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論文 |
論文
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Uchiyama, K. ; Ino, H. ; Hayashi, Kenshi ; Fujioka, K. ; Takabatake, S. ; Yokawa, J. ; Namura, M. ; Mizuno S. ; Tatami, R. ; Kanaya, H. ; Nitta, Y. ; Michishita, I. ; Hirase, H. ; Ueda, K. ; Aoyama, T. ; Okeie, K. ; Haraki, T. ; Mori, K. ; Araki, T. ; Minamoto, M. ; Oiwake, H. ; Konno, Tetsuo ; Sakata, Kenji ; Kawashiri, Masa-aki ; Yamagishi, Masakazu ; 林, 研至 ; 山岸, 正和
概要:
金沢大学医薬保健研究域医学系<br />Percutaneous coronary intervention (PCI) using a drug-eluting stent (DES) leads to less re-stenosis
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than PCI using a bare metal stent (BMS), however there is still controversy whether use of a DES for severe coronary disease leads to an acceptable outcome in patients with diabetes mellitus (DM). In this study 8159 lesions were treated in 6739 patients (mean age 68.9 years) with coronary artery disease. Use of a DES significantly decreased the re-stenosis rate compared with BMS in both DM (9.6% versus 21.3%) and non-DM (9.5% versus 17.1%) patients. The re-stenosis rate was significantly higher in DM than in non-DM patients in the BMS group but not in the DES group. There was no statistically significant difference in event-free survival after stenting of patients with left main coronary artery (LMCA) disease between the BMS and DES groups. It was concluded that, compared with BMS, DES reduced re-stenosis in patients with DM, however, we advise careful treatment after using DES for severe coronary disease, including LMCA lesions, in patients with DM. © 2011 Field House Publishing LLP.
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論文
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Nomura, Akihiro ; Konno, Tetsuo ; Fujita, Takashi ; Tanaka, Yoshihiro ; Nagata, Yoji ; Tsuda, Toyonobu ; Hodatsu, Akihiko ; Sakata, Kenji ; Nakamura, Hiroyuki ; Kawashiri, Masa-aki ; Fujino, Noboru ; Yamagishi, Masakazu ; Hayashi, Kenshi ; 今野, 哲雄 ; 坂田, 憲治 ; 川尻, 剛照 ; 藤野, 陽 ; 山岸, 正和 ; 林, 研至
概要:
金沢大学医薬保健研究域医学系<br />Background: Although fragmented QRS complex (frag-QRS) reflecting intra-ventricular conduction delay
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has been shown to be a prognostic marker for cardiac events, few data exist regarding the impact of frag-QRS on cardiac events in hypertrophic cardiomyopathy (HCM).Methods and Results: Ninety-four HCM patients (56 male; mean age, 58}17 years) were retrospectively investigated. Frag-QRS was defined as the presence of various RsR’ patterns in at least 2 contiguous ECG leads. Major arrhythmic events (MAE) were defined as sudden cardiac death, and combined sustained ventricular tachycardia/ventricular fibrillation. New-onset atrial fibrillation (AF) was diagnosed based on ECG during provisional or routine medical examination. Heart failure (HF) with hospitalization was defined as hospital admission due to subjective or objective symptoms. Frag-QRS was detected in 31 patients (33%). TNNI3 was the most frequent disease-causing gene. Median follow-up was 4.6 years. The 4-year cumulative survival rates of cardiac death, MAE, new-onset AF and HF with hospitalization were 97.6%, 94.6%, 87.5% and 89.3%, respectively. On multivariate analysis, frag-QRS was significantly associated with HF with hospitalization (adjusted hazard ratios [95% confidence intervals]: 5.4 [1.2–36], P=0.03). Moreover, HF-free survival was significantly lower in the frag-QRS (+) group compared to the frag-QRS (–) group (79.0% vs. 95.1%, P=0.03).Conclusions: Frag-QRS is associated with HF with hospitalization in HCM patients who had a unique distribution of gene mutations. © 2014, The Japanese Circulation Society<br />出版者照会後に全文公開
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