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外周動脈疾患における急性四肢血栓不全
Connie N Hess1, Zhen Huang2, Manesh R Patel2
1Division of Cardiology, Department of Medicine, University of Colorado School of Medicine and CPC Clinical Research, Aurora (C.N.H., W.R.H.).
Circulation
|June 27, 2019
まとめ
急性肢体缺血 (ALI) のリスクは,以前に再血管化,心房細動,または足首-腕指数が低い患者に高い. ALIの入院は,心血管疾患,死亡率,および切断のリスクを大幅に増加させます.
科学分野:
- 心血管医学
- 血管 外科
- 臨床試験の分析
背景:
- 急性四肢不全症 (ALI) は,重要な臨床イベントであり,心臓血管研究における新たな結果である.
- ALIの危険因子と結果の包括的な評価が必要である.
研究 の 目的:
- 周辺動脈疾患 (PAD) の患者におけるALI入院に関連したベースラインの要因を特定する.
- ALIの入院が後の主要な心血管疾患 (MACE),全因死亡率,および主要な切断に与える影響を分析する.
主な方法:
- PADにおけるEUCLID試験 (チカグレロとクロピドグレル) の13, 885人の患者の分析
- ALIの危険因子を特定するためのコックスの比例的な危険モデル.
- ALI入院を時間依存の共変数として使用した二次結果モデルの開発.
主要な成果:
- 患者の1. 7%が293件のALI入院を経験し,以前の再血管化,心房細動,および下肢-腕指数 (ABI ≤0. 60) と関連したリスクが高かった.
- 高齢とスタチンの使用は,ALIリスクの低下と関連していました.
- ALIの入院はMACEの増加 (HR1. 4),あらゆる原因による死亡率 (HR3. 3),および大切断 (HR34. 2) と関連していた.
結論:
- 以前の外周再血管化,出血時の心房細動,および低ABIは,PAD患者でALIのリスクが高いことを特定します.
- ALIは,その後の心血管疾患および肢体関連疾患および死亡率の有意な予測因子です.
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