著者
Satoshi Katano Toshiyuki Yano Takanori Tsukada Hidemichi Kouzu Suguru Honma Takuya Inoue Yuhei Takamura Ryohei Nagaoka Tomoyuki Ishigo Ayako Watanabe Katsuhiko Ohori Masayuki Koyama Nobutaka Nagano Takefumi Fujito Ryo Nishikawa Hiroyuki Takashima Akiyoshi Hashimoto Masaki Katayose Tetsuji Miura
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.84, no.12, pp.2224-2234, 2020-11-25 (Released:2020-11-25)
参考文献数
37
被引用文献数
5 15

Background:The clinical significance of osteoporosis in chronic heart failure (CHF) remains unclear.Methods and Results:A total of 303 CHF patients (75 years, [interquartile range (IQR) 66–82 years]; 41% female) were retrospectively examined. Bone mineral densities (BMDs) at the lumbar spine, femoral neck, and total femur were measured by using dual-energy X-ray absorptiometry (DEXA), and osteoporosis was diagnosed when the BMD at any of the 3 sites was <70% of the Young Adult Mean percentage (%YAM). The prevalence of osteoporosis in CHF patients was 40%. Patients with osteoporosis were older (79 [IQR, 74–86] vs. 72 [IQR, 62–80] years), included a large percentage of females, had slower gait speed and had a lower body mass index. Multivariate logistic regression analysis indicated that sex, BMI, gait speed, loop diuretics use and no use of direct oral anticoagulants (DOACs) were independently associated with osteoporosis. Kaplan-Meier survival curves showed that the rate of death and heart failure hospitalization was higher in patients with osteoporotic BMD at 2 or 3 sites than in patients without osteoporosis (hazard ratio 3.45, P<0.01). In multivariate Cox regression analyses, osteoporotic BMD at 2 or 3 sites was an independent predictor of adverse events after adjustment for prognostic markers.Conclusions:Loop diuretics use and no DOACs use are independently associated with osteoporosis in CHF patients. Osteoporosis is a novel predictor of worse outcome in patients with CHF.

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#23JCS ランチョンセミナー38 循環器診療における骨折予防の重要性と循環器内科医の役割~なぜ、循環器内科医の私が骨粗鬆症診療に取り組んでいるのか?~ 私達の心不全と骨粗鬆症の論文もご参照ください! https://t.co/id78CjnXUA
@KenkasCR 骨折などを重複すると、入院期間の延長や、どちらかの機能的には到達可能な能力が、片方の影響で到達できない、など、問題が生じてきますよね。 たしか札医大の片野さんの発表だったのではないでしょうか。論文化もされています。 https://t.co/mlhKAtW9WZ
【骨粗鬆症でCHF例のCV転帰増悪?骨予知因子は?/ Circ J】 日本、慢性心不全303例解析:40%に骨粗鬆症。「複数箇所骨密度低下」は「死亡・HF入院」の独立した予知因子。「複数箇所骨密度低下」と独立して相関していた因子は「女性」、「低歩行速度」と「ループ利尿薬」。 https://t.co/T9y0ywbZZe https://t.co/AkgkjQJFrp

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