Cardiovascular events in Japan. Lessons from the J-ACCESS multicenter prognostic study using myocardial perfusion imaging

Circulation Journal : Official Journal of the Japanese Circulation Society
Kenichi Nakajima, Tsunehiko Nishimura

Abstract

The multicenter Japanese-Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS), which involved 117 institutions and 4,629 patients, was the first attempt to quantify cardiac events and survival using stress-rest-gated single-photon emission computed tomography myocardial perfusion images (MPI) and QGS software in Japan. A 3-year follow-up study showed a relatively lower incidence of hard events than in the USA and some European countries, but a similar role of perfusion and left ventricular (LV) function. A low event risk with normal MPI and a higher incidence of major cardiac events in patients with large perfusion defects and LV dysfunction were defined. MPI was useful even among patients with proven coronary artery stenosis. The association between diabetes and chronic kidney disease (CKD) was an important predictor of cardiac events and the risk was evaluated using new software and risk charts. Additional studies were extended to include asymptomatic diabetes (J-ACCESS 2) and CKD (J-ACCESS 3). Because risk estimation is linked to the national healthcare system and clinical practice, optimal risk stratification and guidance for therapeutic strategies are recommended.

Citations

Feb 12, 2017·European Journal of Preventive Cardiology·Danny Ajp van de SandeHareld Mc Kemps
Jun 28, 2018·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Kenichi NakajimaTsunehiko Nishimura
Nov 2, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Masato OkadaYoshio Yasumura
Dec 20, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Kensuke IzumaruYutaka Kiyohara
May 23, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Tatsuhiko FuruhashiHiroshi Fukuda
Apr 21, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Fei XiaoHuanzi Dai
Feb 19, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Masakazu YamagishiUNKNOWN Japanese Circulation Society Working Group

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