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経皮的冠動脈インターベンション後の安定冠動脈疾患を有する高齢者における術前の臨床的虚弱性と臨床転帰の関連性
http://hdl.handle.net/10232/0002000354
http://hdl.handle.net/10232/00020003543bf6e4fb-4607-4535-9877-f173f7636fdd
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| Item type | 学位論文 / Thesis or Dissertation(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2024-06-07 | |||||
| タイトル | ||||||
| タイトル | Association of preoperative clinical frailty and clinical outcomes in elderly patients with stable coronary artery disease after percutaneous coronary intervention | |||||
| タイトル言語 | en | |||||
| タイトル | ||||||
| タイトル | 経皮的冠動脈インターベンション後の安定冠動脈疾患を有する高齢者における術前の臨床的虚弱性と臨床転帰の関連性 | |||||
| タイトル言語 | ja | |||||
| 著者 |
下野, 洋和
× 下野, 洋和 |
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| 言語 | ||||||
| 言語 | eng | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Clinical frailty scale | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Stable coronary artery disease | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Percutaneous coronary intervention | |||||
| キーワード | ||||||
| 主題言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | Clinical outcome | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||
| 資源タイプ | doctoral thesis | |||||
| アクセス権 | ||||||
| アクセス権 | open access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_abf2 | |||||
| 要約 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | There are few reports on the long-term clinical outcome after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) complicated with frailty. This novel study investigated the association between pre-PCI frailty and long-term clinical outcomes in elderly patients aged 65 years or older with stable CAD who underwent elective PCI. We assessed 239 consecutive patients aged 65 years or older with stable CAD who underwent successful elective PCI at Kagoshima City Hospital between January 1st, 2017 and December 31st, 2020. Frailty was retrospectively assessed using the Canadian Study and Aging Clinical Frailty Scale (CFS). Based on the pre-PCI CFS, patients were divided into two groups: the non-frail (CFS < 5) and the frail (CFS ≥ 5) group. We investigated the association between pre-PCI CFS and major adverse cardiovascular events (MACEs) defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and heart failure requiring hospitalization. Additionally, we assessed the association between pre-PCI CFS and major bleeding events defined as Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. The mean age was 74.8 ± 7.0 years, and 73.6% were men. According to the pre-PCI frailty assessment, 38 (15.9%) and 201 (84.1%) were classified as frail and non-frail groups, respectively. During a median follow-up of 962 (607–1284) days, 46 patients developed MACEs and 10 patients developed major bleeding events. Kaplan–Meier curves showed a significantly higher incidence of MACE in the frail group compared to those in the non-frail group (Log-rank p < 0.001). Even in multivariate analysis, pre-PCI frailty (CFS ≥ 5) was independently associated with MACE (HR 4.27, 95% CI 1.86–9.80, p-value: < 0.001). Additionally, the cumulative incidence of major bleeding events was significantly higher in the frail group than in the non-frail group (Log-rank p = 0.001). Pre-PCI frailty was an independent risk factor for MACE and bleeding events in elderly patients with stable CAD who underwent elective PCI. | |||||
| 内容記述言語 | en | |||||
| 要約 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | Hirokazu Shimono, Akihiro Tokushige, Daisuke Kanda, Ayaka Ohno, Masao Hayashi, Mana Fukuyado, Mitsumasa Akao, Mariko Kawasoe, Ryo Arikawa, Hideaki Otsuji, Hideto Chaen, Hideki Okui, Naoya Oketani & Mitsuru Ohishi Association of preoperative clinical frailty and clinical outcomes in elderly patients with stable coronary artery disease after percutaneous coronary intervention Heart and Vessels 38, 1205–1217 (2023) https://doi.org/10.1007/s00380-023-02276-3 |
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| 内容記述言語 | en | |||||
| 要約 | ||||||
| 内容記述タイプ | Other | |||||
| 内容記述 | The version of record of this article, first published in Heart and Vessels, is available online at Publisher’s website: https://doi.org/10.1007/s00380-023-02276-3 | |||||
| 内容記述言語 | en | |||||
| 作成日 | ||||||
| 日付 | 2024-03-08 | |||||
| 日付タイプ | Collected | |||||
| 出版タイプ | ||||||
| 出版タイプ | VoR | |||||
| 出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
| ファイル（説明） | ||||||
| 内容記述 | 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨 | |||||
| 公開者・出版者 | ||||||
| 出版者 | Springer Nature | |||||
| 出版者言語 | en | |||||
| 公開者・出版者 | ||||||
| 出版者 | 鹿児島大学 | |||||
| 出版者言語 | ja | |||||
| 備考 | ||||||
| 備考言語 | ja | |||||
| 備考 | 【指導教員:大石充】 | |||||
| date.appl | ||||||
| appl | 【学位申請日】2023-11-01 | |||||
| 学位名 | ||||||
| 学位名の言語 | ja | |||||
| 学位名 | 博士(医学) | |||||
| 学位名 | ||||||
| 学位名の言語 | en | |||||
| 学位名 | Doctor of Philosophy in Medical Science | |||||
| 学位授与機関名 | ||||||
| 学位授与機関識別子Scheme | kakenhi | |||||
| 学位授与機関識別子 | 17701 | |||||
| 学位授与機関名の言語 | ja | |||||
| 学位授与機関名 | 鹿児島大学 | |||||
| 学位授与年月日 | ||||||
| 学位授与年月日 | 2024-03-25 | |||||
| 学位授与番号 | ||||||
| 学位授与番号 | 甲総研第733号 | |||||
