| Project/Area Number |
17K15890
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
General internal medicine(including psychosomatic medicine)
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| Research Institution | Kitasato University |
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Principal Investigator |
Yamada Yoko 北里大学, 北里研究所病院, 医員 (30701007)
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| Project Period (FY) |
2017-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | 超高齢者 / 抗凝固療法 / 高齢者 / 心房細動 / 抗凝固薬 / フレイル |
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| Outline of Final Research Achievements |
Geriatrician’s decision on anticoagulant therapy based on comorbid conditions and comprehensive geriatric assessment including living environment might help reduce adverse outcomes among older patients. For this purpose, we examined the outcomes of geriatric patients with atrial fibrillation on or off anticoagulant therapy in a retrospective observational study. 175 patients aged ≧75 who were admitted to the geriatric ward of the University of Tokyo Hospital with atrial fibrillation were enrolled. Each patient followed up for 1 to 5 years. There was no significant association between anticoagulant therapy and bleeding. Unexpectedly, the patients under anticoagulant therapy were found to have significantly higher risk for cerebral infarction. Resultantly, patients with anticoagulant therapy had lower risk for mortality. These results suggest that geriatric evaluation and management help reduce the risk for adverse outcomes in geriatric patients with atrial fibrillation.
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| Academic Significance and Societal Importance of the Research Achievements |
心房細動は塞栓性脳梗塞を起こすことが知られており、起こした後の患者のQOLは著しく低下するため、その予防としての抗凝固療法が重要である。しかし、超高齢者においては、抗凝固療法による出血性合併症がそのメリットを超えてしまうこともあり、選択は難しい。本研究では、メリットがデメリットを超えるような選択基準についての検討を行い、現在老年病科で行われいるような、高齢者総合機能評価を用いた抗凝固療法の選択は、デメリットよりもメリットの方が多い適正な選択であると考えられた。
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