风险因素与心脏结局的关联在患有突发心脏病死亡的主要预防的患者中:HINODE研究子分析
Hiroshi Hayashi1, Wataru Shimizu1, Yuki Iwasaki1
1Department of Cardiovascular Medicine, Nippon Medical School, Bunkyo, Japan.
Journal of cardiovascular electrophysiology
|August 18, 2025
概括
植入式心脏转移器除器 (ICD) 和心脏再同步治疗-除器 (CRT-Ds) 对于预防心脏突然死亡是有效的,即使在患有多种危险因素的患者中也是如此. 高风险患者经历了更多的心力衰竭住院治疗与ICDs.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
背景情况:
- 在HINODE研究的初级分析显示,日本和西方患者的死亡率和腹腔动脉节律不良事件率相似,用于初级预防心脏突然死亡.
- 一个子分析根据累积的风险因素 (RF) 评估事件率,包括左心室喷射率,NYHA类,LBBB,功能障碍,糖尿病,AFib,MI,年龄和吸烟.
研究的目的:
- 根据积累的风险因素 (RF) 的数量,评估可植入心脏转心器除器 (ICD) 和心脏再同步治疗-除器 (CRT-Ds) 的患者的事件率 (心室动脉冲动/动,心力衰竭住院,全因死亡率).
- 为了比较较低风险 (2-3 RF) 和高风险 (4-5 RF) 患者群体之间的结果.
主要方法:
- 在24个月内对102名ICD和69名CRT-D学员进行评估,首次适当治疗VT/VF,重复性HF住院,以及所有原因死亡率.
- 时间到事件分析被用来比较每个设备队列中的低风险和高风险患者组之间的事件率.
主要成果:
- 在ICD或CRT-D队列中,较低风险和较高风险组之间的VT/VF事件率或全因死亡率没有显著差异.
- 在ICD队列中,风险较高的患者患心力衰竭住院的风险显著增加 (2.24倍),住院时间更长.
- 在CRT-D队列中,心力衰竭住院率没有显著差异.
结论:
- 不管有多少危险因素,应考虑植入可植入心脏转换器除器 (ICD) 植入用于预防心脏突然死亡.
- 适当的心脏再同步治疗-除器 (CRT-D) 植入可能会随着时间的推移降低风险因素,并缩短心力衰竭住院的持续时间.
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