Prognostic Impact of Reduced Left Ventricular Ejection Fraction After Endovascular Therapy for Lower Extremities
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- Fukino Keiko
- The Third Department of Internal Medicine, Teikyo University Chiba Medical Center
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- Ueshima Daisuke
- Department of Cardiology, Kameda Medical Center
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- Yamaguchi Tetsuo
- Department of Cardiology, Toranomon Hospital
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- Mizuno Atsushi
- Department of Cardiology, St. Luke’s International Hospital
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- Tobita Kazuki
- Department of Cardiology, Shonan Kamakura General Hospital
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- Suzuki Kenji
- Department of Cardiology, Tokyo Saiseikai Central Hospital
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- Murata Naotaka
- Department of Cardiology, Tokyo Medical University
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- Jujo Kentaro
- Department of Cardiology, Saitama Medical Center
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- Kodama Takahide
- Department of Cardiology, Toranomon Hospital
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- Nakamura Fumitaka
- The Third Department of Internal Medicine, Teikyo University Chiba Medical Center
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- Higashitani Michiaki
- Department of Cardiology, Tokyo Medical University, Ibaraki Medical Center
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<p>Background: The mechanism underlying a poor prognosis in patients with lower-extremity artery disease (LEAD) with heart failure is unknown. We examined the prognostic impact of the left ventricular ejection fraction (LVEF) in patients with LEAD who underwent endovascular therapy (EVT).</p><p>Methods and Results: From August 2014 to August 2016, 2,180 patients with LEAD (mean age, 73.2 years; male, 71.9%) underwent EVT and were stratified into low-LVEF (LVEF <40%; n=234, 10.7%) and not-low LVEF groups. In the low- vs. not-low LVEF groups, there was a higher prevalence of heart failure (i.e., history of heart failure hospitalization or New York Heart Association functional class III or IV symptoms) (44.0% vs. 8.3%, respectively), diabetes mellitus, chronic kidney disease, below-the-knee lesion, critical limb ischemia, and incidence of major cardiovascular and cerebrovascular events (MACCEs) and major adverse limb events (MALEs) (P<0.001, all). Low LVEF independently predicted MACCEs (hazard ratio: 2.23, 95% confidence interval: 1.63–3.03; P<0.001) and MALEs (hazard ratio: 1.85, 95% confidence interval: 1.15–2.96; P=0.011), regardless of heart failure (P value for interaction: MACCEs: 0.27; MALEs: 0.52).</p><p>Conclusions: Low LVEF, but not symptomatic heart failure, increased the incidence of MACCEs and MALEs. Intensive cardiac dysfunction management may improve LEAD prognosis after EVT.</p>
収録刊行物
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- Circulation Journal
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Circulation Journal 88 (3), 341-350, 2024-02-22
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390299229355379328
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 033364417
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- PubMed
- 37813602
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
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- 抄録ライセンスフラグ
- 使用不可