誘멸뎅 �쓽猷뚮낫�뿕�뜲�씠�꽣 �썑�뼢�쟻 肄뷀샇�듃�뿰援� 寃곌낵
[荑좏궎 嫄닿컯] 濡쒖떆湲�由ы��議닿낵 �뵾�삤湲�由ы��議댁씠 �떦�눊蹂묓솚�옄�쓽 �떖�삁愿�吏덊솚 �쐞�뿕 諛쒖깮�씠 鍮꾩듂�븳 寃껋쑝濡� �솗�씤�릱�떎.
誘멸뎅 �뿬�뒪肄붿뼱 �뜲釉뚮씪 �쎇痢�(Debra A. Wertz) 諛뺤궗媛� Circulation: Cardiovascular Quality and Outcomes�뿉�꽌 �쓽猷뚮낫�뿕 �뜲�씠�꽣瑜� �넗���濡� �썑�뼢�쟻 肄뷀샇�듃 �뿰援щ�� �떎�떆�븳 寃곌낵, �씠媛숈씠 �굹����궗�떎怨� 蹂닿퀬�뻽�떎.
吏�湲덇퉴吏� 誘멸뎅�닚�솚湲곗쟾臾몄쓽��� 誘몄떇�뭹�쓽�빟援�(FDA) �뿰援ы����� 濡쒖떆湲��씪���議댁씠 �떖�삁愿�吏덊솚 �쐞�뿕�쓣 利앷���떆�궓�떎怨� 蹂닿퀬�빐 �솕�쑝硫�, FDA��� �쑀�읇�쓽�빟�뭹泥�(EMEA)�룄 �듅�씤 �옱怨� �벑�쓣 寃��넗 以묒씠�떎.
�뾿誘멸뎅�떦�눊蹂묓븰�쉶 ��쒖쐞�뿕 諛쒖깮瑜� 4%�뒗 �솗�떎�엳 �넂��� �닔移섃��
�씠踰� �뿰援� ����긽��� 2001�뀈 1�썡~2005�뀈 12�썡�뿉 濡쒖떆湲�由ы��議� �삉�뒗 �뵾�삤湲�由ы��議댁쓣 泥섎갑諛쏆�� 18�꽭 �씠�긽 �떦�눊蹂묓솚�옄 3留� 6,628紐�[58%媛� �궓�꽦, �굹�씠(以묒븰移�) 54�꽭]. 1�뀈 �씠�궡�뿉 �씤�뒓由곗쓣 �궗�슜�븳 �솚�옄�뒗 �젣�쇅�떆耳곕떎.
Propensity score matching踰뺤쓣 �씠�슜�빐 33媛쒖썡 �씠�긽 �뼇履� �빟�젣 �닾�뿬援곗뿉�꽌 �굹����궃 湲됱꽦�떖洹쇨꼍�깋(AMI) 諛� 湲됱꽦�떖遺��쟾(AHF) �삉�뒗 �궗留� 諛쒖깮瑜좎쓣 鍮꾧탳�뻽�떎.
洹� 寃곌낵, 濡쒖떆湲�由ы��議닿뎔�쓽 �궗怨� 諛쒖깮瑜좎�� 4.16%(602紐�), �뵾�삤湲�由ы��議닿뎔�뿉�꽌�뒗 4.14%(599紐�)濡� �씠�뱾 蹂듯빀 �씠踰ㅽ듃 �쐞�뿕�쓽 �빐����뱶鍮꾩뿉 �쑀�쓽李⑤뒗 �굹����굹吏� �븡�븯�떎(1.03, 95竊꿂I 0.91~1.15, P竊�0.666).
�궗怨좊�� 媛쒕퀎�쟻�쑝濡� 蹂댁븘�룄 �뼇履쎄뎔 媛꾩쓽 鍮꾩쑉��� 留덉갔媛�吏�����떎. 濡쒖떆湲�由ы��議닿뎔, �뵾�삤湲�由ы��議닿뎔�뿉�꽌 �굹����궃 �궗怨� 諛쒖깮 鍮꾩쑉��� �떎�쓬怨� 媛숇떎. AMI:96紐� vs 121紐�, AHF:265紐� vs 243紐�, AMI쨌AHF:24紐� vs 18紐�, �궗留�:217紐� vs 217紐�.
�삉 媛� 援곗뿉�꽌 �빟臾쇱쓣 蹂듭슜 �썑 �궗怨� 諛쒖깮源뚯�� 嫄몃┛ 湲곌컙�쓽 以묒븰移�(�굹�씠, �꽦蹂�, �떖�삁愿�吏덊솚 湲곗솗�젰, �떦�눊蹂묓빀蹂묒쬆 �벑�쓣 蹂댁젙)瑜� 蹂댁젙�븳 寃곌낵, 濡쒖떆湲�由ы��議닿뎔�뿉�꽌 14媛쒖썡, �뵾�삤湲�由ы��議닿뎔�뿉�꽌 19媛쒖썡濡� �굹����궗�떎.
�쎇痢� 諛뺤궗�뒗 �씠踰� 遺꾩꽍�뿉�꽌 �뼇履� �빟臾� 媛꾩쓽 AMI, AHF, �궗留앹쓽 諛쒖깮瑜좎뿉 �쑀�쓽李⑤뒗 �굹����굹吏� �븡�븯�떎怨� 寃곕줎�궡�졇�떎. �븘�슱�윭 ��쒖턀洹� �떎�떆�맂 �쓽猷뚮낫�뿕�뿉 洹쇨굅�븳 蹂닿퀬����뒗 �떖由� 異붿쟻湲곌컙�씠 �긽����쟻�쑝濡� 湲몄뿀�뜕 �씠踰� �뿰援ъ뿉�꽌�뒗 �뼇履� �빟�젣�쓽 �쐞�뿕�씠 媛숈븯�떎��앸ʼn 異붿쟻湲곌컙�뿉 �뵲�씪 寃곌낵媛� �떖�씪議뚯쓬�쓣 �떆�궗�뻽�떎.
誘멸뎅�떦�눊蹂묓븰�쉶(ADA)�뒗 怨듭떇�궗�씠�듃 �쓽猷뚯씤�슜�젙蹂� 肄붾꼫�뿉�꽌 ��쒖쐞�뿕 諛쒖깮瑜좎씠 4%�씪�뒗 寃껋�� �씠 寃��넗�쓽 異붿쟻湲곌컙�쓣 怨좊젮�븷 �븣 ��섎ℓ�슦 �넂�떎���(pretty high)��앸뒗 �쟾臾멸�� 寃ы빐瑜� �냼媛쒗뻽�떎. 援�誘쇱씪蹂� 荑좏궎�돱�뒪 �젣�쑕�궗 / 硫붾뵒移쇳듃由щ럽 源�以��샇 湲곗옄 jkim30@medical-tribune.co.kr
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