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ヤマザキ ケンジ
Yamazaki Kenji
山崎 健二 所属 医学部 医学科（東京女子医科大学病院） 職種 客員教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Implication of Preoperative Existence of Atrial Fibrillation on Hemocompatibility-Related Adverse Events During Left Ventricular Assist Device Support. |
| 掲載誌名 | 正式名：Circulation journal : official journal of the Japanese Circulation Society 略 称：Circ J ISSNコード：13469843/13474820 |
| 掲載区分 | 国内 |
| 出版社 | (一社)日本循環器学会 |
| 巻・号・頁 | 83(6),pp.1286-1292 |
| 著者・共著者 | Imamura Teruhiko†, Kinugawa Koichiro, Ono Minoru, Kinoshita Osamu, Fukushima Norihide, Shiose Akira, Matsui Yoshiro, Yamazaki Kenji, Saiki Yoshikatsu, Usui Akihiko, Niinami Hiroshi, Matsumiya Goro, Atai Hirokuni, Sawa Yoshiki |
| 発行年月 | 2019/05 |
| 概要 | BACKGROUND:Hemocompatibility-related adverse events (HRAEs) are substantial issues in patients with left ventricular assist devices (LVADs). Atrial fibrillation (AF) is associated with worse prognosis in patients with heart failure (HF), but its effect on HRAEs following LVAD implantation remain uncertain.
METHODS AND RESULTS:Data from the Japanese Mechanically Assisted Circulatory Support registry of consecutive patients who received HeartMate II LVADs and were followed for 1 year were retrospectively reviewed. Among 190 patients, 23 had AF and 167 had sinus rhythm. The AF group had comparable baseline characteristics with the non-AF group except for their higher age (53 vs. 42 years, P<0.001). Following LVAD implantation, most cases of AF (73%) persisted. Antiplatelet therapy, anticoagulation therapy, and LVAD speed following LVAD implantation were comparable between groups (P>0.05 for all). The 1-year survival free from HRAEs was comparable between groups (83% vs. 76%, P=0.52). Event rates of the breakdown of HRAEs were comparable between groups except for a relatively higher rate of surgically managed pump thrombosis in the AF group (0.16 vs. 0.04, incidence rate ratio 3.75, 95% confidence interval 0.87-16.1, P=0.075). These trends still remained with propensity score-matched comparison. CONCLUSIONS:Existence of AF had no effect on the development of HRAEs following LVAD implantation. The need to aggressively treat AF before or after LVAD implantation needs further investigation. |
| DOI | 10.1253/circj.CJ-18-1215 |
| PMID | 31019163 |