Prasugrel Monotherapy After Percutaneous Coronary Intervention for Chronic Coronary Syndrome Insights From ASET Pilot Studies

Background The ASET (Acetyl-Salicylic Elimination Trial) pilot studies recently investigated P2Y12 inhibitor monotherapy without aspirin immediately after percutaneous coronary intervention (PCI) in Brazil and Japan. Objectives This comparative analysis of the 2 ASET pilot studies aimed to summarize clinical outcomes and assess geographic and ethnic differences in baseline demographics and procedures. Methods Patients undergoing successful platinum-chromium everolimus-eluting stent implantation for chronic coronary syndrome were included. Following the index PCI, patients received prasugrel monotherapy with a maintenance dose of 10 mg/day in Brazil and 3.75 mg/day in Japan. The primary ischemic endpoint was the composite of cardiac death, spontaneous target vessel myocardial infarction, or definite stent thrombosis. The primary bleeding endpoint was Bleeding Academic Research Consortium types 3 and 5 bleeding at up to 3 months. Result Of 409 enrollments, 3-month follow-up was completed in 406 patients. Mean age was 64.3 ± 8.4 years, and 73% were men. Overall, post-TIMI flow grade 3 was achieved in 99.8%. Intravascular imaging for poststent optimization was used in 16.8% and 99.6% of treated lesions in Brazil and Japan, respectively. The primary ischemic and bleeding endpoints occurred in the same patient (0.2%). No stent thrombosis events occurred. Conclusions Prasugrel monotherapy following PCI was safe and feasible in selected low-risk chronic coronary syndrome patients after optimal platinum-chromium everolimus-eluting stent implantation regardless of the ethnic and geographic differences in baseline demographics, procedures, and prasugrel dosage. Randomized controlled trials will be needed to compare P2Y12 inhibitor monotherapy without aspirin with the current standard of care

Randomized Comparison Between Everolimus-Eluting Bioresorbable Scaffold and Metallic Stent: Multimodality Imaging Through 3 Years

Objectives: The aim of this study was to investigate the vascular responses and fates of the scaffold after bioresorbable vascular scaffold (BVS) implantation using multimodality imaging. Background: Serial comprehen

Geographic disparity of pathophysiological coronary artery disease characteristics: Insights from ASET trials

The geographical disparity in the pathophysiological pattern of coronary artery disease (CAD) among patients undergoing percutaneous coronary intervention (PCI) is unknown. To elucidate the geographical variance in the pathophysiological characteristics of CAD. Physiological indices derived from angiography-based fractional flow reserve pullbacks from patients with chronic coronary syndrome enrolled in the ASET Japan (n = 206) and ASET Brazil (n = 201) studies, which shared the same eligibility criteria, were analysed. The pathophysiological patterns of CAD were characterised using Murray law-based quantitative flow ratio (μQFR)-derived indices acquired from pre-PCI angiograms. The diffuseness of CAD was defined by the μQFR pullback pressure gradient index. Significant functional stenoses pre-PCI (μQFR ≤0.80) were more frequent in ASET Japan compared to ASET Brazil (89.9% vs. 67.5%, p < 0.001), as were rates of a post-PCI μQFR <0.91 (22.1% vs. 12.9%, p = 0.013). In the multivariable analysis, pre-procedural μQFR and diffuse disease were independent factors for predicting a post-PCI μQFR <0.91, which contributed to the different rates of post-PCI μQFR ≥0.91 between the studies. Among vessels with a post-PCI μQFR <0.91, a consistent diffuse pattern of CAD pre- and post-PCI occurred in 78.3% and 76.7% of patients in ASET Japan and Brazil, respectively; only 6.3% (Japan) and 10.0% (Brazil) of vessels had a major residual gradient. Independent risk factors for diffuse disease were diabetes mellitus in ASET Japan, and age and male gender in Brazil. There was geographic disparity in pre-procedural angiography-based pathophysiological characteristics. The combined pre-procedural physiological assessment of vessel μQFR and diffuseness of CAD may potentially identify patients who will benefit most from PCI. [Abstract copyright: Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

肘関節外反スタビライザーとしての屈曲回内筋群のはたらき -投げ型運動における肘関節内側部組織への外反荷重に抗う内反筋力の定量化-

早稲田大学博士(スポーツ科学)早大学位記番号:新9620doctoral thesi

A novel method intersecting three-dimensional motion capture and medial elbow strength dynamometry to assess elbow injury risk in baseball pitchers

Abstract In baseball pitching, resultant elbow varus torque reaches the peak value of 50–120 N m, exceeding the joint failure limit that risks damage to the ulnar collateral ligament (UCL). In-vivo methodology is lacking to assess whether pitchers have sufficient muscular strength to shield UCL and how strongly the elbow musculature must contract to minimize valgus loading on UCL. This study introduces a method to assess relative percentages of muscular varus strength required to unload the UCL. The maximum voluntary isometric varus strength (MVIVS) produced by the medial elbow musculature and the maximum resultant varus torques at elbow in pitching fastballs and other types were measured for two professional pitchers. Simulation was conducted to determine the relative percentages of MVIVS required to unload the UCL to varying degrees and the impact of athletes’ previous UCL reconstruction on the relative percentages was examined. The maximum resultant varus torque in pitching was found to range 72–97%MVIVS depending on the type of pitch. The elbow musculature had to produce 21–49%MVIVS to avoid acute failure of intact UCL whereas the corresponding requirements were 39–63%MVIVS for UCL reconstructed joint. The method offers new insight into baseball pitcher’s training/rehabilitation and physical assessment to reduce the risk of UCL injury

Double Alkylene-Strapped Diphenylanthracene as a Photostable and Intense Solid-State Blue-Emitting Material

We report the synthesis and photochemical and photophysical properties of double alkylene-strapped 9,10-diphenylanthracene derivatives <b>3a</b>–<b>c</b> (<b>a</b>: C6 strap, <b>b</b>: C7 strap, <b>c</b>: C8 strap) in which the reactive central aromatic ring of the anthracene moiety is protected by the double alkylene straps. Thus, <b>3a</b>–<b>c</b> were much more resistant to photochemical reactions than the parent 9,10-diphenylanthracene (DPA). Furthermore, <b>3b</b> in C₆H₁₂ as well as in a cast film and the powder state showed the highest fluorescence quantum yields among <b>3a</b>, <b>3b</b>, quadruple triethylsilyl-protected DPA <b>4</b>, and DPA, wherein the C7 strap in <b>3b</b> effectively serves to block fluorescence self-quenching

Double Alkylene-Strapped Diphenylanthracene as a Photostable and Intense Solid-State Blue-Emitting Material

We report the synthesis and photochemical and photophysical properties of double alkylene-strapped 9,10-diphenylanthracene derivatives <b>3a</b>–<b>c</b> (<b>a</b>: C6 strap, <b>b</b>: C7 strap, <b>c</b>: C8 strap) in which the reactive central aromatic ring of the anthracene moiety is protected by the double alkylene straps. Thus, <b>3a</b>–<b>c</b> were much more resistant to photochemical reactions than the parent 9,10-diphenylanthracene (DPA). Furthermore, <b>3b</b> in C₆H₁₂ as well as in a cast film and the powder state showed the highest fluorescence quantum yields among <b>3a</b>, <b>3b</b>, quadruple triethylsilyl-protected DPA <b>4</b>, and DPA, wherein the C7 strap in <b>3b</b> effectively serves to block fluorescence self-quenching

Double Alkylene-Strapped Diphenylanthracene as a Photostable and Intense Solid-State Blue-Emitting Material

We report the synthesis and photochemical and photophysical properties of double alkylene-strapped 9,10-diphenylanthracene derivatives <b>3a</b>–<b>c</b> (<b>a</b>: C6 strap, <b>b</b>: C7 strap, <b>c</b>: C8 strap) in which the reactive central aromatic ring of the anthracene moiety is protected by the double alkylene straps. Thus, <b>3a</b>–<b>c</b> were much more resistant to photochemical reactions than the parent 9,10-diphenylanthracene (DPA). Furthermore, <b>3b</b> in C₆H₁₂ as well as in a cast film and the powder state showed the highest fluorescence quantum yields among <b>3a</b>, <b>3b</b>, quadruple triethylsilyl-protected DPA <b>4</b>, and DPA, wherein the C7 strap in <b>3b</b> effectively serves to block fluorescence self-quenching

Double Alkylene-Strapped Diphenylanthracene as a Photostable and Intense Solid-State Blue-Emitting Material

We report the synthesis and photochemical and photophysical properties of double alkylene-strapped 9,10-diphenylanthracene derivatives <b>3a</b>–<b>c</b> (<b>a</b>: C6 strap, <b>b</b>: C7 strap, <b>c</b>: C8 strap) in which the reactive central aromatic ring of the anthracene moiety is protected by the double alkylene straps. Thus, <b>3a</b>–<b>c</b> were much more resistant to photochemical reactions than the parent 9,10-diphenylanthracene (DPA). Furthermore, <b>3b</b> in C₆H₁₂ as well as in a cast film and the powder state showed the highest fluorescence quantum yields among <b>3a</b>, <b>3b</b>, quadruple triethylsilyl-protected DPA <b>4</b>, and DPA, wherein the C7 strap in <b>3b</b> effectively serves to block fluorescence self-quenching