Events Triap Group (Aoki S, Ibuki C, Murakami D, Ohba T, Seimiya K, Seino Y, Takano M, Tokuyama K, Yodogawa K), K Mizuno
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Journal Title
Journal of Hypetension
Volume: 29(8)
Pages: 1649-1659
Related Report
Peer Reviewed
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[Journal Article] Secondary preventive effects of a calcium antagonist for iscemic heart attack : randomized parallel comparison with β-blockers2011
Author(s)
Nakagomi A, Kodani E, Takano H, Uchida T, Sato N, Ibuki C, Kusama Y, Seino Y, Munakata K, Mizuno K, Takano T
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Journal Title
Circulation Journa
Volume: 75(7)
Pages: 1696-1705
Related Report
Peer Reviewed
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[Presentation] Characteristic Features of Disordered Breathing in the Convalescent PhaseDissection-Comparative Analysis withStable Coronary Artery Disease2013
Author(s)
Seino Y, Kanou S, Shimura T, Kurihara O, Yamamoto M, Kimata M, Inami T, Kobayashi N, Munakata R, Ohba T, IbukiC, Seino Y, Mizuno K
Organizer
第77回日本循環器学会 (Round Table Discussion)
Place of Presentation
パシフィコ横浜
Year and Date
2013-03-15
Related Report
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[Presentation] High-Risk Plaques Associated with Peri-procedural Myocardial Injury Following Perctaneous Coronary Intervention : Assessment by High-Sensitivity Troponin-Tand Optical Coherence Tomography2012
Author(s)
Kurihara O, Yamamoto M, Shimura T, Kimata N, Yamamoto T, Inami T, Munakata R, Murakami D, Abe J, Maruyama M, Takano M, Ohba T, Ibuki C, Seino Y, Mizuno K
Organizer
第76回日本循環器学会
Place of Presentation
福岡
Year and Date
2012-03-18
Related Report
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[Presentation] Prevention of Myocardial Injury with Short-period and High-Statin During Coronary Intervention : PRIMITIVE Study2012
Author(s)
Takano H, Ohba T, Yamamoto E, Miyachi H, Inui K, Kawanaka H, Kamiya M, Kikuchi A, Takahashi Y, Tanabe J, Inami S, Takagi G, Asai K, Yasutake M, Ibuki C, Tanaka K, Kusama Y, Seino Y, Munakata K, Mizuno K
Organizer
第76回日本循環器学会
Place of Presentation
福岡
Year and Date
2012-03-16
Related Report
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[Presentation] Detection of high risk plaque associated with periprocedural myocardial injury following perctaneous coronary intervention assessed by high-sensitivity troponin-T and optical coherence tomography2011
Author(s)
Kurihara O, Yamamoto M, Seino Y, Otsuka T, Negishi K, Inami T, Murakami D, Okamatsu K, Tanako M, Ohba T, Ibuki C, Mizuno K
Organizer
ESC Congress
Place of Presentation
パリ
Year and Date
2011-08-11
Related Report
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[Presentation] Links between Sleep Apnea Syndrome and Aortic Dissection : Differences in Patent Folse Lumen Type versus Thrombossed Type2011
Author(s)
Inami T, Seino Y, Kurihara O, Yamamoto M, Kimata N, Murai K, Murakami D, Takano M, Ohara T, Ibuki C, Hata N., Mizuno K
Organizer
第75回日本循環器学会
Place of Presentation
横浜
Year and Date
2011-08-04
Related Report
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[Presentation] 慢性腎機能障害を有する末梢動脈疾患患者に対する炭酸ガス造影DSA併用カテーテルインターベンションの有用性2010
Author(s)
木股仲恒, 清野精彦, 山本真功, 稲見徹, 村井綱児, 村上大介, 高野雅充, 大場崇芳, 雪吹周生, 川俣博志, 水野杏一
Organizer
第58回日本心臓病学会
Place of Presentation
東京
Year and Date
2010-09-18
Related Report
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[Presentation] 慢性心不全における経口狭心薬療法の有用性と問題点:Real World analysis2010
Author(s)
村井綱児, 清野精彦, 木股仲恒, 山本真功, 稲見徹, 村上大介, 阿部純子, 淀川顕司, 高野雅充, 大場崇芳, 大野則彦, 雪吹周生, 水野杏一, 下村直樹, 福田恵子
Organizer
第58回日本心臓病学会
Place of Presentation
東京
Year and Date
2010-09-17
Related Report
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[Presentation] 重度の睡眠時無呼吸症候群を合併した急性大動脈解離の1症例2010
Author(s)
根岸経太, 栗原理, 木股仲恒, 山本真功, 村井綱児, 村上大介, 阿部純子, 淀川顕司, 高野雅充, 大野則彦, 大揚崇芳, 雪吹周生, 清野精彦, 水野杏一
Organizer
第217回日本循環器学会関東甲信越地方会
Place of Presentation
東京
Year and Date
2010-09-11
Related Report
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