術後の脳卒中と心臓外科手術を受けた患者の死亡率との関連
PubMedで要約を見る
まとめ
この要約は機械生成です。心臓外科手術中の左心房閉塞は,脳卒中と死亡リスクを減少させる. しかし,LAAOは,心房細動 (AF) の医療利用の増加と関連しており,その全体的な役割に関するさらなる調査を正当化しています.
科学分野
- 心臓病科
- 心臓外科
- 電気生理学
背景
- 左心房付属体の外科閉塞 (LAAO) は心臓手術中に行われます.
- LAAOの脳卒中リスクおよびその後の心房細動 (AF) との長期的な関連に関するデータは限られている.
研究 の 目的
- 心臓外科手術中の LAAO の脳卒中,死亡率,およびその後の AF 発症のリスクとの関連性を評価する.
主な方法
- 冠動脈バイパス移植またはバルブ手術を受けた成人のコホート研究.
- LAAOの患者と無患者を比較するために,傾向スコアをマッチングした大規模な米国行政データベースを使用しました.
- 手術前における AF 病歴に基づく分層分析
主要な成果
- 傾向スコアが一致した患者では,LAAOは脳卒中リスク (HR,0. 73) と死亡率 (HR,0. 71) の減少と関連していました.
- LAAOはAFに関連した外来診察と入院率の上昇と関連していました.
- 以前AFを患っていた患者では,LAAOが脳卒中 (HR,0. 68) と死亡率 (HR,0. 67) を減少させた.
結論
- 心臓外科手術中に併用されたLAAOは,その後の脳卒中と全因死亡率の減少と関連しています.
- ランダム化臨床試験を含むさらなる研究が,外科的なLAAOの役割を決定的に確立するために必要である.
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