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このページは機械翻訳されています。他のページは英語で表示される場合があります。View in English
  1. ホーム
  3. 研究分野
  5. 生物医学と臨床科学
  7. 心血管医学と血液学
  9. 心臓病 (心血管疾患を含む)
  11. 冠動脈バイパス移植を受けた発血性心不全患者の急性心死: Stichランダム化臨床試験 (発血性心不全の手術による治療) の結果

冠動脈バイパス移植を受けた発血性心不全患者の急性心死: STICHランダム化臨床試験 (発血性心不全の手術による治療) の結果

Meena P Rao1, Sana M Al-Khatib1, Sean D Pokorney1

  • 1From Duke Clinical Research Institute (M.P.R., S.M.A.-K., S.D.P., L.S., K.L.L., E.J.V.) and Departments of Biostatistics and Bioinformatics (K.L.L.) and Medicine (S.M.A.-K., E.J.V.), Duke University School of Medicine, Durham, NC; State Research Institute of Circulation Pathology, Novosibirsk, Russia (A.R.); Heart Institute, University of São Paulo Medical School, Brazil (J.C.N.); Washington DC Veterans Affairs Medical Center (P.C.); Division of Cardiothoracic Surgery, University of Utah, Salt Lake City (C.H.S.); Institute of Cardiology, Warsaw, Poland (J.S.); National Heart and Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, London, UK (J.G.F.C.); Siriraj Hospital, Mahidol University, Bangkok, Thailand (W.T.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (P.M.D.-N.); University of North Carolina at Chapel Hill (C.A.S.); University Heart Center Freiburg-Bad Krozingen, Germany (M.S.); Medical University of Vienna, Austria (I.L.); Department of Medicine, Temple University School of Medicine, Philadelphia, PA (A.M.F.); St. Vincent's Hospital, University of Melbourne, Fitzroy, Australia (M.Y.); and Department of Medicine, Montreal Heart Institute, University of Montreal, Quebec, Canada (J.L.R.).

Circulation
|February 4, 2017

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PubMed で要約を見る

まとめ
この要約は機械生成です。

冠動脈バイパス移植 (CABG) の後の心不全患者では,突然の心臓死 (SCD) のリスクが高くなります. 早期のリスク分層は,特に30~90日以内には,シストリック量指数とB型ナトリウレチンペプチドを用いて決定的に重要です.

キーワード:
冠動脈バイパス突然の心臓発作による死亡心不全

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科学分野:

  • 心臓病科
  • 心臓 外科
  • 心不全 の 治療

背景:

  • 心不全患者の冠動脈バイパス移植 (CABG) 後の突然心臓死 (SCD) のリスクは,現在の試験データがない.
  • この研究では,CABG後のSCD発生率,タイミング,および予測要因が検討されています.

研究 の 目的:

  • 心不全のためにCABGを受ける患者のSCDの発生率,タイミング,および臨床予測値を決定する.
  • 術後期における早期のリスク分層化戦略を策定する

主な方法:

  • STICH試験の患者の分析 (心室再建またはそれなしのCABG).
  • 既往の implantable cardioverter-defibrillators を使った患者,または医療療法のみにランダムに割り当てられた患者を除外する.
  • SCDの判断は盲目委員会によって行われ,CoxとFine-Grayモデルが分析に使用された.

主要な成果:

  • 46ヶ月間,1411人のCABG患者のうち113人がSCD (5年発生率8. 5%) を経験した.
  • SCDのリスクはCABG後31~90日間で最も高かった.
  • 末縮量指数とB型ナトリウレチンペプチドは,SCDの強い予測因子でした.

結論:

  • SCDの月間リスクが最も高いのは,CABG後の最初の3ヶ月間です.
  • 低エジェクション分数の患者には,早期の術後のリスクの分層化が推奨されます.
  • B型ナトリウレチンペプチドと手術前末期シストリックボリュームインデックスの増加は,高リスクの個人を特定します.