Secular Decreasing Trend in Plasma Eicosapentaenoic and Docosahexaenoic Acids among Patients with Acute Coronary Syndrome from 2011 to 2019: A Single Center Descriptive Study

Despite intensive lipid-lowering interventions, patients treated with statins develop atherosclerotic cardiovascular disease (ASCVD), and these patients have an increased risk of developing recurrent cardiovascular events during follow-up. Therefore, there is a need to focus on the residual risks in patients in statin therapy to further reduce ASCVD. The aim of this study was to retrospectively investigate the 10-year trend (2011-2019) regarding changes in polyunsaturated fatty acids (PUFAs) in patients with acute coronary syndrome (ACS) in a single center. We included 686 men and 203 women with ACS admitted to Kagawa Prefectural Central Hospital. Plasma PUFAs, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-gamma-linolenic acid (DGLA), were measured at admission for suspected ACS. A secular decreasing trend in the levels of EPA and DHA and the EPA/AA ratio, but not of AA and DGLA, was observed. The analyses based on age (>70 or <70 years) and sex showed that the decreasing trend in the levels of EPA and DHA did not depend on age and remained significant only in men. Further studies are needed to obtain robust evidence to justify that the administration of n-3 PUFA contributes to the secondary prevention of ACS

Cancer activity and bleeding events post-PCI

Purpose : Limited data exist about clinically relevant bleeding events related to antiplatelet therapy after percutaneous coronary intervention (PCI) in cancer patients. We investigated the risk factors for clinically relevant bleeding events in patients with cancer after PCI with stent implantation. Patients and Methods : Patients with solid cancer subjected to first PCI were divided into active (n = 45) and non-active cancer groups (n = 44). The active group included non-operable patients on treatment or with metastasis ; the non-active included those already subjected to or for whom radical surgery was planned within 3 months after the index PCI. Results : During a median follow-up of 2.2 years, 11 bleeding events occurred, with only one occurring in the non-active cancer group. Half of them occurred during the dual-antiplatelet therapy (DAPT) period, and the rest occurred during single-antiplatelet therapy (SAPT) period. Kaplan-Meier analysis showed significantly more bleeding events in the active cancer group (p = 0.010). Multivariate Cox regression hazard analysis revealed cancer activity as a significant independent risk factor for bleeding (p = 0.023) ; but not for three-point major adverse cardiovascular events. Conclusion : Clinically relevant bleeding risk after PCI was significantly lower in non-active cancer. Active cancer group had clinically relevant bleeding during both DAPT and SAPT periods

Acoustic-gravity waves from the source region of the 2011 great Tohoku earthquake (Mw=9.0)

Atmospheric pressure waves were recorded within 5 h after the 2011 great Tohoku earthquake (Mw = 9.0) by sensitive microbarographs at four regional stations and eight International Monitoring System stations at distances up to 6700 km. While its apparent phase velocity between the regional stations is 341 m/s, the global stations indicate weak dispersive wave trains with low frequencies between 1.6 and 4.8 mHz, propagating with an average phase velocity around 364 m/s. The low-frequency waves may be interpreted as acoustic-gravity waves excited by upheaval and depression of the sea surface in the source region due to coseismic uplift and subsidence of the sea bottom during this great thrust earthquake. Assuming the source dimension and the average coseismic vertical displacements of the sea surface, with reference to tsunami observations, we calculate synthetic waveforms for some of the far-field stations by incorporating a standard sound velocity structure in the atmosphere up to an altitude of 220 km. The synthetics provide reasonable explanations for the general features of the observed waveforms, suggesting possible ranges for the source parameters generating these acoustic-gravity waves. Our analysis suggests that the average initial upheaval of the sea surface in the central zones of the source region may exceed 4–6 m and that the risetime of the coseismic deformation may be in the range between 3 and 4 min. In the eastern narrow zone adjacent to the Japan Trench, the deformation has significantly higher initial amplitude and shorter risetime