Impact of Low Diastolic Blood Pressure on Risk of Cardiovascular Death in Elderly Patients With Coronary Artery Disease After Revascularization – The CREDO-Kyoto Registry Cohort-1 –
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- Kai Hisashi
- Department of Cardiology, Kurume University Medical Center
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- Kimura Takeshi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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- Fukuda Kenji
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine Department of Cerebrovascular Medicine, St. Mary’s Hospital
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- Fukumoto Yoshihiro
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine
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- Kakuma Tatsuyuki
- Biostatisctics Center, Kurume University
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- Furukawa Yutaka
- Division of Cardiology, Kobe City Medical Center General Hospital
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Abstract
Background:We investigated the effects of age and low diastolic blood pressure (DBP) on cardiovascular death in patients with coronary artery disease (CAD) after coronary revascularization.Methods and Results:Stable, chronic CAD patients after coronary revascularization in the CREDO-Kyoto registry cohort-1 were allocated to the Young (≤64 years, n=2,619), Young-Old (65–74 years, n=2,932), and Old-Old (≥75 years, n=1,629) groups. Kaplan-Meier analysis showed that the crude cumulative incidence of cardiovascular death was higher in Young-Old patients with DBP <70 mmHg (P<0.001) and in Old-Old patients with DBP <60 mmHg (P=0.017), but not <70 mmHg (P=0.629), compared with each counterpart. Low DBP did not increase cardiovascular death in young patients. After adjustments with independent predictors, DBP <60 mmHg did not increase the cardiovascular death in the Old-Old group (HR=1.579 [95% CI, 0.944–2.642], P=0.082) and DBP <70 mmHg remained a predictor in the Young-Old group (HR=1.665 [1.094–2.532], P=0.017). On multivariate stepwise Cox proportional hazard regression analysis, independent predictors for cardiovascular death in low DBP patients were creatinine clearance (CCr; inversely), prior cerebrovascular disease, and aortic disease in the Young-Old group and CCr (inversely) and malignancy in the Old-Old group.Conclusions:DBP <60 mmHg was not an independent factor for predicting cardiovascular death in Old-Old revascularized CAD patients, whereas DBP <70 mmHg remained a predictor in the Young-Old. (Circ J 2016; 80: 1232–1241)
Journal
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- Circulation Journal
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Circulation Journal 80 (5), 1232-1241, 2016
The Japanese Circulation Society
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Details 詳細情報について
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- CRID
- 1390282680084016384
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- NII Article ID
- 130005147673
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- NII Book ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL BIB ID
- 027270056
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- PubMed
- 27053493
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- Text Lang
- en
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- Data Source
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
- KAKEN
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- Abstract License Flag
- Disallowed