心内シャントの患者における静脈経パッチングと全身性血栓栓塞栓:多センター研究
Paul Khairy1, Michael J Landzberg, Michael A Gatzoulis
1Adult Congenital Heart and Electrophysiology Services, Montreal Heart Institute, Montreal, Canada. paul.khairy@umontreal.ca
Circulation
|May 17, 2006
まとめ
静脈経導線は,心内シャントの患者の全身性血栓栓塞栓のリスクを大幅に増加させ,その危険性を2倍以上増やす. この発見は,この患者集団における鉛選択の重要な考慮事項を強調しています.
科学分野:
- 心臓病学 心臓病学
- 医療機器 医療機器について
- 血栓塞栓症の研究 血栓塞栓症の研究
背景:
- 心臓内シャントは,心臓の電子機器を必要とする患者にユニークなリスクをもたらす.
- 心臓内シャントの患者における静脈経導線と関連した全身性血栓栓 (血栓) の特定のリスクは,以前は知られていませんでした.
研究 の 目的:
- 心臓内シャントの患者における全身性血栓栓塞栓のリスクを,使用した心臓鉛の種類に基づいて定量化します.
- この特定の患者コホートにおける全身性血栓塞栓の独立した予測要因を特定する.
主な方法:
- 心臓内シャントの患者202人を対象とした多センター,遡及的なコホート研究.
- 患者は3つのグループに分けられた: 静脈経由のリード (n=64), エピカルディアのリード (n=56) と,リードなしのリード (n=82).
- 系統性血栓栓塞栓の発生を追跡するためにフォローアップデータを収集し,フォローアップの平均期間は7.3年から17.0年であった.
主要な成果:
- 系統性血栓栓塞栓は,静脈経導線患者15.6%,心導線患者8.9%,無導線患者11.0%で発生しました.
- 静脈経導線は,全身性血栓塞栓の独立した予測因子として特定されました (危険比率 [HR],2.6;P=0.0265).
- 高齢,心房細動/振動,および進行中のフルボトミーも,静脈経導管患者の重要なリスク要因でした.
結論:
- 静脈経導線は,心内シャントの患者において,全身性血栓栓塞栓のリスクが2倍以上の増加と関連しています.
- この発見は,心臓内シャントの患者の管理において,血栓栓塞栓のリスクを軽減するために,鉛の種類を考慮することの重要性を強調しています.
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