シガ　ツヨシ   Shiga Tsuyoshi   志賀　剛    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
言語種別	英語
発表タイトル	Clinical Features of Japanese Hypertrophic Cardiomyopathy Patients with Stroke and Systemic Embolic Events
会議名	The 79th Annual Scientific Meeting of the Japanese Circulation Society
主催者	Japanese Circulation Society
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	◎HARUKI Shintaro, MINAMI Yuichiro, SUZUKI Atsushi, SUZUKI Tsuyoshi, SHIGA Tsuyoshi, HAGIWARA Nobuhisa
発表年月日	2015/04/26
開催地 （都市, 国名）	Osaka, JAPAN
学会抄録	PROGRAM JCS 2015 616
概要	Background: Although stroke and systemic embolic events are known to occur as complications of hypertrophic cardiomyopathy (HCM), few data are available regarding the occurrence and profile of these events from Japan. We investigated the frequency and clinical features of HCM patients with these complications from a tertiary referral cohort in Japan. Methods and Results: Of the 550 HCM patients (follow-up: 10.9±7.4 years), 62 patients (11.3%) experienced embolic events including 57 patents with stroke, and age at first event ranged from 23 to 83 (mean 60.0±11.8) years. Although patients with events had larger left atrium, there were no significant differences with respect to age at diagnosis, gender, family history of sudden death, syncope, left ventricular obstruction and wall thickness between the patients with and without events. Of the 149 patients with documented atrial fibrillation (AF), 73 patients received anticoagulation with warfarin. The incidence of embolic events among non-anticoagulated patients with AF was higher than anticoagulated patients with AF (21.1% vs. 13.7%). At the time of the initial event, however, AF was not previously documented in 36 (58.1%) of 62 patients with events. Conclusion: Stroke and systemic embolic events showed an incidence of 1.0%/year in Japanese HCM patients. Although anticoagulation might be effective in reducing the events in patients with AF, prevention of events in patients without AF remains a clinical challenge.