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Severe aortic stenosis in dialysis patients
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نویسنده
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kawase y. ,taniguchi t. ,morimoto t. ,kadota k. ,iwasaki k. ,kuwayama a. ,ohya m. ,shimada t. ,amano h. ,maruo t. ,fuku y. ,izumi c. ,kitai t. ,saito n. ,minamino-muta e. ,kato t. ,inada t. ,inoko m. ,ishii k. ,komiya t. ,hanyu m. ,minatoya k. ,kimura t. ,sakata r. ,shiomi h. ,imai m. ,tazaki j. ,toyota t. ,higami h. ,kawaji t. ,ando k. ,shirai s. ,korai k. ,arita t. ,miura s. ,yamaji k. ,aoyama t. ,kanamori n. ,onodera t. ,murata k. ,furukawa y. ,kim k. ,miyawaki h. ,misao a. ,nakagawa y. ,miyake m. ,amano m. ,takahashi y. ,yoshikawa y. ,nishimura s. ,kuroda m. ,shirotani m. ,mitsuoka h. ,miki s. ,mizoguchi t. ,kato m. ,yokomatsu t. ,kushiyama a. ,yaku h. ,watanabe t. ,miyazaki s. ,hirano y. ,matsuda m. ,matsuda s. ,sugioka s. ,nagao k. ,takahashi n. ,fukuchi k. ,murakami t. ,mabuchi h. ,takeda t. ,sakaguchi t. ,maeda k. ,yamaji m. ,maenaka m. ,tadano y. ,sakamoto h. ,takeuchi y. ,motooka m. ,nishikawa r. ,eizawa h. ,yamane k. ,kawato m. ,kinoshita m. ,aida k. ,tamura t. ,toyofuku m. ,takahashi k. ,ko e. ,akao m. ,ishii m. ,masunaga n. ,ogawa h. ,iguchi m. ,unoki t. ,takabayashi k. ,hamatani y. ,yamashita y. ,himura y. ,ikeda t. ,komasa a. ,sato y. ,hotta k. ,tsuji s. ,hiraoka y. ,higashitani n. ,kouchi i. ,kato y. ,ikeguchi s. ,inuzuka y. ,nishio s. ,seki j. ,shinoda e. ,yamada m. ,kawamoto a. ,maeda c. ,konishi t. ,jinnai t. ,sogabe k. ,tachiiri m. ,matsumura y. ,ota c. ,kitaguchi s. ,morikami y. ,minakata k. ,yamazaki f. ,koyama t. ,yamanaka k. ,nishiwaki n. ,nakajima h. ,ohnaka m. ,osada h. ,meshii k. ,saga t. ,onoe m. ,kitayama h. ,nakayama s. ,sakaguchi g. ,iwakura a. ,shiraga k. ,ueyama k. ,fujiwara k. ,fukumoto a. ,miwa s. ,nishizawa j. ,kitano m. ,watanabe h. ,nakatsuma k. ,sasa t.
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منبع
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journal of the american heart association - 2017 - دوره : 6 - شماره : 7
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چکیده
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Background-characteristics and prognosis of hemodialysis patients with severe aortic stenosis have not yet been well defined. methods and results-the current as (contemporary outcomes after surgery and medical treatment in patients with severe aortic stenosis) registry,a japanese multicenter registry,enrolled 3815 consecutive patients with severe aortic stenosis. there were 405 hemodialysis patients (initial aortic valve replacement [avr] group: n=135 [33.3%],and conservative group: n=270) and 3410 nonhemodialysis patients (initial avr group: n=1062 [31.1%],and conservative group: n=2348). the median follow-up duration after the index echocardiography was 1361 days,with 90% follow-up rate at 2 years. the cumulative 5-year incidence of all-cause death was significantly higher in hemodialysis patients than in nonhemodialysis patients in both the entire cohort (71% versus 40%,p < 0.001) and in the initial avr group (63.2% versus 17.9%,p < 0.001). among hemodialysis patients,the initial avr group as compared with the conservative group was associated with significantly lower cumulative 5-year incidences of all-cause death (60.6% versus 75.5%,p < 0.001) and sudden death (10.2% versus 31.7%,p < 0.001). nevertheless,the rate of aortic valve procedure-related death,which predominantly occurred within 6 months of the avr procedure,was markedly higher in the hemodialysis patients than in the nonhemodialysis patients (21.2% and 2.3%,p < 0.001). conclusions-among hemodialysis patients with severe aortic stenosis,the initial avr strategy as compared with the conservative strategy was associated with significantly lower long-term mortality risk,particularly the risk for sudden death,although the effect size for the survival benefit of the initial avr strategy was smaller than that in the nonhemodialysis patients. © 2017 the authors.
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کلیدواژه
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Aortic stenosis; Hemodialysis; Prognosis
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آدرس
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department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of clinical epidemiology,hyogo college of medicine,nishinomiya, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,tenri hospital,tenri, Japan, department of cardiovascular surgery,kurashiki central hospital,kurashiki,japan,department of cardiovascular medicine,kobe city medical center general hospital,kobe, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto,japan,cardiovascular center,the tazuke kofukai medical research institute,kitano hospital,osaka, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto,japan,cardiovascular center,the tazuke kofukai medical research institute,kitano hospital,osaka, Japan, department of cardiovascular center,osaka red cross hospital,osaka, Japan, cardiovascular center,the tazuke kofukai medical research institute,kitano hospital,osaka, Japan, department of cardiology,kansai electric power hospital,osaka, Japan, department of cardiovascular surgery,kurashiki central hospital,kurashiki, Japan, department of cardiovascular surgery,kokura memorial hospital,kitakyushu, Japan, department of cardiovascular surgery,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular surgery,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular medicine,kyoto university graduate school of medicine,kyoto, Japan, department of cardiology,kokura memorial hospital, Japan, department of cardiology,kokura memorial hospital, Japan, department of cardiology,kokura memorial hospital, Japan, department of cardiology,kokura memorial hospital, Japan, department of cardiology,kokura memorial hospital, Japan, department of cardiology,kokura memorial hospital, Japan, division of cardiology,shimada municipal hospital, Japan, division of cardiology,shimada municipal hospital, Japan, department of cardiology,shizuoka city shizuoka hospital, Japan, department of cardiology,shizuoka city shizuoka hospital, Japan, department of cardiovascular medicine,kobe city medical center general hospital,kobe, Japan, department of cardiovascular medicine,kobe city medical center general hospital,kobe, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,kurashiki central hospital,kurashiki, Japan, department of cardiology,tenri hospital,tenri, Japan, department of cardiology,tenri hospital,tenri, Japan, department of cardiology,tenri hospital,tenri, Japan, department of cardiology,tenri hospital,tenri, Japan, department of cardiology,tenri hospital,tenri, Japan, department of cardiology,tenri hospital,tenri, Japan, department of cardiology,tenri hospital,tenri, Japan, division of cardiology,nara hospital,kinki university faculty of medicine, Japan, division of cardiology,nara hospital,kinki university faculty of medicine, Japan, department of cardiology,mitsubishi kyoto hospital, Japan, department of cardiology,mitsubishi kyoto hospital, Japan, department of cardiology,mitsubishi kyoto hospital, Japan, department of cardiology,mitsubishi kyoto hospital, Japan, department of cardiology,mitsubishi kyoto hospital, Japan, department of cardiology,mitsubishi kyoto hospital, Japan, department of cardiology,mitsubishi kyoto hospital, Japan, department of cardiology,kinki university hospital, Japan, department of cardiology,kinki university hospital, Japan, department of cardiology,kishiwada city hospital, Japan, department of cardiology,kishiwada city hospital, Japan, department of cardiology,kishiwada city hospital, Japan, department of cardiovascular center,osaka red cross hospital,osaka, Japan, department of cardiovascular center,osaka red cross hospital,osaka, Japan, department of cardiovascular center,osaka red cross hospital,osaka, Japan, department of cardiology,koto memorial hospital, Japan, department of cardiology,koto memorial hospital, Japan, department of cardiology,koto memorial hospital, Japan, department of cardiology,koto memorial hospital, Japan, department of cardiology,koto memorial hospital, Japan, department of cardiology,koto memorial hospital, Japan, department of cardiology,koto memorial hospital, Japan, department of cardiology,koto memorial hospital, Japan, department of cardiology,shizuoka general hospital, Japan, department of cardiology,shizuoka general hospital, Japan, department of cardiology,shizuoka general hospital, Japan, department of cardiology,shizuoka general hospital, Japan, department of cardiology,nishikobe medical center, Japan, department of cardiology,nishikobe medical center, Japan, department of cardiology,nishikobe medical center, Japan, department of cardiology,nishikobe medical center, Japan, department of cardiology,nishikobe medical center, Japan, department of cardiology,japanese red cross wakayama medical center, Japan, department of cardiology,japanese red cross wakayama medical center, Japan, department of cardiology,japanese red cross wakayama medical center, Japan, department of cardiology,japanese red cross wakayama medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,national hospital organization kyoto medical center, Japan, department of cardiology,hikone municipal hospital, Japan, department of cardiology,hikone municipal hospital, Japan, department of cardiology,kansai electric power hospital,osaka, Japan, department of cardiology,hyogo prefectural amagasaki general medical center, Japan, department of cardiology,hyogo prefectural amagasaki general medical center, Japan, department of cardiology,hyogo prefectural amagasaki general medical center, Japan, department of cardiology,rakuwakai otowa hospital, Japan, department of cardiology,rakuwakai otowa hospital, Japan, department of cardiology,saiseikai noe hospital, Japan, department of cardiology,saiseikai noe hospital, Japan, department of cardiology,shiga medical center for adults, Japan, department of cardiology,shiga medical center for adults, Japan, department of cardiology,shiga medical center for adults, Japan, department of cardiology,shiga medical center for adults, Japan, department of cardiology,hamamatsu rosai hospital, Japan, department of cardiology,hamamatsu rosai hospital, Japan, department of cardiology,hamamatsu rosai hospital, Japan, department of cardiology,hamamatsu rosai hospital, Japan, department of cardiology,japanese red cross otsu hospital, Japan, department of cardiology,japanese red cross otsu hospital, Japan, department of cardiology,japanese red cross otsu hospital, Japan, department of cardiology,japanese red cross otsu hospital, Japan, department of cardiology,japanese red cross otsu hospital, Japan, department of cardiology,japanese red cross otsu hospital, Japan, department of cardiology,hirakata kohsai hospital, Japan, department of cardiology,hirakata kohsai hospital, Japan, department of cardiovascular surgery,kyoto university graduate school of medicine,kyoto, Japan, department of cardiovascular surgery,shizuoka city shizuoka hospital, Japan, department of cardiovascular surgery,kobe city medical center general hospital, Japan, department of cardiovascular surgery,tenri hospital, Japan, department of cardiovascular surgery,nara hospital,kinki university faculty of medicine, Japan, department of cardiovascular surgery,mitsubishi kyoto hospital, Japan, department of cardiovascular surgery,mitsubishi kyoto hospital, Japan, department of cardiovascular surgery,mitsubishi kyoto hospital, Japan, department of cardiovascular surgery,mitsubishi kyoto hospital, Japan, department of cardiovascular surgery,kinki university hospital, Japan, department of cardiovascular surgery,kishiwada city hospital, Japan, department of cardiovascular surgery,kishiwada city hospital, Japan, department of cardiovascular surgery,osaka red cross hospital, Japan, department of cardiovascular surgery,shizuoka general hospital, Japan, department of cardiovascular surgery,japanese red cross wakayama medical center, Japan, department of cardiovascular surgery,national hospital organization kyoto medical center, Japan, department of cardiovascular surgery,cardiovascular center,the tazuke kofukai medical research institute,kitano hospital, Japan, department of cardiovascular surgery,hyogo prefectural amagasaki general medical center, Japan, department of cardiovascular surgery,rakuwakai otowa hospital, Japan, department of cardiovascular surgery,shiga medical center for adults, Japan, department of cardiovascular surgery,hamamatsu rosai hospital, Japan, department of cardiovascular surgery,japanese red cross otsu hospital, Japan, kyoto university graduate school of medicine, Japan, kyoto university graduate school of medicine, Japan, kishiwada city hospital, Japan
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Authors
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