| Autor: |
Satoshi Kainuma, Koichi Toda, Shigeru Miyagawa, Yasushi Yoshikawa, Hiroki Hata, Daisuke Yoshioka, Takuji Kawamura, Ai Kawamura, Takayoshi Ueno, Toru Kuratani, Haruhiko Kondoh, Takafumi Masai, Arudo Hiraoka, Taichi Sakaguchi, Hidenori Yoshitaka, Yukitoshi Shirakawa, Toshiki Takahashi, Shunsuke Saito, Osamu Monta, Junya Sado, Tetsuhisa Kitamura, Sho Komukai, Atsushi Hirayama, Kazuhiro Taniguchi, Yoshiki Sawa |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
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| Zdroj: |
ESC Heart Failure, Vol 7, Iss 4, Pp 1560-1570 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
2055-5822 |
| DOI: |
10.1002/ehf2.12705 |
| Popis: |
Abstract Aims In patients with ischaemic mitral regurgitation (MR), the impact of mitral valve surgery with concomitant coronary artery bypass grafting (CABG) on post‐operative survival and left ventricular (LV) reverse remodelling remains unknown. Therefore, we investigated these outcomes following restrictive mitral annuloplasty (RMA) with and without CABG in those patients. Methods and results This study included 309 patients with chronic MR and ischaemic cardiomyopathy for whom concomitant CABG was indicated (n = 225) or not indicated (n = 84) with RMA. The primary endpoint was all cause mortality during the follow‐up, and the secondary endpoint was defined as the composite of mortality and re‐admission for heart failure. Linear mixed model was used to analyse serial echocardiographic changes in LV function. To reduce the impact of treatment bias and potential confounding in the direct comparisons between patients who underwent RMA with and those who underwent it without CABG, we established weighted Cox proportional‐hazards regression models with inverse‐probability‐of‐treatment weighting. Pre‐operatively, there were no intergroup differences in age (RMA with CABG, 67 ± 9 vs. RMA without CABG, 68 ± 11, P = 0.409) and logistic EuroSCORE II (16 ± 14 vs. 15 ± 15%, P = 0.496). The 30‐day mortalities were 2.7% and 3.6%, respectively (P = 0.67). During follow‐up with a mean duration of 72 ± 37 months (range, 5.6–179), there were 157 deaths and 105 re‐admissions for heart failure. Overall 1‐year and 5‐year survival rates were 83 ± 2% and 58 ± 3%, respectively. Patients who did not receive CABG with RMA had a significantly lower 5‐year survival rate (45% vs. 63%, P = 0.049) and freedom from adverse events defined as mortality and/or admission for heart failure (19% vs. 43%, P |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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