Evidence map›Paper›PMID 42142094›Full record

ArticleJACC. Asia2026

Defecation Patterns and Cardiovascular Outcomes in Acute Coronary Syndrome: The Influence of Stimulant Laxative Use.

Yasushi Matsuzawa, Kenichi Tsujita, Takaomi Kessoku, Masaomi Gohbara, Masanobu Ishii, Taishi Nakamura, Hisaya Kondo, Tomohiro Yoshii, Ryusuke Sekii, Jin Kirigaya and 14 more

Abstract read
In one paragraph

Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Yasushi MatsuzawaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. Electronic address: matsuzawa-y@kumamoto-u.ac.jp.
Kenichi TsujitaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Takaomi KessokuDepartment of Palliative Medicine and Gastroenterology, International University of Health and Welfare Narita Hospital, Narita, Japan; Department of Gastroenterology, International University of Health and Welfare Graduate School of Medicine, Narita, Japan; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan.
Masaomi GohbaraDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Masanobu IshiiDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Department of Medical Information Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Taishi NakamuraDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Department of Medical Information Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Hisaya KondoDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Tomohiro YoshiiDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Ryusuke SekiiDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Jin KirigayaDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kengo TerasakaDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Hidefumi NakahashiDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Eiichi AkiyamaKawaguchi Cardiovascular and Respiratory Hospital, Saitama, Japan.
Masaaki KonishiDepartment of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Toshihiro YamadaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Yuichiro ArimaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; International Research Center for Medical Sciences (IRCMS), Kumamoto University, Kumamoto, Japan.
Shinsuke HanataniDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Seiji TakashioDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Hiroki UsukuDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan.
Yasuhiro IzumiyaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Eiichiro YamamotoDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Masami KosugeDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kazuo KimuraYokosuka City Hospital, Yokosuka, Japan.
Kiyoshi HibiDivision of Cardiology, Yokohama City University Medical Center, Yokohama, Japan; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAppropriate defecation patterns may be important for the prevention of recurrent cardiovascular events.

objectivesThis study aimed to investigate the association of defecation patterns and laxative use during hospitalization with future cardiovascular events in patients with acute coronary syndrome (ACS).

methodsThis 2-center retrospective observational study included 1,817 patients hospitalized for ACS. In addition to: 1) "average daily defecation frequency," we comprehensively evaluated the following abnormal defecation patterns; 2) "% of nondefecation days;" 3) "consecutive nondefecation days;" and 4) "maximum daily defecation frequency." Cutoff values were determined using maximization of the log-rank statistic. The primary outcome was a composite of all-cause mortality, myocardial infarction, ischemic stroke, and hemorrhagic stroke. Laxatives were categorized into stimulant and nonstimulant types, and their associations with defecation patterns and cardiovascular outcomes were assessed.

resultsDuring a median follow-up of 48 months (IQR: 29-74 months), 375 of 1,817 patients (20.6 [95% CI: 18.8-22.6]%) developed the primary outcome. Frequent nondefecation days (adjusted HR for ≥33.8%: 1.549; 95% CI: 1.217-1.971; P < 0.001)-corresponding to at least 1 nondefecation day every 3 days-and high maximum daily defecation-frequency (adjusted HR for ≥5 times/d: 1.803; 95% CI: 1.273-2.554; P < 0.001) were significant predictors. Those with reduced defecation frequency more often used stimulant laxative, which was independently associated with the primary outcome (adjusted HR: 1.285; 95% CI: 1.003-1.646; P = 0.047).

conclusionsAbnormal defecation patterns and stimulant laxative use during ACS hospitalization were independent factors associated with an increased risk of future cardiovascular events.

Indexed as

acute coronary syndromecardiovascular eventsdefecation patterngut frailtystimulant laxatives

Identifiers

PMID42142094
PMCPMC13350099

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.