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Risk scores for predicting mortality after surgical ventricular reconstruction for ischemic cardiomyopathy: Results of a Japanese multicenter study

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Title: Risk scores for predicting mortality after surgical ventricular reconstruction for ischemic cardiomyopathy: Results of a Japanese multicenter study
Authors: Wakasa, Satoru Browse this author →KAKEN DB
Matsui, Yoshiro Browse this author →KAKEN DB
Isomura, Tadashi Browse this author
Takanashi, Shuichiro Browse this author
Yamaguchi, Atsushi Browse this author
Komiya, Tatsuhiko Browse this author
Cho, Yasunori Browse this author
Kobayashi, Junjiro Browse this author
Yaku, Hitoshi Browse this author
Kokaji, Kiyokazu Browse this author
Arai, Hirokuni Browse this author
Sawa, Yoshiki Browse this author
Issue Date: Jun-2014
Publisher: Elsevier
Journal Title: Journal of Thoracic and Cardiovascular Surgery
Volume: 147
Issue: 6
Start Page: 1868
End Page: 1874.e2
Publisher DOI: 10.1016/j.jtcvs.2013.06.036
PMID: 23968870
Abstract: Objectives: Surgical ventricular reconstruction has been believed to be beneficial for those with ischemic cardiomyopathy. However, the effectiveness of surgical ventricular reconstruction was not proved by a large-scale trial, and no report has clearly demonstrated the exact indications and limitations of surgical ventricular reconstruction. The purpose of this study was to elucidate predictive factors of mortality after surgical ventricular reconstruction and to develop a prognostic model by calculating risk scores. Methods: The study subjects were 596 patients who underwent surgical ventricular reconstruction for chronic ischemic heart failure in 11 Japanese cardiovascular hospitals between 2000 and 2010. Potential predictors of postoperative mortality were assessed using the Cox proportional hazards model, and a risk score was calculated. Results: Forty-one patients died before discharge, and 81 patients died during a mean follow-up time of 2.9 years. Four independent predictors of mortality were identified: age, Interagency Registry for Mechanically Assisted Circulatory Support profile, left ventricular ejection fraction, and severity of mitral regurgitation. Each variable was assigned a number of points proportional to its regression coefficient. A risk score was calculated using the point scores for each patient, and 3 risk groups were developed: a low-risk group (0-4 points), an intermediate-risk group (5-6 points), and a high-risk group (7-12 points). Their 3-year survivals were 93%, 81%, and 44%, respectively (log-rank P < .001). Harrell's C-index of the predictive model was 0.69. Conclusions: A simple prognostic model was developed to predict mortality after surgical ventricular reconstruction. It can be useful in clinical practice to select treatment options for ischemic heart failure.
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 若狭 哲

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