学術雑誌論文 Causes of Death in Patients with Severe Aortic Stenosis: An Observational study

Minamino-Muta, Eri  ,  Kato, Takao  ,  Morimoto, Takeshi  ,  Taniguchi, Tomohiko  ,  Shiomi, Hiroki  ,  Nakatsuma, Kenji  ,  Shirai, Shinichi  ,  Ando, Kenji  ,  Kanamori, Norio  ,  Murata, Koichiro  ,  Kitai, Takeshi  ,  Kawase, Yuichi  ,  Miyake, Makoto  ,  Izumi, Chisato  ,  Mitsuoka, Hirokazu  ,  Kato, Masashi  ,  Hirano, Yutaka  ,  Matsuda, Shintaro  ,  Nagao, Kazuya  ,  Inada, Tsukasa  ,  Murakami, Tomoyuki  ,  Takeuchi, Yasuyo  ,  Yamane, Keiichiro  ,  Toyofuku, Mamoru  ,  Ishii, Mitsuru  ,  Inoko, Moriaki  ,  Ikeda, Tomoyuki  ,  Komasa, Akihiro  ,  Tada, Eiji  ,  Ishii, Katsuhisa  ,  Hotta, Kozo  ,  Higashitani, Nobuya  ,  Jinnai, Toshikazu  ,  Kato, Yoshihiro  ,  Inuzuka, Yasutaka  ,  Maeda, Chiyo  ,  Morikami, Yuko  ,  Saito, Naritatsu  ,  Sakata, Ryuzo  ,  Minatoya, Kenji  ,  Kimura, Takeshi

72017-11-07 , Springer Nature
ISSN:2045-2322
内容記述
Whether patients with severe aortic stenosis (AS) die because of AS-related causes is an important issue for the management of these patients. We used data from CURRENT AS registry, a Japanese multicenter registry, to assess the causes of death in severe AS patients and to identify the factors associated with non-cardiac mortality. We enrolled 3815 consecutive patients with a median follow-up of 1176 days; the 1449 overall deaths comprised 802 (55.3%) from cardiac and 647 (44.7%) from non-cardiac causes. Heart failure (HF) (25.7%) and sudden death (13.0%) caused the most cardiac deaths, whereas infection (13.0%) and malignancy (11.1%) were the main non-cardiac causes. According to treatment strategies, infection was the most common cause of non-cardiac death, followed by malignancy, in both the initial aortic valve replacement (AVR) cohort (N = 1197), and the conservative management cohort (N = 2618). Both non-cardiac factors (age, male, body mass index <22, diabetes, prior history of stroke, dialysis, anemia, and malignancy) and cardiac factors (atrial fibrillation, ejection fraction <68%, and the initial AVR strategy) were associated with non-cardiac death. These findings highlight the importance of close monitoring of non-cardiac comorbidities, as well as HF and sudden death, to improve the mortality rate of severe AS patients.
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http://repository.kulib.kyoto-u.ac.jp/dspace/bitstream/2433/227888/1/s41598-017-15316-6.pdf

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