Effect of Immunosuppressive Therapy on Clinical Outcomes

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  • Kaihara Toshiki
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Izumo Masaki
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Kameshima Haruka
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Sato Yukio
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Kuwata Shingo
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Koga Masashi
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Watanabe Mika
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Okuyama Kazuaki
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Kamijima Ryo
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Ishibashi Yuki
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Tanabe Yasuhiro
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Higuma Takumi
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Harada Tomoo
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Akashi Yoshihiro J.
    Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine

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タイトル別名
  • Effect of Immunosuppressive Therapy on Clinical Outcomes for Patients With Aortic Stenosis Following Transcatheter Aortic Valve Implantation

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説明

<p>Background:Transcatheter aortic valve implantation (TAVI) is an established treatment for symptomatic patients with severe aortic stenosis (AS). Sometimes patients with severe AS taking immunosuppressants are encountered. The effect of immunosuppressive therapy on clinical outcomes in patients with AS following TAVI were investigated.</p><p>Methods and Results:In total, 282 consecutive patients with severe AS who underwent transfemoral TAVI from January 2016 to December 2018 at St. Marianna University School of Medicine were reviewed. They were divided into 2 groups: the immunosuppressants group (IM group) in which patients continually used immunosuppressive drugs (n=22) and the non-immunosuppressants group (non-IM group) (n=260). The composite endpoints of a major adverse cardiovascular and cerebrovascular event (MACCE) defined as non-lethal myocardial infarction, unstable angina pectoris, heart failure requiring hospitalization, stroke, and cardiovascular death were evaluated. There were no differences in the incidence of vascular access complications (32% vs. 20%, P=0.143) and the rate of procedure success (100% vs. 93%, P=0.377) between the IM and non-IM groups. During the median follow-up period of 567 (16–1,312) days after the TAVI procedure, there were no significant differences between the IM and non-IM groups in the incidence of infectious complications (14% vs. 9%, P=0.442) or MACCE (18% vs. 20%, respectively; P=0.845).</p><p>Conclusions:The use of IM after TAVI is not associated with increased vascular access complications or mid-term MACCE in patients with severe AS treated with TAVI.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 84 (12), 2296-2301, 2020-11-25

    一般社団法人 日本循環器学会

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