Differences in coronary risk factors, procedural characteristics, mortality and stent thrombosis between two all-comers percutaneous coronary intervention registries from Europe and Japan: a patient-level data analysis of the Bern-Rotterdam and j-Cypher registries

Aims: The reported rate of stent thrombosis (ST) after drug-eluting stent (DES) implantation varies among registries. To investigate differences in baseline characteristics and clinical outcome in European and Japanese all-comers registries, we performed a pooled analysis of patient-level data. Methods and results: The j-Cypher registry (JC) is a multicentre observational study conducted in Japan, including 12,824 patients undergoing SES implantation. From the Bern-Rotterdam registry (BR) enrolled at two academic hospitals in Switzerland and the Netherlands, 3,823 patients with SES were included in the current analysis. Patients in BR were younger, more frequently smokers and presented more frequently with ST-elevation myocardial infarction (MI). Conversely, JC patients more frequently had diabetes and hypertension. At five years, the definite ST rate was significantly lower in JC than BR (JC 1.6% vs. BR 3.3%, p<0.001), while the unadjusted mortality tended to be lower in BR than in JC (BR 13.2% vs. JC 14.4%, log-rank p=0.052). After adjustment, the j-Cypher registry was associated with a significantly lower risk of all-cause mortality (HR 0.56, 95% CI: 0.49-0.64) as well as definite stent thrombosis (HR 0.46, 95% CI: 0.35-0.61). Conclusions: The baseline characteristics of the two large registries were different. After statistical adjustment, JC was associated with lower mortality and ST.

Potential Future Coral Habitats Around Japan Depend Strongly on Anthropogenic CO2 Emissions

Using the results from the NCAR CSM1.4-coupled global carbon cycle– climate model under the Intergovernmental Panel on Climate Change (IPCC) emission scenarios SRES A2 and B1, we estimated the effects of both global warming and ocean acidification on the future habitats of corals in the seas around Japan during this century. As shown by Yara et al. (Biogeosciences 9:4955–4968,2012), under the high-CO₂-emission scenario (SRES A2), coral habitats will be sandwiched and narrowed between the northern region, where the saturation state of the carbonate mineral aragonite (Ωarag) decreases, and the southern region, where coral bleaching occurs. We found that under the low-emission scenario SRES B1, the coral habitats will also shrink in the northern region by the reduced Ωarag but to a lesser extent than under SRES A2, and in contrast to SRES A2, no bleaching will occur in the southern region. Therefore, coral habitats in the southern region are expected to be largely unaffected by ocean acidification or surface warming under the low-emission scenario. Our results show that potential future coral habitats depend strongly on CO₂ emissions and emphasize the importance of reducing CO₂ emissions to prevent negative impacts on coral habitats.