コグレ　トモヒト   Kogure Tomohito   小暮　智仁    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
言語種別	日本語
発表タイトル	Platelet Distribution Width is a Useful Marker for Cardiac Events Late after the Fontan Procedure
会議名	第80回日本循環器学会学術集会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎稲井慶, 小暮智仁, 島田衣里子, 朝貝省史, 篠原徳子, 朴仁三
発表年月日	2016/03/20
開催地 （都市, 国名）	仙台市
概要	Background: Platelet distribution width (PDW) is a simple, inexpensive, and widely available marker that directly measures variability in platelet size, and represents a parameter of platelet activity. Recently, PDW has received substantial attention for its potential in the risk prediction and stratification of various cardiovascular diseases. However, few studies have been published data regarding the clinical implications of PDW in patients with Fontan circulation.Objects and methods: We retrospectively enrolled a cohort of 102 adult patients with Fontan circulation. We analyzed patient data to determine whether PDW is a useful predictor of cardiac events, especially thromboembolic events and worsening heart failure (HF).Results: PDW is significantly associated with exercise capacity and functional class in patients with Fontan circulation. During a mean observation period of 10 years, there were 16 thromboembolic events and 23 HF-hospitalizations. The highest tertile of PDW presented significant prognostic value for thromboembolism (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.2-1.8, p = 0.03) and HF-hospitalization (HR 2.7, 95% CI 1.9-9.8, p<0.01) when the respective lowest tertile was used as a reference. Conclusions: It is likely that PDW is a useful marker for identifying individuals at higher risk of thromboembolism and worsening HF. Further investigation is needed to determine whether PDW also represents organ damage late after the Fontan procedure.