Effect of Heart Failure on Long‐Term Clinical Outcomes After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Severe Coronary Artery Disease

[Background] Heart failure might be an important determinant in choosing coronary revascularization modalities. There was no previous study evaluating the effect of heart failure on long‐term clinical outcomes after percutaneous coronary intervention (PCI) relative to coronary artery bypass grafting (CABG). [Methods and Results] Among 14 867 consecutive patients undergoing first coronary revascularization with PCI or isolated CABG between January 2011 and December 2013 in the CREDO‐Kyoto PCI/CABG registry Cohort‐3, we identified the current study population of 3380 patients with three‐vessel or left main coronary artery disease, and compared clinical outcomes between PCI and CABG stratified by the subgroup based on the status of heart failure. There were 827 patients with heart failure (PCI: N=511, and CABG: N=316), and 2553 patients without heart failure (PCI: N=1619, and CABG: N=934). In patients with heart failure, the PCI group compared with the CABG group more often had advanced age, severe frailty, acute and severe heart failure, and elevated inflammatory markers. During a median 5.9 years of follow‐up, there was a significant interaction between heart failure and the mortality risk of PCI relative to CABG (interaction P=0.009), with excess mortality risk of PCI relative to CABG in patients with heart failure (HR, 1.75; 95% CI, 1.28–2.42; P<0.001) and no excess mortality risk in patients without heart failure (HR, 1.04; 95% CI, 0.80–1.34; P=0.77). [Conclusions] There was a significant interaction between heart failure and the mortality risk of PCI relative to CABG with excess risk in patients with heart failure and neutral risk in patients without heart failure

Effect of self-reported walking difficulty on bone mass and bone resorption marker in Japanese people aged 40?years and over

Background: This study aimed to examine the association of walking difficulty with bone mass or bone turnover among community-dwelling Japanese people aged 40 years and older. Methods: We studied 1097 community-dwelling Japanese people aged 40 years and older (379 men and 718 women) who were invited to participate in periodic health examinations in 2006?2009. Walking difficulty was defined as having difficulty walking 100 m on a level surface (self-administered questionnaire). Calcaneal stiffness index (bone mass) was measured by quantitative ultrasound. Spot urine samples were collected, and urinary N-terminal cross-linking telopeptide of type I collagen (NTx) was measured. Values were corrected for creatinine (Cre) concentration. Results: The prevalence of walking difficulty was significantly higher in women than in men (7.4 vs. 3.4 %, p?=?0.011) and significantly increased with age in men (p for trend?=?0.02) and women (p for trend <0.001). In univariate analysis, men and women with walking difficulty were older (p?<?0.001) and had a lower stiffness index (p?<?0.001), compared with those without walking difficulty. Among women, individuals with walking difficulty had significantly higher urinary NTx/Cre than those without walking difficulty (p?<?0.001); however, this was not so among men (p?=?0.39). Multiple regression analysis adjusted for age, weight, and menopausal status showed a significant association between walking difficulty and lower stiffness index in men (p?=?0.004) and women (p?=?0.005). In women, walking difficulty was significantly associated with higher NTx/Cre (p?=?0.001), but not in men (p?=?0.35). Conclusions: Walking difficulty may contribute to low bone mass in both sexes but might cause high bone turnover in women only

Geochemical and Microstructural Signals in Giant Clam Tridacna maxima Recorded Typhoon Events at Okinotori Island, Japan

To validate the usability of the giant clam shell as a recorder of short-term environmental changes such as typhoons, we collected a live Tridacna maxima from Okinotori Island, Japan, on 15 June 2006. Growth increment thickness, stable isotope ratio (O-18(shell), C-13(shell)), and the barium/calcium ratio (Ba/Ca) in the T.maxima shell sample were measured and compared to Okinotori Island instrumental environmental data. In the outer layer of the shell sample, there were 3656 growth increments per year, as estimated by the O-18(shell) profile compared with sea surface temperature. The growth increments in the specimen were formed daily, and thus, we can determine the date of the sampling points of O-18(shell), C-13(shell) and the Ba/Ca ratio by counting growth increments. After typhoon approach, there is a decrease in increment thickness and some disturbed growth increments. The positive peaks in the shell Ba/Ca ratio and O-18(shell) corresponded to lower sea surface temperature caused by typhoons. These results indicated that the microstructural and geochemical record in Tridacna maxima shells could be useful for detecting past typhoon events

Changes in dynamic drapability of polyester fabrics with weave density, yarn twist and yarn count obtained by regression equations

223-229Somc ncw parameters of dynamic drapability, such as revolving drape increase coefficient (DJ, revolving drape coefficicnt at 200 rpm (D₂₀₀), and dynamic drapc coeflicient at swinging motion (Dd), have been defined using a device of dynamic drape tester and the regression equations are derivcd fi'om mechanical parameters of fabrics obtained Ii'om KES systcm. These equations have been applied to polyester fabrics used for women's fine dress materials and the effects of weave dcnsity, yarn twist and yarn count on these parameters studied. It is observed that Dr and Dd have a maximum value at the optimum weave density. These values increase with the increase in yarn twist in the case of Dechine" fabrics. These values decrease in the case of taffeta fabrics, and increase in the case of georgette with yam count. Changes in D200 with weave density, yarn twist and yarn count are found to be little for all the fabrics. ode number decreases and conventional static drape coefficient (Ds) increases with weave density

Seasonal variations in the nitrogen isotope composition of Okinotori coral in the tropical western Pacific : A new proxy for marine nitrate dynamics

To demonstrate the utility of coral skeletons as a recorder of nitrate dynamics in the surface ocean, we collected coral skeletons of Porites lobata and determined their nitrogen isotope composition (δ15N_[coral]) from 2002 to 2006. Skeletons were collected at Okinotori Island in southwestern Japan, far from any sources of terrestrial nitrogen. Nitrogen isotope compositions along the growth direction were determined at 800 μm intervals (∼1 month resolution) and compared against the skeletal carbon isotope composition (δ13C_[coral-carb]), barium/calcium ratio (Ba/Ca), and Chlorophyll-a concentration (Chl-a). From 2002 to 2004, ratios of the δ15N_[coral] varied between +0.8 and +8.3‰ with inverse variation to SST (r = -0.53). Ba/Ca ratios and Chl-a concentrations were also observed to be high during seasons with low SST. These results suggested that the vertical mixing that occurs during periods of low SST carries nutrients from deeper water (δ15N_[DIN]; +5∼+6‰) to the sea surface. In 2005 onward, δ15N_[coral] and Ba/Ca ratios also had positive peaks even in high SST during periods of transient upwelling caused by frequent large typhoons (maximum wind speed 30 m/s). In addition, low δ15N_[coral] (+0.8∼+2.0‰) four months after the last typhoon implied nitrogen fixation because of the lack of typhoon upwelling through the four years record of δ15N_[coral]. Variations in the δ13C_[coral-carb] and δ15N_[coral] were synchronized, suggesting that nitrate concentration could control zooxanthellae photosynthesis. Our results suggested that δ15N_[coral] holds promise as a proxy for reconstructing the transport dynamics of marine nitrate and thus also a tool for estimating nitrate origins in the tropical and subtropical oceans