Deng Jin-Long, Wu Yin-Xiong, Liu Jie
From the Cadre Integrated Ward, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Medicine (Baltimore). 2015 Feb;94(5):e418. doi: 10.1097/MD.0000000000000418.
The aim of this meta-analysis was to compare the efficacy of implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy (CRT) monotherapies with CRT-ICD combined therapy. Databases were searched to identify studies that compared CRT or ICD alone with CRT-ICD combined therapy in patients with heart failure. The primary outcome was rate of death for any cause, and secondary outcomes included rate of death or hospitalization due to heart failure or any cause. Nine studies with 7679 patients were included. Combined data of ICD and CRT monotherapies found that there was a higher risk of all-cause death (odds ratio [OR] 1.348, P < 0.001) and death or hospitalization from heart failure (OR 1.368, P < 0.001) with monotherapy compared with CRT-ICD combined therapy. No significant difference was observed between mono and combined therapy groups for risk of death or hospitalization from any cause (OR 1.292, P = 0.083). Compared with ICD or CRT monotherapy, CRT-ICD therapy had favorable outcomes regarding all-cause death and the risk of hospitalization or death due to heart failure.
本荟萃分析的目的是比较植入式心脏复律除颤器（ICD）和心脏再同步治疗（CRT）单一疗法与CRT-ICD联合疗法的疗效。检索数据库以确定在心力衰竭患者中比较单独使用CRT或ICD与CRT-ICD联合疗法的研究。主要结局是任何原因导致的死亡率，次要结局包括因心力衰竭或任何原因导致的死亡或住院率。纳入了9项研究，共7679例患者。ICD和CRT单一疗法的合并数据发现，与CRT-ICD联合疗法相比，单一疗法的全因死亡风险更高（比值比[OR] 1.348，P<0.001），因心力衰竭导致的死亡或住院风险更高（OR 1.368，P<0.001）。单一疗法组和联合疗法组在任何原因导致的死亡或住院风险方面未观察到显著差异（OR 1.292，P=0.083）。与ICD或CRT单一疗法相比，CRT-ICD疗法在全因死亡以及因心力衰竭导致的住院或死亡风险方面具有良好的结局。
