直近一年間の累計
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ID 110000
タイトル別表記
虚血性心疾患患者で植込み型除細動器移植後の長期予後に及ぼす冠動脈慢性完全閉塞病変の影響
Prognostic impact of chronic total coronary occlusion on long-term outcomes in implantable cardioverter-defibrillator recipients with ischemic heart disease
著者
西川, 達哉 徳島大学大学院医科学教育部(医学専攻)
Fujino, Masashi National Cerebral and Cardiovascular Center|Kumamoto University
Nakajima, Ikutaro National Cerebral and Cardiovascular Center
Asaumi, Yasuhide National Cerebral and Cardiovascular Center
Kataoka, Yu National Cerebral and Cardiovascular Center
Anzai, Toshihisa National Cerebral and Cardiovascular Center
Kusano, Kengo National Cerebral and Cardiovascular Center
Noguchi, Teruo National Cerebral and Cardiovascular Center
Goto, Yoichi National Cerebral and Cardiovascular Center
Nishimura, Kunihiro National Cerebral and Cardiovascular Center
Miyamoto, Yoshihiro National Cerebral and Cardiovascular Center
Kiso, Keisuke National Cerebral and Cardiovascular Center
Yasuda, Satoshi National Cerebral and Cardiovascular Center|Kumamoto University
キーワード
CTO
植込み型除細動器
虚血性心疾患
血行再建
心筋viability
Chronic total occlusion
implantable cardioverter-defibrillator
ischemic heart disease
revascularization
myocardial viability
資料タイプ
学位論文
抄録
Aims The prognostic impact of chronic total coronary occlusion (CTO) on implantable cardioverterdefibrillator (ICD) recipients remains unclear.
Methods and Results Eighty-four consecutive patients with ischemic heart disease who received ICD therapy for primary or secondary prevention were analyzed. We investigated all-cause mortality and major adverse cardiac events (MACEs) including cardiac death, appropriate device therapy, hospitalization for heart failure, and ventricular assist device implantation. Of the study patients (mean age 70 ± 8 years; 86% men), 34 (40%) had CTO. There were no significant differences in age, left ventricular ejection fraction (LVEF), NYHA functional class III or IV status, and proportion who underwent secondary prevention between patients with CTO (CTO group) and without CTO (non-CTO group). During a median follow-up of 3.8 years (interquartile range 2.7 to 5.4 years), the CTO group tended to have a higher MACE rate (log-rank P=0.054) than the non-CTO group. Within the CTO group, there was no difference in the MACE rate between patients with and without viable myocardium. In patients with ICD for secondary prevention (n=47), 16 patients (34%) with CTO had a higher MACE rate than patients without CTO (logrank P<0.01). Cox proportional hazards regression analysis showed that the presence of CTO, but 3 not LVEF, was associated with a higher MACE rate. Multivariate analysis showed that the presence of CTO was a predictor of MACE (P<0.05).
Conclusion In patients with ischemic heart disease receiving ICD implantation, the presence of CTO has an adverse impact on long-term prognosis, especially as secondary prevention.
掲載誌名
EP Europace
ISSN
15322092
10995129
cat書誌ID
AA11533917
AA12105839
出版者
European Society of Cardiology|Oxford University Press
19
7
開始ページ
1153
終了ページ
1162
発行日
2016-10-14
備考
内容要旨・審査要旨・論文本文の公開:
内容要旨・審査要旨 : LID201701261001.pdf
論文本文 : k3001_fulltext.pdf
著者の申請により要約(2017-01-26公開)に替えて論文全文を公開(2018-06-15)
本論文は, 著者Tatsuya Nishikawaの学位論文として提出され, 学位審査・授与の対象となっている。
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3001号
学位記番号
甲医第1306号
学位授与年月日
2016-11-24
学位名
博士(医学)
学位授与機関
徳島大学
部局
医学系