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Virtual Histology-intravascular ultrasound (VH-IVUS) has been reported to be a useful tool for tissue characterization of coronary atherosclerotic plaque. We investigated relationships between plaque composition and inflammation-related factors possibly contributing to atheromatous plaque formation and progression, since these are largely unknown. Using VH-IVUS, we measured plaque volume and composition at the culprit lesions in patients with stable angina undergoing elective percutaneous coronary intervention (n = 33, 39 de novo lesions), and then analyzed correlations between plaque components and serum levels of inflammatory factors in both aorta and culprit coronary artery obtained by aspiration using a distal protection device. Linear regression analysis revealed that both aortic and coronary LDL cholesterol levels correlated with %plaque burden along the culprit lesions (r = 0.535 and 0.539, respectively), but with none of the plaque components. Of %plaque components, fibro-fatty (FF) correlated positively with both aortic and coronary T cell\u002FB cell ratios (r = 0.335 and 0.359, respectively) whereas necrotic core (NC) correlated negatively with both aortic and coronary T cell\u002FB cell ratios (r = −0.373 and −0.483, respectively). These results suggest that LDL cholesterol may be a good marker for total coronary plaque volume whereas the lymphocyte subset of T cell\u002FB cell ratios may be a good marker for plaque composition, especially FF and NC components volume.",{"EN":132},"Relationships between inflammatory mediators and coronary plaque composition in patients with stable angina investigated by ultrasound radiofrequency data analysis",{"VOID":134},"[\"2982968447889836886\"]",{"VOID":136},"10.1007\u002Fs12928-011-0058-z","PUBLICATION","VERIFIED","2024-05-04T03:13:37.776+00:00","Auto 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Enhanced levels of soluble and membrane-bound CD40 ligand in patients with unstable angina. Possible reflection of T lymphocytes and platelet involvement in the pathogenesis of acute coronary syndromes. Circulation. 1999;100:614–20.",{},{"id":325,"text":326,"url":327,"identifiers":328},"7477ec30-51a7-444b-a404-acde97789d4d","Heeschen C, Dimmeler S, Hamm CW, van den Brand MJ, Boersma E, Zeiher AM, et al. Soluble CD40 ligand in acute coronary syndromes. N Eng J Med. 2003;348:1104–11.","http:\u002F\u002Fwww.nejm.org\u002Fdoi\u002Fabs\u002F10.1056\u002FNEJMoa022600",{"doi":329},"10.1056\u002Fnejmoa022600",{"id":331,"text":332,"url":333,"identifiers":334},"58e89f0a-c164-44ce-92d6-cb214df0209e","Mach F, Schönbeck U, Sukhova GK, Bourcier T, Bonnefoy J-Y, Pober JS, et al. Functional CD40 ligand is expressed on human vascular endothelial cells, smooth muscle cells, and macrophages: Implications for CD40-CD40 ligand signaling in atherosclerosis. 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The prognostic value of C-reactive protein and serum amyloid A protein in severe unstable angina. N Eng J Med. 1994;331:417–24.",{"doi":311},{"id":22,"text":349,"url":22,"identifiers":350},"Maier W, Altwegg LA, Corti R, Gay S, Hersberger M, Maly FE, et al. Inflammatory markers at the site of ruptured plaque in acute myocardial infarction. Locally increased interleukin-6 and serum amyloid A but decreased C-reactive protein. Circulation. 2005;111:1355–61.",{},{"id":307,"text":352,"url":309,"identifiers":353},"Inoue T, Kato T, Uchida T, Sakuma M, Nakajima S, Shibazaki M, et al. Local release of C-reactive protein from vulnerable plaque or coronary arterial wall injured by stenting. J Am Coll Cardiol. 2005;46:239–45.",{"doi":311},{"id":307,"text":355,"url":309,"identifiers":356},"Satoh S, Mori E, Yokoyama S, Kimura Y, Sagara Y, Mori T, et al. Characterization of differences in inflammatory markers and lymphocyte subsets at culprit lesions in patients with stable angina and acute myocardial infarction. Jpn J Interv Cardiol. 2009;23:422–9.",{"doi":311},{"id":307,"text":358,"url":309,"identifiers":359},"Nair A, Kuban BD, Tuzcu EM, Schoenhagen P, Nissen P, Vince DG. Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation. 2002;106:2200–6.",{"doi":311},{"id":307,"text":361,"url":309,"identifiers":362},"Garcia-Garcia HM, Goedhart D, Serruys PW. Relation of plaque size to necrotic core in the three major coronary arteries in patients with acute coronary syndrome as determined by intravascular ultrasonic imaging radiofrequency. Am J Cardiol. 2007;99:790–2.",{"doi":311},{"id":307,"text":364,"url":309,"identifiers":365},"Higashikuni Y, Tanabe K, Yamamoto H, Aoki J, Nakazawa G, Onuma Y, et al. Relationship between coronary artery remodeling and plaque composition in culprit lesions. 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Treatment effect of drug coated balloons is durable to 3years in the femoropopliteal arteries: long term results of the INPACT SFA Randomized Trial. Circ Cardiovasc Interv. 2018;11:e005891.",{"doi":1369},"10.1161\u002FCIRCINTERVENTIONS.117.005891",{"id":22,"text":1371,"url":22,"identifiers":1372},"Gray WA, Keirse K, Soga Y, Benko A, Babaev A, Yokoi Y, et al. A polymer-coated, paclitaxel eluting stent (Eluvia) versus a polymer-free, paclitaxel-coated stent (Zilver PTX) for endovascular femoropopliteal intervention (IMPERIAL): a randomised, non-inferiority trial. Lancet. 2018;392:1541–51.",{"doi":1373},"10.1016\u002FS0140-6736(18)32262-1",{"id":22,"text":1375,"url":22,"identifiers":1376},"Armstrong EJ, Jeon-Slaughter H, Kahlon RS, Niazi KA, Shammas NW, Banerjee S. Comparative outcomes of supera interwoven nitinol vs bare nitinol stents for the treatment of femoropopliteal disease: insights from the XLPAD registry. J Endovasc Ther. 2020;27:60–5.",{"doi":1377},"10.1177\u002F1526602819885652",{"id":22,"text":1379,"url":22,"identifiers":1380},"Davaine JM, Quérat J, Guyomarch B, Brennan MA, Costargent A, Chaillou P, et al. Incidence and the clinical impact of stent fractures after primary stenting for TASC C and D femoropopliteal lesions at 1 year. Eur J Vasc Endovasc Surg. 2013;46:201–12.",{"doi":1381},"10.1016\u002Fj.ejvs.2013.05.010",{"id":22,"text":1383,"url":22,"identifiers":1384},"Tsujimura T, Takahara M, Iida O, Hiramori S, Hayakawa N, Karashima E, et al. One-year clinical outcomes following implantation of InnovaTM self-expanding nitinol stents in patients with peripheral artery diseases presenting femoropopliteal artery lesions. J Atheroscler Thromb. 2019;26:847–55.",{"doi":1385},"10.5551\u002Fjat.47399",{"id":22,"text":1387,"url":22,"identifiers":1388},"Gostev AA, Osipova OO, Cheban AV, Saaya SB, Rubtsun AA, Ignatenko PV, et al. Treatment of long femoropopliteal occlusive lesions with self-expanding interwoven nitinol stent: 24 month outcomes of the STELLA-SUPERA-SIBERIA register trial. J Endovasc Ther. 2023;2:15266028231170124.",{"doi":1389},"10.1177\u002F15266028231170125",{"id":22,"text":1391,"url":22,"identifiers":1392},"Giannopoulos S, Strobel A, Rudofker E, Kovach C, Kokkosis AA, Armstrong EJ. Outcomes of stented vs nonstented femoropopliteal lesions treated with drug-coated balloon angioplasty. J Endovasc Ther. 2023;30:194–203.",{"doi":1393},"10.1177\u002F15266028221079770",{"id":22,"text":1395,"url":22,"identifiers":1396},"Kum S, Ipema J, Huizing E, Tan YK, Lim D, Lok IY, et al. Outcomes of the paclitaxel-eluting Eluvia stent for long femoropopliteal lesions in Asian patients with predominantly chronic limb-threatening ischemia. Vasc Med. 2021;26:267–72.",{"doi":1397},"10.1177\u002F1358863X20987894",{"id":22,"text":1399,"url":22,"identifiers":1400},"Aboyans V, Ricco JB, Bartelink MEL, Björck M, Brodmannet M, Cohnert T, et al. 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS) document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. Endorsed by the European Stroke Organization (ESO), the task force for the diagnosis and treatment of peripheral arterial diseases of the European Society of Cardiology (ESC), and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39:763–816.",{"doi":1401},"10.1093\u002Feurheartj\u002Fehx095",{"id":22,"text":1403,"url":22,"identifiers":1404},"Rogers JH, Lasala JM. Coronary artery dissection and perforation complicating percutaneous coronary intervention. J Invasive Cardiol. 2004;16:493–9.",{},{"id":22,"text":1406,"url":22,"identifiers":1407},"Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019;69:3S-125S.",{"doi":1408},"10.1016\u002Fj.jvs.2019.02.016",{"id":22,"text":1410,"url":22,"identifiers":1411},"Rocha-Singh KJ, Zeller T, Jaff MR. Peripheral arterial calcification: prevalence, mechanism, detection, and clinical implications. Catheter Cardiovasc Interv. 2014;83:E212–20.",{"doi":1412},"10.1002\u002Fccd.25387",{"id":22,"text":1414,"url":22,"identifiers":1415},"Bhatt H, Kovach R, Janzer S, George JC. SUPERA stent outcomes in Above-The-Knee IntervEntions: Effects of COMPression and ELongation (SAKE-COMPEL) Sub-study. Cardiovasc Revasc Med. 2018;19:512–5.",{"doi":1416},"10.1016\u002Fj.carrev.2017.11.007",{"id":22,"text":1418,"url":22,"identifiers":1419},"Patel MR, Conte MS, Cutlip DE, Dib N, Geraghty P, Gray W, et al. Evaluation and treatment of patients with lower extremity peripheral artery disease: consensus definitions from Peripheral Academic Research Consortium (PARC). J Am Coll Cardiol. 2015;65:931–41.",{"doi":1420},"10.1016\u002Fj.jacc.2014.12.036",{"id":22,"text":1422,"url":22,"identifiers":1423},"Iida O, Takahara M, Soga Y, Fujihara M, Kawasaki D, Hirano K, et al. A novel angiographic risk score for femoropopliteal interventions. J Endovasc Ther. 2020;27:967–73.",{"doi":1424},"10.1177\u002F1526602820948472",{"id":22,"text":1426,"url":22,"identifiers":1427},"Davaine JM, Querat J, Kaladji A, Guyomarch B, Chaillou P, Costargent A, et al. Treatment of TASC C and D femoropoliteal lesions with paclitaxel eluting stents: 12 month results of the STELLA-PTX registry. Eur J Vasc Endovasc Surg. 2015;50:631–7.",{"doi":1428},"10.1016\u002Fj.ejvs.2015.07.018",{"id":22,"text":1430,"url":22,"identifiers":1431},"Suzuki K, Ueshima D, Higashitani M, Yamauchi Y, Hozawa K, Hayakawa N, et al. Two-year results of endovascular therapy for femoropopliteal arterydisease in Japan during the introduction of drug-eluting devices. Cardiovasc Interv Ther. 2023;38:113–20.",{"doi":1432},"10.1007\u002Fs12928-022-00873-z",{"id":22,"text":1434,"url":22,"identifiers":1435},"Iida O, Takahara M, Soga Y, Yamaoka T, Fujihara M, Kawasaki D, et al. 1-Year outcomes of fluoropolymer-based drug-eluting stent in femoropopliteal practice: predictors of restenosis and aneurysmal degeneration. JACC Cardiovasc Interv. 2022;15:630–8.",{"doi":1436},"10.1016\u002Fj.jcin.2022.01.019",{"id":22,"text":1438,"url":22,"identifiers":1439},"Bisdas T, Beropoulis E, Argyriou A, Torsello G, Stavroulakis K. 1-Year All-comers analysis of the eluvia drug-eluting stent for long femoropopliteal lesions after suboptimal angioplasty. JACC Cardiovasc Interv. 2018;11:957–66.",{"doi":1440},"10.1016\u002Fj.jcin.2018.03.046",{"id":22,"text":1442,"url":22,"identifiers":1443},"Tan M, Takahara M, Soga Y, Mori S, Tsuchiya T, Mazaki T, et al. Three-year clinical outcomes following implantation of LifeStent self-expanding nitinol stents in patients with femoropopliteal artery lesions. Angiology. 2022;73:244–51.",{"doi":1444},"10.1177\u002F00033197211042685",{"id":22,"text":1446,"url":22,"identifiers":1447},"Scheinert D, Micari A, Brodmann M, Tepe G, Peeters P, Jaff MR, et al. Drug-coated balloon treatment for femoropopliteal artery disease. Circ Cardiovasc Interv. 2018;11:e005654.",{"doi":1448},"10.1161\u002FCIRCINTERVENTIONS.117.005654",{"id":22,"text":1450,"url":22,"identifiers":1451},"Soga Y, Takahara M, Iida O, Tomoi Y, Kawasaki D, Tanaka A, et al. Vessel patency and associated factors of drug-coated balloon for femoropopliteal lesion. J Am Heart Assoc. 2023;12:e025677.",{"doi":1452},"10.1161\u002FJAHA.122.025677",{"id":22,"text":1454,"url":22,"identifiers":1455},"Fujihara M, Takahara M, Iida O, Kawasaki D, Soga Y, Tobita K, et al. Endovascular therapy with interwoven nitinol stent placement after predilation for heavily calcified femoropopliteal artery disease: results of the BURDOCK study. 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Fractional flow reserve (FFR) measurements were performed with motorized pullback imaging in 20 patients who underwent successful percutaneous coronary intervention (PCI) of the left anterior descending artery. Physiological lesion length (PLL) was calculated using frame counts to determine stent length. FFR area was calculated by integrating the FFR values recorded during pullback tracing (FFRarea). The percentage increase in FFR area (%FFRarea) was defined as the ratio of the difference between the pre- and post-intervention FFRarea to the total frame count. The average FFR values were enhanced following PCI, from 0.64 to 0.82, and the median value of the difference between pre- and post-interventional FFR values (D-FFR) and %FFRarea were 0.13 and 10.6%, respectively. The %FFRarea demonstrated a significant positive correlation with D-FFR (R\n                2, 0.61; p \u003C 0.01). PLL tended to be longer and the %FFRarea was smaller in lesions with a gradual pressure-drop pattern than those with an abrupt pressure-drop pattern (35.37 vs. 20.40 mm, p = 0.07; 5.78 vs. 16.21%, p \u003C 0.05, respectively). 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M, Dixon SR, Safian RD, O’Neill WW, Grines CL, Finta B, et al. Diagnosis, management, and clinical outcome of cardiac tamponade complicating percutaneous coronary intervention. Am J Cardiol. 2002;90(11):1183–6.",{"doi":2127},"10.1016\u002FS0002-9149(02)02831-X",{"id":22,"text":2129,"url":22,"identifiers":2130},"Briguori C, Nishida T, Anzuini A, Di Mario C, Grube E, Colombo A. Emergency polytetrafluoroethylene-covered stent implantation to treat coronary ruptures. Circulation. 2000;102(25):3028–31.",{"doi":2131},"10.1161\u002F01.CIR.102.25.3028",{"id":22,"text":2133,"url":22,"identifiers":2134},"Ellis SG, Ajluni S, Arnold AZ, Popma JJ, Bittl JA, Eigler NL, et al. Increased coronary perforation in the new device era. Incidence, classification, management, and outcome. Circulation. 1994;90(6):2725–30.",{"doi":2135},"10.1161\u002F01.CIR.90.6.2725",{"id":22,"text":2137,"url":22,"identifiers":2138},"Ajluni SC, Glazier S, Blankenship L, O’Neill WW, Safian RD. Perforations after percutaneous coronary interventions: clinical, angiographic, and therapeutic observations. Catheter Cardiovasc Diagn. 1994;32(3):206–12.",{"doi":2139},"10.1002\u002Fccd.1810320303",{"id":22,"text":2141,"url":22,"identifiers":2142},"Elsner M, Zeiher AM. Perforation and rupture of coronary arteries. Herz. 1998;23(5):311–8.",{"doi":2143},"10.1007\u002FBF03044364",{"id":22,"text":2145,"url":22,"identifiers":2146},"Holmes DR Jr, Reeder GS, Ghazzal ZM, Bresnahan JF, King SB 3rd, Leon MB, et al. Coronary perforation after excimer laser coronary angioplasty: the excimer laser coronary angioplasty registry experience. J Am Coll Cardiol. 1994;23(2):330–5.",{"doi":2147},"10.1016\u002F0735-1097(94)90415-4",{"id":22,"text":2149,"url":22,"identifiers":2150},"Kini A, Marmur JD, Duvvuri S, Dangas G, Choudhary S, Sharma SK. Rotational atherectomy: improved procedural outcome with evolution of technique and equipment. Single-center results of first 1,000 patients. Catheter Cardiovasc Interv. 1999;46(3):305–11.",{"doi":2151},"10.1002\u002F(SICI)1522-726X(199903)46:3\u003C305::AID-CCD9>3.0.CO;2-U",{"id":22,"text":2153,"url":22,"identifiers":2154},"Schuhlen H, Kastrati A, Dirschinger J, Hausleiter J, Elezi S, Wehinger A, et al. Intracoronary stenting and risk for major adverse cardiac events during the first month. Circulation. 1998;98(2):104–11.",{"doi":2155},"10.1161\u002F01.CIR.98.2.104",{"id":22,"text":2157,"url":22,"identifiers":2158},"Ben-Gal Y, Weisz G, Collins MB, Genereux P, Dangas GD, Teirstein PS, et al. Dual catheter technique for the treatment of severe coronary artery perforations. Catheter Cardiovasc Interv. 2010;75(5):708–12.",{"doi":2159},"10.1002\u002Fccd.22331",{"id":22,"text":2161,"url":22,"identifiers":2162},"Lansky AJ, Yang YM, Khan Y, Costa RA, Pietras C, Tsuchiya Y, et al. Treatment of coronary artery perforations complicating percutaneous coronary intervention with a polytetrafluoroethylene-covered stent graft. Am J Cardiol. 2006;98(3):370–4.",{"doi":2163},"10.1016\u002Fj.amjcard.2006.02.041",{"id":22,"text":2165,"url":22,"identifiers":2166},"Dippel EJ, Kereiakes DJ, Tramuta DA, Broderick TM, Shimshak TM, Roth EM, et al. Coronary perforation during percutaneous coronary intervention in the era of abciximab platelet glycoprotein IIb\u002FIIIa blockade: an algorithm for percutaneous management. Catheter Cardiovasc Interv. 2001;52(3):279–86.",{"doi":2167},"10.1002\u002Fccd.1065",{"id":22,"text":2169,"url":22,"identifiers":2170},"Gruberg L, Pinnow E, Flood R, Bonnet Y, Tebeica M, Waksman R, et al. Incidence, management, and outcome of coronary artery perforation during percutaneous coronary intervention. Am J Cardiol. 2000;86(6):680–2.",{"doi":2171},"10.1016\u002FS0002-9149(00)01053-5",{"id":2173,"createTime":2174,"updateTime":2175,"relativeEntities":2176,"slug":2177,"properties":2178,"entityType":137,"verifyStatus":138,"verifyTime":2189,"verifyNote":140,"languages":22,"translateLanguages":22,"viewCount":23,"primaryUrl":2190,"fullTextUrl":22,"authors":2191,"publicationType":242,"publisherRelationship":2515,"citationCount":114,"citationInfo":2570,"publishDate":2572,"publishYear":568,"citationAnalyzeStatus":21,"lastCitationAnalyze":2573,"indexDatabases":2574,"openAccess":22,"references":22,"isForceReanalyzing":414},"a8144b0c-7a46-42df-809c-4119fd8a3d9b","2023-11-08T10:22:31.258+00:00","2026-04-21T11:21:01.224+00:00",[],"Japanese-high-bleeding-risk-criteria-status-predicts-low-thrombogenicity-and-bleeding-events-in-patients-undergoing-percutaneous-coronary-intervention",{"abstract":2179,"title":2181,"gsPaper":2183,"references":2185,"doi":2187},{"EN":2180},"Although the Japanese high bleeding risk criteria (J-HBR) were established to predict bleeding risk in patients undergoing percutaneous coronary intervention (PCI), the thrombogenicity in the J-HBR status remains unknown. Here, we examined the relationships among J-HBR status, thrombogenicity and bleeding events. This study was a retrospective analysis of 300 consecutive patients who underwent PCI. Blood samples obtained on the day of PCI were used in the total thrombus-formation analysis system (T-TAS) to investigate the thrombus-formation area under the curve (AUC; PL18-AUC10 for platelet chip; AR10-AUC30 for atheroma chip). The J-HBR score was calculated by adding 1 point for any major criterion and 0.5 point for any minor criterion. We assigned patients to three groups based on J-HBR status: a J-HBR-negative group (n = 80), a low score J-HBR-positive group (positive\u002Flow, n = 109), and a high score J-HBR-positive group (positive\u002Fhigh, n = 111). The primary end point was the 1-year incidence of bleeding events defined by the Bleeding Academic Research Consortium types 2, 3, or 5. Both PL18-AUC10 and AR10-AUC30 levels were lower in the J-HBR-positive\u002Fhigh group than the negative group. Kaplan–Meier analysis showed worse 1-year bleeding event-free survival in the J-HBR-positive\u002Fhigh group compared with the negative group. In addition, both T-TAS levels in J-HBR positivity were lower in those with bleeding events than in those without bleeding events. In multivariate Cox regression analyses, the J-HBR-positive\u002Fhigh status was significantly associated with 1-year bleeding events. In conclusion, the J-HBR-positive\u002Fhigh status could reflect low thrombogenicity as measured by T-TAS and high bleeding risk in patients undergoing PCI.",{"EN":2182},"Japanese high bleeding risk criteria status predicts low thrombogenicity and bleeding events in patients undergoing percutaneous coronary intervention",{"VOID":2184},"[\"13831147138103656926\"]",{"VOID":2186},"Palmerini T, Benedetto U, Bacchi-Reggiani L, Della Riva D, Biondi-Zoccai G, Feres F, et al. Mortality in patients treated with extended duration dual antiplatelet therapy after drug-eluting stent implantation: a pairwise and Bayesian network meta-analysis of randomised trials. Lancet. 2015;385:2371–82.\nUrban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the academic research consortium for high bleeding risk. Eur Heart J. 2019;40:2632–53.\nUrban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention. Circulation. 2019;140:240–61.\nUeki Y, Bär S, Losdat S, Otsuka T, Zanchin C, Zanchin T, et al. Validation of the academic research consortium for high bleeding risk (ARC-HBR) criteria in patients undergoing percutaneous coronary intervention and comparison with contemporary bleeding risk scores. EuroIntervention. 2020;16:371–9.\nNatsuaki M, Morimoto T, Shiomi H, Yamaji K, Watanabe H, Shizuta S, et al. Application of the academic research consortium high bleeding risk criteria in an all-comers registry of percutaneous coronary intervention. Circ Cardiovasc Interv. 2019;12: e008307.\nNakamura M, Kadota K, Nakao K, Nakagawa Y, Shite J, Yokoi H, et al. High bleeding risk and clinical outcomes in East Asian patients undergoing percutaneous coronary intervention: the PENDULUM registry. EuroIntervention. 2021;16:1154–62.\nCao D, Mehran R, Dangas G, Baber U, Sartori S, Chandiramani R, et al. Validation of the academic research consortium high bleeding risk definition in contemporary PCI patients. J Am Coll Cardiol. 2020;75:2711–22.\nNakamura M, Iijima R. Implications and characteristics of high bleeding risk in East Asian patients undergoing percutaneous coronary intervention: start with what is right rather than what is acceptable. J Cardiol. 2021;78:91–8.\nNatsuaki M, Morimoto T, Yamaji K, Watanabe H, Yoshikawa Y, Shiomi H, et al. Prediction of thrombotic and bleeding events after percutaneous coronary intervention: CREDO-Kyoto thrombotic and bleeding risk scores. J Am Heart Assoc. 2018;7:e008708.\nNakamura M, Kitazono T, Kozuma K, Sekine T, Nakamura S, Shiosakai K, et al. Prasugrel for Japanese patients with ischemic heart disease in long-term clinical practice (PRASFIT-Practice II) - 1-year follow-up results of a postmarketing observational study. Circ J. 2019;84:101–8.\nNumasawa Y, Kohsaka S, Ueda I, Miyata H, Sawano M, Kawamura A, et al. Incidence and predictors of bleeding complications after percutaneous coronary intervention. J Cardiol. 2017;69:272–9.\nNakamura M, Kimura K, Kimura T, Ishihara M, Otsuka F, Kozuma K, et al. JCS 2020 guideline focused update on antithrombotic therapy in patients with coronary artery disease. Circ J. 2020;84:831–65.\nNatsuaki M, Morimoto T, Shiomi H, Ehara N, Taniguchi R, Tamura T, et al. Application of the modified high bleeding risk criteria for Japanese patients in an all-comers registry of percutaneous coronary intervention - from the CREDO-Kyoto registry cohort-3. Circ J. 2021;85:769–81.\nShimizu T, Sakuma Y, Kurosawa Y, Muto Y, Sato A, et al. Validation of Japanese bleeding risk criteria in patients after percutaneous coronary intervention and comparison with contemporary bleeding risk criteria. Circ Rep. 2022. https:\u002F\u002Fdoi.org\u002F10.1253\u002Fcircrep.CR-22-0023.\nKaikita K, Hosokawa K, Dahlen JR, Tsujita K. Total thrombus-formation analysis system (T-TAS): clinical application of quantitative analysis of thrombus formation in cardiovascular disease. Thromb Haemost. 2019;119:1554–62.\nIto M, Kaikita K, Sueta D, Ishii M, Oimatsu Y, Arima Y, et al. Total thrombus-formation analysis system (T-TAS) can predict periprocedural bleeding events in patients undergoing catheter ablation for atrial fibrillation. J Am Heart Assoc. 2016;5:e002744.\nOimatsu Y, Kaikita K, Ishii M, Mitsuse T, Ito M, Arima Y, et al. Total thrombus-formation analysis system predicts periprocedural bleeding events in patients with coronary artery disease undergoing percutaneous coronary intervention. J Am Heart Assoc. 2017;6:e005263.\nMitsuse T, Kaikita K, Ishii M, Oimatsu Y, Nakanishi N, Ito M, et al. Total thrombus-formation analysis system can predict 1-year bleeding events in patients with coronary artery disease. J Atheroscler Thromb. 2020;27:215–25.\nNakanishi N, Kaikita K, Ishii M, Kuyama N, Tabata N, Ito M, et al. Development and assessment of total thrombus-formation analysis system-based bleeding risk model in patients undergoing percutaneous coronary intervention. Int J Cardiol. 2021;325:121–6.\nNakanishi N, Kaikita K, Ishii M, Kuyama N, Tabata N, Ito M, et al. Hemodialysis-related low thrombogenicity measured by total thrombus-formation analysis system in patients undergoing percutaneous coronary intervention. Thromb Res. 2021;200:141–8.\nNakanishi N, Kaikita K, Ishii M, Kuyama N, Tabata N, Ito M, et al. Malnutrition-associated high bleeding risk with low thrombogenicity in patients undergoing percutaneous coronary intervention. Nutr Metab Cardiovasc Dis. 2022;32:1227–35.\nMaisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347:161–7.\nHill SA, Booth RA, Santaguida PL, Don-Wauchope A, Brown JA, Oremus M, et al. Use of BNP and NT-proBNP for the diagnosis of heart failure in the emergency department: a systematic review of the evidence. 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Int J Cardiol. 2015;197:98–100.\nMehran R, Rao SV, Bhatt DL, Gibson CM, Caixeta A, Eikelboom J, et al. Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the bleeding academic research consortium. Circulation. 2011;123:2736–47.\nValle JA, Shetterly S, Maddox TM, Ho PM, Bradley SM, Sandhu A, et al. Postdischarge bleeding after percutaneous coronary intervention and subsequent mortality and myocardial infarction: insights from the HMO research network-stent registry. Circ Cardiovasc Interv. 2016;9:e003519.\nPalmerini T, Bacchi Reggiani L, Della Riva D, Romanello M, Feres F, Abizaid A, et al. Bleeding-related deaths in relation to the duration of dual-antiplatelet therapy after coronary stenting. J Am Coll Cardiol. 2017;69:2011–22.\nKaikita K, Yasuda S, Akao M, Ako J, Matoba T, Nakamura M, et al. Bleeding and subsequent cardiovascular events and death in atrial fibrillation with stable coronary artery disease: insights from the AFIRE trial. Circ Cardiovasc Interv. 2021;14: e010476.\nYasuda S, Kaikita K, Akao M, Ako J, Matoba T, Nakamura M, et al. Antithrombotic therapy for atrial fibrillation with stable coronary disease. N Engl J Med. 2019;381:1103–13.\nPalmerini T, Stone GW. Optimal duration of dual antiplatelet therapy after drug-eluting stent implantation: conceptual evolution based on emerging evidence. Eur Heart J. 2016;37:353–64.\nMalinin A, Pokov A, Spergling M, Defranco A, Schwartz K, Schwartz D, et al. Monitoring platelet inhibition after clopidogrel with the VerifyNow-P2Y12(R) rapid analyzer: the VERIfy thrombosis risk assessment (VERITAS) study. Thromb Res. 2007;119:277–84.\nZafar MU, Santos-Gallego CG, Badimon L, Badimon JJ. Badimon perfusion chamber: an ex vivo model of thrombosis. Methods Mol Biol. 2018;1816:161–71.\nNogami K. The utility of thromboelastography in inherited and acquired bleeding disorders. Br J Haematol. 2016;174:503–14.\nTóth O, Calatzis A, Penz S, Losonczy H, Siess W. 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A 64 multi-slice computed tomography (MSCT) demonstrated a non-calcified plaque with positive remodeling. Intravascular ultrasound showed severe attenuation which suggested high risk of coronary no reflow during PCI. In order to avoid this, we used an embolic protection device, Filtrap. Immediately after deployment of a Taxus stent, ST-elevation with chest pain and coronary no reflow appeared. After retrieval of the Filtrap device, ST-elevation and no reflow disappeared. The filter was filled with yellow materials. 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