Virginia Cardiovascular Associates, 8100 Ashton Ave, STE 200, Manassas, VA 20109, USA.
J Cardiovasc Transl Res. 2011 Feb;4(1):27-34. doi: 10.1007/s12265-010-9236-0. Epub 2010 Nov 18.
In patients with heart disease, diabetes and age predict adverse outcomes. It remains unclear whether persons with diabetes who have implantable cardioverter defibrillators (ICDs) have fewer appropriate and inappropriate ICD shocks. The objective of this study is to determine if persons with diabetes who have ICDs receive a similar amount of appropriate and inappropriate shocks compared to persons without diabetes. In a post hoc analysis of 1,528 patients enrolled in the INTRINSIC RV trial, all-cause mortality and ICD shocks between persons with and without diabetes, stratified by age, was compared. The relationship between shock and mortality was also assessed. Mortality 1 year after ICD implant was lower for persons without diabetes vs. persons with diabetes (3.5% vs. 7.9%, p < 0.001). Young and old persons with diabetes received a similar number of total and appropriate ICD shocks. However, older persons with diabetes were less likely to receive inappropriate ICD shocks vs. older persons without diabetes (1.9% vs. 6.9%, p < 0.01). ICD shocks were not temporally related to mortality regardless of diabetes status. In the INTRINSIC RV trial, persons with diabetes and older persons without diabetes undergoing ICD implant were at a higher risk of death. Older persons with diabetes received less inappropriate shocks and still had a similar amount of appropriate shocks compared to persons without diabetes of similar age.
在患有心脏病、糖尿病和年龄的患者中,这些因素预测着不良结局。目前尚不清楚是否植入式心脏复律除颤器 (ICD) 患者的糖尿病会导致更少的合适和不合适 ICD 电击。本研究的目的是确定与非糖尿病患者相比,患有 ICD 的糖尿病患者是否接受了相似数量的合适和不合适电击。在 INTRINSIC RV 试验的 1528 名患者的事后分析中,比较了糖尿病与非糖尿病患者的全因死亡率和 ICD 电击次数,按年龄分层。还评估了电击与死亡率之间的关系。与糖尿病患者相比,植入 ICD 后 1 年无糖尿病患者的死亡率更低(3.5% vs. 7.9%,p<0.001)。年轻和老年糖尿病患者接受的总电击次数和合适电击次数相似。然而,与老年非糖尿病患者相比,老年糖尿病患者接受不合适 ICD 电击的可能性较低(1.9% vs. 6.9%,p<0.01)。无论糖尿病状态如何,电击与死亡率均无时间相关性。在 INTRINSIC RV 试验中,接受 ICD 植入的糖尿病患者和老年非糖尿病患者的死亡风险更高。与年龄相似的非糖尿病患者相比,老年糖尿病患者接受的不合适电击更少,但合适电击次数仍相似。