长期结果在ICD:所有原因的死亡率和第一个适当的干预在缺血和非缺血病因
Marco Cittar1, Massimo Zecchin1, Marco Merlo1
1Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy.
The American journal of cardiology
|October 6, 2024
概括
植入式心脏转移器除器 (ICD) 患者的结果因心脏病类型而异. 缺血性心脏病患者的死亡率较高,但与非缺血性心脏病患者相比,ICD干预率相似.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 对于具有各种心脏病的可植入心脏转换器除器 (ICD) 患者的长期结果的现实数据有限.
- 了解这些结果对于患者管理和风险分层至关重要.
研究的目的:
- 为了比较首次适当的ICD干预的长期风险和ICD患者的整体存活率,按心脏病病因理分层.
- 分析特定的非缺血性心脏病 (NIHD) 病因,包括扩张性心肌病 (DCM) 亚型.
主要方法:
- 在2010年1月1日至2022年12月31日期间植入ICD的1184名患者的回顾性分析.
- 缺血性心脏病 (IHD) 和NIHD组之间的结果比较.
- 在53个月的中位数随访期间分析死亡率和适当的ICD干预率.
主要成果:
- 与NIHD患者 (43%) 相比,IHD患者的全因死亡率明显高 (60%).
- 在IHD和NIHD组之间没有观察到10年适当的ICD干预率的显著差异 (34%与40%对比).
- 在NIHD中,膜心脏病,放射/化疗后DCM (rctDCM) 和高血压DCM的死亡率较高. 酒精DCM和rctDCM的不适当的ICD干预率更高.
结论:
- 长期的结果,包括死亡率和适当的ICD干预措施,根据潜在的心脏病病因而异.
- 在ICD患者的预后分层时,应考虑心血管风险概况和植入时的特定心脏病类型.
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