Prognostic impact of chronic total coronary occlusion on long-term outcomes in implantable cardioverter-defibrillator recipients with ischaemic heart disease
書誌事項
- タイトル
- Prognostic impact of chronic total coronary occlusion on long-term outcomes in implantable cardioverter-defibrillator recipients with ischaemic heart disease
- タイトル別名
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- 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
- 著者別名
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- ニシカワ, タツヤ
- Nishikawa, Tatsuya
- 著者
- フジノ, マサシ
- 著者別名
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- Fujino, Masashi
- 著者
- ナカジマ, イクタロウ
- 著者別名
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- Nakajima, Ikutaro
- 著者
- アサウミ, ヤスヒデ
- 著者別名
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- Asaumi, Yasuhide
- 著者
- カタオカ, ユウ
- 著者別名
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- Kataoka, Yu
- 著者
- アンザイ, トシヒサ
- 著者別名
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- Anzai, Toshihisa
- 著者
- クサノ, ケンゴ
- 著者別名
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- Kusano, Kengo
- 著者
- ノグチ, テルオ
- 著者別名
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- Noguchi, Teruo
- 著者
- ゴトウ, ヨウイチ
- 著者別名
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- Goto, Yoichi
- 著者
- ニシムラ, クニヒロ
- 著者別名
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- Nishimura, Kunihiro
- 著者
- ミヤモト, ヨシヒロ
- 著者別名
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- Miyamoto, Yoshihiro
- 著者
- キソ, ケイスケ
- 著者別名
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- Kiso, Keisuke
- 著者
- ヤスダ, サトシ
- 著者別名
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- Yasuda, Satoshi
- 学位授与大学
- 徳島大学
- 取得学位
- 博士（医学）
- 学位授与番号
- 甲医第1306号
- 学位授与年月日
- 2016-11-24
この論文をさがす
説明
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.