{"created":"2023-05-15T11:21:33.612944+00:00","id":228,"links":{},"metadata":{"_buckets":{"deposit":"c3fe1004-1730-4284-9969-79740121c95f"},"_deposit":{"created_by":1,"id":"228","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"228"},"status":"published"},"_oai":{"id":"oai:showa.repo.nii.ac.jp:00000228","sets":["1:6:26:32"]},"author_link":["1127","1136","1129","1126","1135","1124","1130","1125","1128","1131","1133","1123","1134","1132","1137"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2015-12"},"bibliographicIssueNumber":"6","bibliographicPageEnd":"664","bibliographicPageStart":"657","bibliographicVolumeNumber":"75","bibliographic_titles":[{"bibliographic_title":"昭和学士会雑誌"}]}]},"item_10002_description_6":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"近年の研究で安静時心拍数の増加が冠動脈疾患の予後因子と報告されているが，ST上昇型心筋梗塞患者 (ST elevated myocardial infarction; STEMI) の退院時心拍数が予後因子となるかどうかの報告はほとんどない．本研究の目的はSTEMIを発症し，責任病変に対して経皮的冠動脈インターベンション (percutaneous coronary intervention; PCI) によって血行再建された患者群の退院時心拍数を測定し，予後に影響を与えるかどうかを検討することである．2001年6月～2013年2月にかけてSTEMIを発症し，24時間以内に責任病変に対してPCIで血行再建された連続386人を退院時心拍数が70以上群 (心拍数≧70群)，173人と70未満群 (心拍数＜70群) 213人に割り付け，退院後の主要心脳血管イベント (Major Adverse Cardiac and Cerebrovascular event; MACCE) 発症を後ろ向きに比較検討した．また，同様の分析を右冠動脈枝 (right coronary artery; RCA)，左前下行枝 (left anterior descending coronary artery; LAD)，左回旋枝 (left circumflex coronary artery; LCX) それぞれで行った．結果は心拍数＜70群は心拍数≧70群と比較して有意にMACCE，全死亡の発症リスクを低下させていた．また罹患枝別に解析するとLAD病変ではMACCE，全死亡においては有意差を持って心拍数＜70群が心拍数≧70群と比較し，リスクを低下させていたが，RCA枝，LCX枝では両群間に有意差は認めなかった．また，多変量解析を用いて全患者のMACCE発症リスクを層別化すると心拍数＜70は独立した予後因子とはならなかったが，罹患枝毎に層別化するとLAD病変では心拍数＜70はMACCE発症回避の独立した予後規定因子となった．今回の研究でSTEMI患者において心拍数＜70は心拍数≧70と比較してMACCE発症リスクが有意に低かった．患者背景とβ遮断薬使用歴などを調整し解析すると全患者群においては心拍数＜70は独立した予後規定因子とならなかったが，LAD病変に関しては独立した予後規定因子となった．","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"昭和大学学士会"}]},"item_10002_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"10.14930/jshowaunivsoc.75.657"}}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"2187-719X"}]},"item_10002_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"星本, 剛一"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大山, 祐司"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"井川, 渉"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小野, 盛夫"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"木戸, 岳彦"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"荏原, 誠太郎"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岡部, 俊孝"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山下, 賢之介"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山本, 明和"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"斎藤, 重男"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"雨宮, 妃"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"薬師寺, 忠幸"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"磯村, 直栄"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"荒木, 浩"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"落合, 正彦"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-07-26"}],"displaytype":"detail","filename":"75_657.pdf","filesize":[{"value":"468.6 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"75_657.pdf","url":"https://showa.repo.nii.ac.jp/record/228/files/75_657.pdf"},"version_id":"2cc8ad9c-9a19-47e5-9695-690807a0eb39"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper"}]},"item_title":"ST上昇型心筋梗塞患者における退院時心拍数の予後への影響　―冠動脈各枝の比較検討も含めて―","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"ST上昇型心筋梗塞患者における退院時心拍数の予後への影響　―冠動脈各枝の比較検討も含めて―"},{"subitem_title":"IMPACT OF HEART RATE AT DISCHARGE AS A PROGNOSIS FACTOR IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI)"}]},"item_type_id":"10002","owner":"1","path":["32"],"pubdate":{"attribute_name":"公開日","attribute_value":"2016-09-30"},"publish_date":"2016-09-30","publish_status":"0","recid":"228","relation_version_is_last":true,"title":["ST上昇型心筋梗塞患者における退院時心拍数の予後への影響　―冠動脈各枝の比較検討も含めて―"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2023-05-15T13:07:39.307098+00:00"}