Long-Term Outcome After Transcatheter Closure of Atrial Septal Defect in Older Patients Impact of Age at Procedure
Long-Term Outcome After Transcatheter Closure of Atrial Septal Defect in Older Patients Impact of Age at Procedure
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DOI：
10.1016/j.jcin.2015.02.002
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发表时间：
2015-04-20
影响因子：
11.3
通讯作者：
Ito, Hiroshi
中科院分区：
文献类型：
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作者：
Takaya, Yoichi;Akagi, Teiji;Ito, Hiroshi
结论本研究评估了老年患者经导管房间隔缺损（ASD）封堵术后的长期结局，尤其是75岁以上的老年患者。方法将244例年龄大于50岁的患者根据手术时的年龄分为3组（50 - 59岁：n = 69; 60 - 74岁：n = 120; 75岁及以上：n = 55）。主要终点定义为全因死亡率和因心力衰竭或卒中住院。术后功能和心脏重塑的改善也进行了评估。结果在中位随访36个月期间，18例患者（7%）因心力衰竭或中风而死亡和住院。在75岁以上的患者中，2例死于非心血管疾病，2例因心力衰竭住院，1例发生卒中。超过90%的75岁以上患者未发生这些事件。Kaplan-Meier分析显示，3个年龄组的无事件生存率无差异（对数秩检验，p = 0.780）。纽约心脏协会功能分级和右心室/左心室舒张末期直径比改善患者年龄大于75岁，类似于其他年龄组。结论：经导管ASD封堵术后的长期结果在患者年龄大于75岁，是类似于其他，相对年轻的年龄组。这表明，经导管ASD封堵术可以被认为是75岁以上患者的一种有价值的治疗选择。(C)2015年美国心脏病学院基金会。
OBJECTIVES This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age.BACKGROUND The clinical benefits of transcatheter ASD closure in this aged population are controversial. METHODS A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n = 69; 60 to 74 years: n = 120; 75 years and older: n = 55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed.RESULTS During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90% of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p = 0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups.CONCLUSIONS Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age. (C) 2015 by the American College of Cardiology Foundation.