{"id":53,"date":"2022-12-31T22:31:06","date_gmt":"2022-12-31T13:31:06","guid":{"rendered":"https:\/\/hara-heart.com\/blog\/?p=53"},"modified":"2023-01-02T00:35:12","modified_gmt":"2023-01-01T15:35:12","slug":"%e3%82%b9%e3%83%86%e3%83%b3%e3%83%88%e6%b2%bb%e7%99%82%e5%be%8c%e3%81%ae%e6%8a%97%e8%a1%80%e5%b0%8f%e6%9d%bf%e8%96%ac%e3%80%81%e6%8a%97%e5%87%9d%e5%9b%ba%e8%96%ac","status":"publish","type":"post","link":"https:\/\/hara-heart.com\/blog\/archives\/53\/","title":{"rendered":"\u30b9\u30c6\u30f3\u30c8\u6cbb\u7642\u5f8c\u306e\u6297\u8840\u5c0f\u677f\u85ac\u3001\u6297\u51dd\u56fa\u85ac"},"content":{"rendered":"\n<pre class=\"wp-block-preformatted\"><strong><mark style=\"background-color:#f3faff;color:#000088\" class=\"has-inline-color\">\u30b9\u30c6\u30f3\u30c8\u6cbb\u7642\u5f8c\u306b\u6b20\u304b\u305b\u306a\u3044\u304f\u3059\u308a<\/mark><mark style=\"background-color:rgba(0, 0, 0, 0);color:#000088\" class=\"has-inline-color\">\n<\/mark><\/strong>\n\u5fc3\u81d3\u306b\u306f\u3001\u51a0\u52d5\u8108\u3068\u3044\u3046\u5fc3\u81d3\u306e\u7b4b\u8089\uff08\u5fc3\u7b4b\uff09\u306b\u9178\u7d20\u3068\u6804\u990a\u3092\u4f9b\u7d66\u3057\u3066\u3044\u308b\u52d5\u8108\u304c\u3042\u308a\u307e\u3059\u3002\n<a href=\"https:\/\/hara-heart.com\/myocardial-infarction.html\" target=\"_blank\" rel=\"noopener\" title=\"\u5fc3\u7b4b\u6897\u585e\u30fb\u72ed\u5fc3\u75c7\">\u5fc3\u7b4b\u6897\u585e\u30fb\u72ed\u5fc3\u75c7<\/a>\u306f\u3001\u51a0\u52d5\u8108\u3067\u306e\u52d5\u8108\u786c\u5316\u304c\u539f\u56e0\u3068\u306a\u308a\u3001\u8840\u7ba1\u304c\u3064\u307e\u3063\u305f\u308a\u3001\u7d30\u304f\u306a\u3063\u305f\u308a\u3057\u3066\u3001\u5fc3\u7b4b\u3078\u306e\u5341\u5206\u306a\u9178\u7d20\u304c\u4f9b\u7d66\u3067\u304d\u306a\u304f\u306a\u308b\u3053\u3068\u3067\u751f\u3058\u307e\u3059\u3002\n\n<a href=\"https:\/\/hara-heart.com\/myocardial-infarction.html\" target=\"_blank\" rel=\"noopener\" title=\"\u5fc3\u7b4b\u6897\u585e\u30fb\u72ed\u5fc3\u75c7\">\u5fc3\u7b4b\u6897\u585e\u30fb\u72ed\u5fc3\u75c7<\/a>\u3078\u306e\u6cbb\u7642\u3067\u6700\u3082\u591a\u304f\u884c\u308f\u308c\u3066\u3044\u308b\u306e\u304c\u3001\u7d4c\u76ae\u7684\u51a0\u52d5\u8108\u5f62\u6210\u8853\uff08\u30ab\u30c6\u30fc\u30c6\u30eb\u6cbb\u7642\uff09\u3067\u3059\u3002\n\u3053\u306e\u6cbb\u7642\u3067\u306f\u3001\u51a0\u52d5\u8108\u306e\u3064\u307e\u3063\u305f\u308a\u72ed\u304f\u306a\u3063\u3066\u3044\u308b\u90e8\u5206\u306b\u3001\u30b9\u30c6\u30f3\u30c8\u3068\u3044\u3046\u91d1\u5c5e\u306e\u7b52\u3092\u7559\u7f6e\u3057\u307e\u3059\u3002\u3053\u308c\u306b\u3088\u3063\u3066\u8840\u6d41\u3092\u6539\u5584\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002\n\u4e00\u65b9\u3067\u3001\u30b9\u30c6\u30f3\u30c8\u306f\u4f53\u304b\u3089\u3059\u308b\u3068\u7570\u7269\u3067\u3042\u308b\u305f\u3081\u3001\u8840\u306e\u584a\uff08\u8840\u6813\uff09\u304c\u3067\u304d\u3084\u3059\u3044\u3068\u3044\u3046\u554f\u984c\u3082\u3042\u308a\u307e\u3059\u3002\u305d\u306e\u305f\u3081\u3001\u30b9\u30c6\u30f3\u30c8\u6cbb\u7642\u5f8c\u306f\u8840\u6db2\u3092\u30b5\u30e9\u30b5\u30e9\u306b\u3059\u308b\u6297\u8840\u5c0f\u677f\u85ac\u3042\u308b\u3044\u306f\u6297\u51dd\u56fa\u85ac\u3068\u8a00\u308f\u308c\u308b\u85ac\u3092\u5185\u670d\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002\n\n\u9662\u9577\u306f\u3001\u30b9\u30c6\u30f3\u30c8\u6cbb\u7642\u5f8c\u306b<mark style=\"background-color:#fffcbf\" class=\"has-inline-color\">\u300c\u3069\u306e\u3088\u3046\u306a\u6297\u8840\u5c0f\u677f\u85ac\u3042\u308b\u3044\u306f\u6297\u51dd\u56fa\u85ac\u3092\u3001\u3069\u306e\u304f\u3089\u3044\u306e\u671f\u9593\u98f2\u3080\u3079\u304d\u304b\u300d<\/mark>\u306b\u95a2\u3057\u3066\u7814\u7a76\u3057\u3066\u304d\u307e\u3057\u305f\u3002(1-12) \n\u3053\u308c\u3089\u306e\u7d50\u679c\u306b\u3088\u308a\u3001<mark style=\"background-color:#fffcbf\" class=\"has-inline-color has-black-color\">\u60a3\u8005\u3055\u3093\u4e00\u4eba\u4e00\u4eba\u306e\u3054\u75c5\u6c17\u306e\u72b6\u614b\u3084\u4ed6\u306b\u3069\u306e\u3088\u3046\u306a\u85ac\u3092\u5185\u670d\u3057\u3066\u3044\u308b\u304b\u306b\u3088\u3063\u3066\u3001\u3088\u308a\u3088\u3044\u9078\u629e\u80a2\u304c\u5909\u308f\u308b<\/mark>\u3053\u3068\u3082\u308f\u304b\u3063\u3066\u304d\u307e\u3057\u305f\u3002\n\n<strong><mark style=\"background-color:#f3faff;color:#000088\" class=\"has-inline-color\">\u6700\u9069\u306a\u304f\u3059\u308a\u306f\uff1f\u3000\u6700\u8fd1\u306e\u77e5\u898b\u304b\u3089<\/mark><\/strong>\n\n\u65e5\u672c\u4eba\uff08\u30a2\u30b8\u30a2\u4eba\uff09\u306f\u51fa\u8840\u306e\u30ea\u30b9\u30af\u304c\u6b27\u7c73\u4eba\u3088\u308a\u3082\u9ad8\u3044\u3053\u3068\u304c\u77e5\u3089\u308c\u3066\u304a\u308a\u3001\u7406\u60f3\u7684\u306a\u5185\u670d\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u3068\u8003\u3048\u3089\u308c\u3066\u304a\u308a\u307e\u3059\u3002\u65e5\u672c\u3067\u3082\u3044\u304f\u3064\u304b\u306e\u5927\u898f\u6a21\u306a\u691c\u8a3c\u8a66\u9a13\u304c\u884c\u308f\u308c\u3066\u304a\u308a\u307e\u3059\u3002<\/pre>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/1ad1ccb86a6aaf225c0c45db4ca053a4-1-1024x796.jpg\" alt=\"\" class=\"wp-image-64\" width=\"210\" height=\"163\" srcset=\"https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/1ad1ccb86a6aaf225c0c45db4ca053a4-1-1024x796.jpg 1024w, https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/1ad1ccb86a6aaf225c0c45db4ca053a4-1-300x233.jpg 300w, https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/1ad1ccb86a6aaf225c0c45db4ca053a4-1-768x597.jpg 768w, https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/1ad1ccb86a6aaf225c0c45db4ca053a4-1-1536x1195.jpg 1536w, https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/1ad1ccb86a6aaf225c0c45db4ca053a4-1.jpg 2016w\" sizes=\"auto, (max-width: 210px) 100vw, 210px\" \/><\/figure>\n<\/div>\n<\/div>\n\n\n\n<pre class=\"wp-block-preformatted\">\uff11\u3064\u76ee\u306f\u3001STOPDAPT-2\u8a66\u9a13\u3067\u3059\u3002\n\u3053\u306e\u8a66\u9a13\u306f\u3001\u30af\u30ed\u30d4\u30c9\u30b0\u30ec\u30eb\uff08\u30d7\u30e9\u30d3\u30c3\u30af\u30b9\uff09\u3068\u30a2\u30b9\u30d4\u30ea\u30f3\uff08\u30d0\u30a4\u30a2\u30b9\u30d4\u30ea\u30f3\uff09\u306b\u3088\u308b\uff12\u5264\u3092\uff11\u30f6\u6708\u5185\u670d\u3057\u305f\u5f8c\u3001\u30af\u30ed\u30d4\u30c9\u30b0\u30ec\u30eb\uff08P2Y12\u53d7\u5bb9\u4f53\u62ee\u6297\u85ac\uff09\u5358\u5264\u3068\u3059\u308b\u7fa4\u3068\uff12\u5264\u3092\u305d\u306e\u307e\u307e12\u30f6\u6708\u307e\u3067\u7d99\u7d9a\u3059\u308b\u7fa4\u3068\u3092\u6bd4\u8f03\u3057\u305f\u8a66\u9a13\u306b\u306a\u308a\u307e\u3059\u3002\u7d50\u679c\u3068\u3057\u3066\u306f\u3001\u30af\u30ed\u30d4\u30c9\u30b0\u30ec\u30eb\u5358\u5264\u7fa4\u306e\u65b9\u304c\u3001\u865a\u8840\u30fb\u51fa\u8840\u3068\u3044\u3063\u305f\u6709\u5bb3\u4e8b\u8c61\u3092\u512a\u4f4d\u306b\u6e1b\u3089\u3059\u3053\u3068\u304c\u308f\u304b\u308a\u307e\u3057\u305f\u3002(13)\n\n\uff12\u3064\u76ee\u306e\u5927\u304d\u306a\u8a66\u9a13\u306f\u3001AFIRE\u8a66\u9a13\u3067\u3059\u3002\n\u3053\u306e\u8a66\u9a13\u3067\u306f\u3001\u5fc3\u623f\u7d30\u52d5\u3092\u6709\u3059\u308b\u5b89\u5b9a\u51a0\u52d5\u8108\u75be\u60a3\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u6297\u51dd\u56fa\u85ac\u30ea\u30d0\u30fc\u30ed\u30ad\u30b5\u30d0\u30f3\uff08\u30a4\u30b0\u30b6\u30ec\u30eb\u30c8\uff09\u5358\u5264\u7642\u6cd5\u3068\u3001\u30ea\u30d0\u30fc\u30ed\u30ad\u30b5\u30d0\u30f3\u3068\u6297\u8840\u5c0f\u677f\u85ac\uff08\u30a2\u30b9\u30d4\u30ea\u30f3\u3001\u30af\u30ed\u30d4\u30c9\u30b0\u30ec\u30eb\u3001\u307e\u305f\u306f\u30d7\u30e9\u30b9\u30b0\u30ec\u30eb[\u30a8\u30d5\u30a3\u30a8\u30f3\u30c8]\uff09\u306e\uff12\u5264\u4f75\u7528\u7642\u6cd5\u3068\u3092\u6bd4\u8f03\u3057\u3066\u304a\u308a\u307e\u3059\u3002\u6297\u51dd\u56fa\u85ac\u30ea\u30d0\u30fc\u30ed\u30ad\u30b5\u30d0\u30f3\u5358\u5264\u7642\u6cd5\u306e\u65b9\u304c\u3001\u51fa\u8840\u30fb\u6897\u585e\u30a4\u30d9\u30f3\u30c8\u304c\u5c11\u306a\u3044\u3053\u3068\u304c\u308f\u304b\u308a\u307e\u3057\u305f\u3002(14)\n\n\u73fe\u5728\u9032\u884c\u4e2d\u306e\u8a66\u9a13\u306e\uff11\u3064\u3067\u3001\u9662\u9577\u3082\u95a2\u308f\u3063\u3066\u3044\u308b\u3082\u306e\u304c\u3001<a href=\"https:\/\/aset-japan.jp\/jp\/\" target=\"_blank\" rel=\"noopener\" title=\"ASET-JAPAN\u8a66\u9a13\">ASET-JAPAN\u8a66\u9a13<\/a>\u3067\u3059\u3002\u5b89\u5b9a\u51a0\u52d5\u8108\u75be\u60a3\u60a3\u8005200\u4f8b\u3001\u975eST\u4e0a\u6607\u578b\u6025\u6027\u51a0\u75c7\u5019\u7fa4\u60a3\u8005200\u4f8b\u306b\u5bfe\u3057\u3001\u30ab\u30c6\u30fc\u30c6\u30eb\u6cbb\u7642\u76f4\u5f8c\u304b\u3089\u306e\u30d7\u30e9\u30b9\u30b0\u30ec\u30eb\u5358\u5264\u7642\u6cd5\u3092\u5c0e\u5165\u3059\u308b\u3001\u3059\u306a\u308f\u3061\u3001\u3053\u308c\u307e\u3067\u6a19\u6e96\u7684\u306b\u5185\u670d\u3057\u3066\u304d\u305f\u30a2\u30b9\u30d4\u30ea\u30f3\u3092\u5185\u670d\u3057\u306a\u3044\u3001\u3068\u3044\u3046\u8a66\u9a13\u306b\u306a\u308a\u307e\u3059\u3002\n\u540c\u69d8\u306e\u30c7\u30b6\u30a4\u30f3\u306e\u8a66\u9a13\u304c\u30d6\u30e9\u30b8\u30eb\u3067\u884c\u308f\u308c\u3001\u5b89\u5168\u6027\u3092\u78ba\u8a8d\u3067\u304d\u3066\u304a\u308a\u3001\u7d50\u679c\u304c\u671f\u5f85\u3055\u308c\u308b\u8a66\u9a13\u3068\u8a00\u3048\u307e\u3059\u3002(5)<\/pre>\n\n\n\n<figure class=\"wp-block-image size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/5c91aaa31e93343190ebdd38ec1b6010-970x1024.jpg\" alt=\"\" class=\"wp-image-60\" width=\"122\" height=\"128\" srcset=\"https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/5c91aaa31e93343190ebdd38ec1b6010-970x1024.jpg 970w, https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/5c91aaa31e93343190ebdd38ec1b6010-284x300.jpg 284w, https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/5c91aaa31e93343190ebdd38ec1b6010-768x811.jpg 768w, https:\/\/hara-heart.com\/blog\/wp-content\/uploads\/2022\/12\/5c91aaa31e93343190ebdd38ec1b6010.jpg 1185w\" sizes=\"auto, (max-width: 122px) 100vw, 122px\" \/><\/figure>\n\n\n\n<pre class=\"wp-block-preformatted\">\u9662\u9577\u306f\u3001\u65e5\u672c\u5fc3\u8840\u7ba1\u30a4\u30f3\u30bf\u30fc\u30d9\u30f3\u30b7\u30e7\u30f3\u6cbb\u7642\u5b66\u4f1a\u304c\u63d0\u793a\u3057\u3066\u3044\u308b\u300c\u6025\u6027\u5fc3\u7b4b\u6897\u585e\u306e\u6cbb\u7642\u306b\u95a2\u3057\u3066\u306e\u30a8\u30ad\u30b9\u30d1\u30fc\u30c8\u30b3\u30f3\u30bb\u30f3\u30b5\u30b9\u300d\u306e\u4f5c\u6210\u306b\u3082\u643a\u308f\u3063\u3066\u304a\u308a\u307e\u3059\u3002(15)\n\n\u60a3\u8005\u3055\u3093\u4e00\u4eba\u4e00\u4eba\u306e\u72b6\u614b\u3092\u628a\u63e1\u3057\u306a\u304c\u3089\u3001\u60a3\u8005\u3055\u3093\u3068\u76f8\u8ac7\u3057\u306a\u304c\u3089\u85ac\u3092\u6c7a\u3081\u3066\u3044\u304f\u3001\u305d\u3093\u306a\u533b\u7642\u304c\u5927\u5207\u3060\u3068\u611f\u3058\u3066\u304a\u308a\u307e\u3059\u3002\n\n\n\u53c2\u8003\u6587\u732e\n1.\tHara H, Ono M, Kawashima H, Onuma Y, Serruys PW. Trade-off Between Bleeding and Thrombotic Risk in Patients With Academic Research Consortium for High Bleeding Risk. JAMA Cardiol 2021;6:1092-1094.\n2.\tHara H, Takahashi K, Kogame N et al. Impact of Bleeding and Myocardial Infarction on Mortality in All-Comer Patients Undergoing Percutaneous Coronary Intervention. Circ Cardiovasc Interv 2020;13:e009177.\n3.\tGamal AS, Hara H, Tomaniak M et al. 'Ticagrelor alone vs. dual antiplatelet therapy from 1 month after drug-eluting coronary stenting among patients with STEMI': a post hoc analysis of the randomized GLOBAL LEADERS trial. Eur Heart J Acute Cardiovasc Care 2021;10:756-773.\n4.\tGao C, Tomaniak M, Takahashi K et al. Ticagrelor monotherapy in patients with concomitant diabetes mellitus and chronic kidney disease: a post hoc analysis of the GLOBAL LEADERS trial. Cardiovasc Diabetol 2020;19:179.\n5.\tKogame N, Guimaraes PO, Modolo R et al. Aspirin-Free Prasugrel Monotherapy Following Coronary Artery Stenting in Patients With Stable CAD: The ASET Pilot Study. JACC Cardiovasc Interv 2020;13:2251-2262.\n6.\tOno M, Chichareon P, Tomaniak M et al. The association of body mass index with long-term clinical outcomes after ticagrelor monotherapy following abbreviated dual antiplatelet therapy in patients undergoing percutaneous coronary intervention: a prespecified sub-analysis of the GLOBAL LEADERS Trial. Clin Res Cardiol 2020;109:1125-1139.\n7.\tTomaniak M, Chichareon P, Klimczak-Tomaniak D et al. Impact of renal function on clinical outcomes after PCI in ACS and stable CAD patients treated with ticagrelor: a prespecified analysis of the GLOBAL LEADERS randomized clinical trial. Clin Res Cardiol 2020;109:930-943.\n8.\tWang R, Takahashi K, Chichareon P et al. The impact of pre-procedure heart rate on adverse clinical outcomes in patients undergoing percutaneous coronary intervention: Results from a 2-year follow-up of the GLOBAL LEADERS trial. Atherosclerosis 2020;303:1-7.\n9.\tGao C, Buszman P, Buszman P et al. Influence of Bleeding Risk on Outcomes of Radial and Femoral Access for Percutaneous Coronary Intervention: An Analysis From the GLOBAL LEADERS Trial. Can J Cardiol 2021;37:122-130.\n10.\tGao C, Takahashi K, Garg S et al. Regional variation in patients and outcomes in the GLOBAL LEADERS trial. Int J Cardiol 2021;324:30-37.\n11.\tKawashima H, Tomaniak M, Ono M et al. Safety and Efficacy of 1-Month Dual Antiplatelet Therapy (Ticagrelor + Aspirin) Followed by 23-Month Ticagrelor Monotherapy in Patients Undergoing Staged Percutaneous Coronary Intervention (A Sub-Study from GLOBAL LEADERS). Am J Cardiol 2021;138:1-10.\n12.\tOno M, Hara H, Kawashima H et al. Ticagrelor monotherapy versus aspirin monotherapy at 12 months after percutaneous coronary intervention: a landmark analysis of the GLOBAL LEADERS trial. EuroIntervention 2022.\n13.\tWatanabe H, Domei T, Morimoto T et al. Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial. JAMA 2019;321:2414-2427.\n14.\tYasuda S, Kaikita K, Akao M et al. Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease. N Engl J Med 2019;381:1103-1113.\n15.\tOzaki Y, Hara H, Onuma Y et al. CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) update 2022. 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