MOMENTUM 3 ランダム化試験における完全磁気浮動対軸流動左心室補助器具の患者における5年経過
Mandeep R Mehra1, Daniel J Goldstein2, Joseph C Cleveland3
1Brigham and Women's Hospital, Boston, Massachusetts.
JAMA
|September 8, 2022
まとめ
完全磁気浮遊式離心流動左心室補助装置 (LVAD) は,生存率を大幅に改善し,軸流動型LVADと比較して5年後に有害事象を減少させます. 進行した心不全の患者に より良い結果をもたらします
科学分野:
- 心臓病科
- 医療機器
- 心臓 不全 の 治療
背景:
- 持続的な左心室補助装置 (LVAD) の治療は,進行した心不全において極めて重要です.
- 2年を超えたLVADの長期的なアウトカムは十分に文書化されていません.
研究 の 目的:
- 脳卒中または再手術のない生存,移植,回復,またはLVADサポートの5年間の複合エンドポイントを評価する.
- 遠心流量 (HeartMate 3) と軸流量 (HeartMate II) のLVADを比較する.
主な方法:
- MOMENTUM 3試験の5年間の追跡調査
- 2年後のLVAD治療を受けている患者も含まれています.
- 477人の患者のプロトコルデータ分析
主要な成果:
- 5年間の複合結果は,軸流 (29. 7%) と対比して,遠心流 (54. 0%) で有意に改善されました.
- 5 年の総生存率は,遠心流動型LVAD (58. 4%) と,軸流動型LVAD (43. 7%) と比較して高かった.
- 脳卒中,出血,ポンプ血栓症などの重篤な有害事象は,離心流量ポンプで少なかった.
結論:
- 完全に磁気浮遊型離心流動型LVADは,5年後の優れた結果と関連しています.
- これらの発見は,先進的な心不全の治療において,遠心流動型LVADの臨床使用を支持する.
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