Valsartan add-on treatment to improve blood pressure control prevented more cardiovascular events than conventional non-ARB treatment in high-risk hypertensive patients in Japan. These benefits cannot be entirely explained by a difference in blood pressure control.

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp arly primary percutaneous coronary intervention (PCI) gives the higher rate of recanalization, contributing to decrease in prevalence of cardiac events and improvement of left ventricular (LV) contractility and survival prognosis. 1-3 Although additional therapies have been reported for cardioprotection after acute myocardial infarction (AMI), 4-6 LV remodeling after AMI is complicated by cardiac failure accompanying enlargement of LV chamber to worsen long-term prognosis. 7, 8 We have often noticed that patients with AMI develops remarkable LV remodeling in the chronic phase in spite of the early recanalization by PCI. Editorial p 2290Erythropoietin (EPO), which controls erythropoiesis, is a glycoprotein hormone with a molecular weight of 34,000 consisting of 165 amino acid residues, and is secreted from the kidney in response to hypoxic stimuli. 9 EPO is expressed by hypoxic-ischemic vascular endothelial cells and myocytes, 10 whose EPO receptors make them potential targets of EPO-mediated endocrine and autocrine/paracrine actions, such as anti-apoptosis and pro-angiogenic properties, resulting in the observation that high-dose EPO reduces infarct size and preserves ventricular function in animal models of reper-

. Of these, the clinical background, risk factors, angiographic findings, acute results of primary percutaneous coronary intervention (PCI) and in-hospital outcomes for 27 young patients <40 (young group), and 338 non-young patients 60≤, <70 years old (non-young group) were retrospectively compared. The young AMI patients were all male. Current smoking, hypercholesterolemia and family history were the most common risk factors in young patients, while hypertension and diabetes mellitus were more prevalent in non-young patients. Young patients had a higher prevalence of single-vessel disease and a lesser incidence of left circumflex coronary artery as a culprit lesion. The young group had high acquisition rates of Thrombolysis In Myocardial Infarction 3 flow just after primary PCI (95.8%) and no in-hospital deaths, which was not significantly different from the non-young group. Conclusions These results suggest that young AMI patients have different clinical characteristics from those in non-young AMI patients, and acute results of primary PCI and in-hospital prognosis in young AMI patients are comparable to those in non-young AMI patients in Japan. (Circ J 2005; 69: 1454 -1458

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SummaryCardiorenal anemia syndrome has recently been receiving greater attention; however, data regarding the relationship between chronic kidney disease (CKD)/anemia on presentation and in-hospital outcome in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are still limited in Japan.A total of 1,447 primary PCI-treated AMI patients were classified into 4 groups according to the presence of CKD and/or anemia on hospital admission (with CKD/with anemia n = 222, with CKD/without anemia n = 299, without CKD/with anemia n = 151, without CKD/without anemia n = 775). Angiographic acute results of primary PCI were similar among the 4 groups. The patients with CKD had a significantly higher in-hospital overall mortality rate than the patients without CKD, and in the presence or absence of CKD, patients with anemia tended to have a higher in-hospital mortality rate than the patients without anemia. According to a multivariate analysis, anemia on admission was found to be an independent predictor of in-hospital mortality, whereas admission CKD and admission eGFR were statistically not independent predictors. Moreover, the multivariable adjusted odds ratio of in-hospital death in AMI patients with CKD alone was 1.855 (95% CI 0.929-3.706), and that in AMI patients with CKD/with anemia was 3.384 (95% CI 1.697-6.748).These results suggest that among real-world, unselected Japanese AMI patients undergoing primary PCI, the combination of CKD and anemia on admission confers significant adverse effects on in-hospital mortality. (Int Heart J 2014; 55: 301-306)