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FUJITA Kosuke

    Department of Medicine　Lecturer in Medical School
Last Updated :2024/04/19

Researcher Information

J-Global ID

Research Areas

  • Life sciences / Cardiology

Published Papers

  • Kenji Yamaji; Yoshitaka Iwanaga; Kazuyoshi Kakehi; Kosuke Fujita; Takayuki Kawamura; Chikara Hirase; Masafumi Ueno; Gaku Nakazawa
    International heart journal 65 (1) 13 - 20 2024 
    Recent studies have showed that asymptomatic cerebral infarction (ACI) developed in a reasonable number of patients after cardiac catheterization. However, no study has investigated the long-term prognostic impact of ACI after cardiac catheterization. We investigated whether ACI after cardiac catheterization affects long-term mortality and subsequent cardiovascular events.We retrospectively enrolled patients who underwent cardiac catheterization before cardiac surgery and cerebral diffusion-weighted magnetic resonance imaging (DWI). The incidence and clinical features of ACI were investigated. The long-term prognosis, including all-cause mortality and subsequent major cardiovascular events (MACE; all-cause mortality, stroke, acute myocardial infarction, fatal arrhythmia, and hospitalized heart failure), was also assessed.A total of 203 patients were enrolled. Of these, 10.3% had ACI diagnosed by DWI. There were no differences in baseline characteristics between patients with and without ACI, except more frequent history of symptomatic stroke in patients with ACI. In the Kaplan-Meier analysis during a median follow-up of 1009 days, the patients with ACI showed worse mortality and a slightly higher occurrence of MACE compared with those without ACI (P = 0.01 and P = 0.08, respectively). In addition, ACI was a prognostic marker independent of age, surgery type, and history of stroke.ACI after cardiac catheterization frequently developed and was also associated with long-term prognosis. It may be an independent prognostic marker in high-risk patients who underwent subsequent cardiac surgery.
  • Kosuke Fujita; Masafumi Ueno; Masakazu Yasuda; Kazuki Mizutani; Tatsuya Miyoshi; Gaku Nakazawa
    European heart journal. Case reports 7 (8) ytad369  2023/08 
    BACKGROUND: Recently, mechanical support obtained with the combination of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and an Impella device, together referred to as ECPELLA, has been shown to be effective for acute myocardial infarction with cardiogenic shock. However, methods for withdrawing VA-ECMO in acute myocardial infarction cases complicated by right ventricular dysfunction are yet to be established. Here, we report the effective use of inhaled nitric oxide during the weaning of VA-ECMO from the ECPELLA management of a patient with acute myocardial infarction with cardiogenic shock. CASE SUMMARY: An 81-year-old man with an acute extensive anterior wall myocardial infarction with cardiogenic shock was supported with ECPELLA to improve his haemodynamics. During ECPELLA, the Impella device could not maintain sufficient flow. Echocardiography revealed a small left ventricle and an enlarged right ventricle, indicating acute right heart failure. Inhaled nitric oxide was initiated to reduce right ventricle afterload, which decreased pulmonary artery pressure from 34/20 to 27/13 mmHg, improved right and left ventricle sizes, and stabilized the Impella support. Afterward, VA-ECMO could be withdrawn because the Impella alone was sufficient for haemodynamic support. DISCUSSION: Inhaled nitric oxide improved right ventricle performance in a patient with severe myocardial infarction with right heart failure supported by ECPELLA. Thus, we suggest that inhaled nitric oxide facilitates the weaning of VA-ECMO from patients with refractory right ventricular dysfunction who are supported by ECPELLA.
  • Kenji Yamaji; Yoshitaka Iwanaga; Takayuki Kawamura; Kosuke Fujita; Masakazu Yasuda; Toru Takase; Chikara Hirase; Masafumi Ueno; Gaku Nakazawa
    Journal of cardiology Elsevier BV 80 (1) 94 - 100 0914-5087 2022/07 
    BACKGROUND: The plaques with higher grade of yellow color by angioscopy are reported to be associated with vulnerability leading to adverse outcomes in coronary artery diseases. However, no studies have been performed for peripheral artery disease (PAD). We aimed to evaluate the relationship of angioscopic findings of peripheral arteries with the long-term prognosis. METHODS: Angioscopy of iliac or femoropopliteal artery was performed before endovascular therapy in patients with PAD. The local plaque color and presence of thrombus were evaluated. Multivariable Cox regression models were used to estimate hazard ratio (HR) for all-cause mortality or major adverse cardiovascular event (MACE) related to the plaque colors as well as presence of thrombus. RESULTS: Among 67 patients, 49.3% had intensive yellow plaques (group H) and the rest had light yellow to yellow ones (group L). Thrombus was detected in 74.6% of the patients and the presence was not different between the two groups. In Kaplan-Meier analysis during a median follow-up of 976 days and 757 days, group H showed increased mortality and MACE compared with group L (p <0.01 for both). Multivariable analysis demonstrated that the intensive yellow color of plaque was independently associated with mortality and MACE [HR: 11.48, 95% confidence interval (CI): 2.19-211.1 and HR: 3.81, 95% CI: 1.36-13.48, respectively] after adjusting for the presence of thrombus. CONCLUSIONS: The yellow color intensity in local plaques by angioscopy may be a novel predictor of long-term prognosis in patients with PAD, regardless of the presence of thrombus.
  • 左冠動脈主幹部病変に対する血行再建方法に関する治療ガイドラインを見直す
    水谷 一輝; 河村 尚幸; 藤田 晃輔; 安田 昌和; 上野 雅史; 中澤 学
    日本心臓病学会学術集会抄録 (一社)日本心臓病学会 69回 FCS3 - 3 2021/09
  • Higher Grade of Yellow Plaque Color is a Novel Predictor for Mortality in Patients with Peripheral Arterial Disease: Angioscopy Analysis(和訳中)
    山治 憲司; 岩永 善高; 藤田 晃輔; 河村 尚幸; 安田 昌和; 渡邉 平太郎; 高瀬 徹; 中村 貴; 上野 雅史; 中澤 学
    日本循環器学会学術集会抄録集 (一社)日本循環器学会 85回 OJ68 - 6 2021/03
  • 家族性高コレステロール血症患者が急性冠症候群を発症し、PCSK9治療の導入前後の冠動脈をOCTで観察できた一例
    高瀬 徹; 上野 雅史; 藤田 晃輔; 渡辺 平太郎; 山治 憲司; 岩永 善高; 宮崎 俊一
    日本心血管インターベンション治療学会抄録集 (一社)日本心血管インターベンション治療学会 27回 MO362 - MO362 2018/08
  • Critical Hand IschemiaのCTO病変に対して血管内視鏡を施行した1例
    鍵岡 賛典; 山治 憲司; 藤田 晃輔; 河村 尚幸; 上野 雅史; 生田 新一郎; 小夫家 和宏; 岩永 善高; 宮崎 俊一
    心臓血管内視鏡 日本心臓血管内視鏡学会 3 (Suppl.) s60 - s60 2188-6571 2017/11
  • 心サルコイドーシスの脚ブロックおよびQRS分裂がもつ臨床的重要性(Clinical Significance of Bundle Branch Block and Fragmented QRS in Cardiac Sarcoidosis)
    丸山 将広; 岩永 善高; 鍵岡 賛典; 藤田 晃輔; 河村 尚幸; 中村 貴; 安田 昌和; 栗田 隆志; 宮崎 俊一
    日本循環器学会学術集会抄録集 (一社)日本循環器学会 81回 PJ - 158 2017/03
  • 薬剤溶出性ステント留置後の追跡冠動脈造影でステント内に透亮像を認めた症例の病態診断に光干渉断層法が有用であった1例
    藤田 晃輔; 上野 雅史; 安田 昌和; 池田 智之; 中村 貴; 岩永 善高; 宮崎 俊一
    日本心血管インターベンション治療学会抄録集 (一社)日本心血管インターベンション治療学会 25回 MO006 - MO006 2016/07
  • Masafumi Ueno; Kosuke Fujita; Hiroyuki Yamamoto; Tomoyuki Ikeda; Tatsuya Suga; Kenji Yamaji; Shinichiro Ikuta; Kazuhiro Kobuke; Yoshitaka Iwanaga; Dominick J. Angiolillo; Shunichi Miyazaki
    JOURNAL OF THROMBOSIS AND THROMBOLYSIS SPRINGER 40 (2) 174 - 181 0929-5305 2015/08 [Refereed]
     
    Although patients with impaired glucose tolerance (IGT) are at increased atherothrombotic risk, it is unclear how antiplatelet drugs act in patients with IGT. The aim of this study was to investigate the pharmacodynamic response to clopidogrel in patients with IGT and insulin resistance (IR). A 75 g oral glucose tolerance test was performed in 65 coronary artery disease (CAD) patients on aspirin and clopidogrel therapy. Platelet function tests were assessed at 3 time-points by light transmittance aggregometry using ADP (5 and 20 mu mol/L) stimuli. 30 patients had IGT and 35 normal glucose tolerance (NGT). Among them, 13 patients showed IR. Following ADP stimuli, patients with IGT showed significantly higher maximal platelet aggregation at each time point than those with NGT patients. This resulted in greater high on-treatment platelet reactivity (HPR) rates at each time point in IGT patients (53.3-36.7 vs. 14.3-11.4 %, p < 0.05). A multivariable logistic regression analysis showed that IGT status was the strongest predictor of HPR (odds ratio 7.54, 95 % CI 1.95-29.1, p = 0.003). Following a glucose load, profiles of platelet reactivity varied according to IR status, with minimal changes over time in patients with IR, while there was a significant reduction in the non-IR patients. In aspirin and clopidogrel-treated patients with CAD, IGT is associated with enhanced platelet reactivity and increased rates of HPR compared with NGT patients. These findings suggest the presence of platelet dysfunction in patients with IGT, which may be attributed to the presence of IR.
  • 症例検討：陳旧性心筋梗塞患者に合併した重症心室頻拍ストームに対して緊急アブレーションが奏功した１例
    藤田 晃輔; 赤岩 譲; 栗田 隆志; 小竹 康仁; 磯野 員理; 安田 昌和; 野並 有紗; 安岡 良文; 小林 直也; 生田 新一郎; 元木 康一郎; 谷口 貢; 宮崎 俊一
    Osaka Heart Club Osaka Heart Club 大阪ハートクラブ 36 (9) 6 - 12 2013/03 
    医局論文番号524

Conference Activities & Talks

  • BMS留置術部に生じた超遅発性ステント血栓症に対して血管内視鏡検査を用いて評価し得た１例  [Not invited]
    藤田 晃輔; 上野 雅史; 生田 新一郎; 山本 広之; 安田 昌和; 池田 智之; 菅 竜也; 山治 憲司; 小夫家 和宏; 岩永 善高; 宮崎 俊一
    第27回 日本冠疾患学会学術集会  2013/12  和歌山市  第27回 日本冠疾患学会学術集会
  • 肝細胞癌に対するラジオ波施行後に生じた、たこつぼ型心筋障害の１例  [Not invited]
    河村 尚幸; 池田 智之; 上野 雅史; 藤田 晃輔; 八木 英次郎; 磯野 員理; 生田 新一郎; 平野 豊; 宮崎 俊一
    第21回 日本心血管インターベンション治療学会近畿地方会  2013/10  豊中市  第21回 日本心血管インターベンション治療学会近畿地方会
  • 当院における超遅発性ステント内血栓症に対する血管内視鏡からの検討  [Not invited]
    藤田 晃輔; 上野 雅史; 生田 新一郎; 山本 広之; 安田昌和; 池田 智之; 菅 竜也; 山治 憲司; 小夫家 和宏; 岩永 善高; 宮崎 俊一
    第21回 日本血管生物医学会学術集会  2013/09  豊中市  第21回 日本血管生物医学会学術集会
  • PCI後に超遅発性ステント血栓症を起こした症例に対して血管内視鏡を用いて得られた特徴的所見および検討  [Not invited]
    藤田 晃輔; 上野 雅史; 生田 新一郎; 山本 広之; 安田 昌和; 池田 智之; 菅 竜也; 山治 憲司; 小夫家 和宏; 岩永 善高; 宮崎 俊一
    第22回 日本心血管インターベンション治療学会学術集会 CVIT2013  2013/07  神戸市  第22回 日本心血管インターベンション治療学会学術集会 CVIT2013
  • スタチン使用による脂質低下療法と薬剤溶出性ステント留置後のストラット被覆度に対するOCTを用いた検討  [Not invited]
    生田 新一郎; 上野 雅史; 山治 憲司; 藤田 晃輔; 山本 広之; 安田 昌和; 池田 智之; 菅 竜也; 小夫家 和宏; 岩永 善高; 宮崎 俊一
    第22回 日本心血管インターベンション治療学会学術集会 CVIT2013  2013/07  神戸市  第22回 日本心血管インターベンション治療学会学術集会 CVIT2013
  • 冠動脈バイパス術後に左冠動脈主幹部に高度石灰化を伴う狭窄病変が出現し、治療方針が悩まれた1症例  [Not invited]
    池田 智之; 上野 雅史; 藤田 晃輔; 安田 昌和; 諸岡 花子; 生田 新一郎; 森本 啓介; 小夫家 和宏; 宮崎 俊一
    第35回 循環器内科・外科フォーラム  2013/02  ブリーゼプラザ （大阪市）  第35回 循環器内科・外科フォーラム
  • 陳旧性心筋梗塞患者に合併した重症心室頻拍ストームに対して緊急アブレーションが奏功した１例  [Not invited]
    藤田 晃輔; 栗田 隆志; 安田 昌和; 赤岩 譲; 野並 有紗; 安岡 良文; 元木 康一郎; 宮崎 俊一
    第113回 日本循環器学会近畿地方会  2012/06  大阪市  第113回 日本循環器学会近畿地方会

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