Desai Harit, Aronow Wilbert S, Tsai Fausan S, Ahn Chul, Lai Hoang M, Amin Harshad, Gandhi Kaushang, Frishman William H, Cohen Martin, Sorbera Carmine
Department of Medicine, New York Medical College, Valhalla, 10595, USA.
J Cardiovasc Pharmacol Ther. 2009 Sep;14(3):176-9. doi: 10.1177/1074248409340157. Epub 2009 Jul 17.
Of 209 patients with heart failure treated with combined cardiac resynchronization therapy and implantable cardioverter-defibrillator therapy, appropriate cardioverter-defibrillator shocks occurred at 34-month follow-up in 22 of 121 patients (18%) on statins and in 30 of 88 patients (34%) not on statins (P = .009). Deaths occurred in 3 of 121 patients (2%) on statins and in 9 of 88 patients (10%) not on statins (P = .017). Stepwise Cox regression analysis showed that significant independent prognostic factors for appropriate shocks were use of statins (risk ratio = 0.46), smoking (risk ratio = 3.5), and diabetes (risk ratio = 0.34). Significant independent prognostic factors for the time to mortality were use of statins (risk ratio = 0.05), use of digoxin (risk ratio = 4.2), systemic hypertension (risk ratio = 14.2), diabetes (risk ratio = 4.3), and left ventricular ejection fraction (risk ratio = 1.1).
在209例接受心脏再同步治疗和植入式心律转复除颤器治疗的心力衰竭患者中，在34个月的随访中，121例服用他汀类药物的患者中有22例（18%）发生了适当的心律转复除颤器电击，而88例未服用他汀类药物的患者中有30例（34%）发生了适当的电击（P = 0.009）。服用他汀类药物的121例患者中有3例（2%）死亡，未服用他汀类药物的88例患者中有9例（10%）死亡（P = 0.017）。逐步Cox回归分析显示，适当电击的显著独立预后因素为服用他汀类药物（风险比 = 0.46）、吸烟（风险比 = 3.5）和糖尿病（风险比 = 0.34）。死亡时间的显著独立预后因素为服用他汀类药物（风险比 = 0.05）、使用地高辛（风险比 = 4.2）、系统性高血压（风险比 = 14.2）、糖尿病（风险比 = 4.3）和左心室射血分数（风险比 = 1.1）。
