Balloon Coronary Angioplasty and Long-Term Survival of Non-Diabetic Patients With Isolated Severe Left Anterior Descending Coronary Artery Disease
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概要
- 論文の詳細を見る
Although long-term survival of diabetic patients with multivessel coronary disease has been reported to be better in those treated with bypass surgery than with coronary angioplasty, it is unclear if diabetic patients who undergo coronary angioplasty show better long-term survival than those treated medically. Between 1985 and 1994, 667 consecutive patients with isolated severe (≥90% diameter stenosis) proximal left anterior descending (LAD) coronary artery disease were divided into 4 groups according to the initial therapeutic choice and their diabetic status: of 225 diabetic patients, 104 were treated medically and 121 underwent coronary angioplasty; of 442 non-diabetic patients, 215 were treated medically and 227 underwent coronary angioplasty. The primary end-point of follow-up was death from any cause, and the secondary end-point was cardiac death. Cox's proportional hazard model was used to assess the relative risk of baseline variables. The mean follow-up interval was 6.5±3.0 years. The relative distribution of baseline parameters of medically treated patients to those treated with coronary angioplasty was identical in diabetic and non-diabetic patients. Although non-diabetic patients who underwent coronary angioplasty showed better long-term survival than those treated medically, this survival advantage was not observed in diabetic patients. After adjustment of parameters using Cox's proportional hazard model, age over 65 years, coronary angioplasty and low left ventricular ejection fraction were independent determinants of total death. Long-term survival in non-diabetic patients with severe LAD coronary artery disease is more favorable in patients treated with coronary angioplasty than those treated medically, but this advantage is overridden when the patients are diabetic.
- 社団法人日本循環器学会の論文
- 2002-05-20
著者
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NONOGI Hiroshi
Division of Cardiology, National Cardiovascular Center
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MIYAZAKI Shunichi
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Fujishiroda
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YASUDA Satoshi
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Fujishiroda
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MORII Isao
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Fujishiroda
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Morii Isao
Division Of Cardiology Department Of Internal Medicine Hokusetsu General Hospital
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Yuda Satoshi
Tohoku University Graduate School Of Medicine
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Yasuda Satoshi
Division Of Cardiology Department Of Internal Medicine Tohoku University Graduate School Of Medicine
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Nonogi Hiroshi
Division Of Cardiology And Emergency Medicine National Cardiovascular Center
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Yuda Satoshi
Division Of Cardiology Department Of Internal Medicine Tohoku University Graduate School Of Medicine
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Sutani Yasuo
Division of Cardiology, Department of Medicine, National Cardiovascular Center
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Tomita Takeshi
Division of Cardiovascular Medicine, Shinshu University School of Medicine
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Miyazaki Shunichi
Division Of Cardiology Department Of Internal Kinki University School Of Medicine
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Morii Isao
Department Cardiology National Cardiovascular Center
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Yasuda Satoshi
Division Of Cardiology Department Of Internal Medicine National Cardiovascular Center
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Sutani Yasuo
Division Of Cardiology Department Of Internal Medicine National Cardiovascular Center
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Tomita Takeshi
Division Of Biotechnology And Biochemistry Faculty Of Agriculture University Of Miyazaki
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Tomita Takeshi
Division Of Cardiology Department Of Internal Medicine National Cardiovascular Center
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Nonogi Hiroshi
Division Of Cardiac Care Unit Department Of Cardiovascular Medicine National Cerebral And Cardiovasc
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