Kabutoya Tomoyuki, Mitsuhashi Takeshi, Shimizu Akihiko, Nitta Takashi, Mitamura Hideo, Kurita Takashi, Abe Haruhiko, Nakazato Yuji, Sumitomo Naokata, Kadota Kazushige, Kimura Kazuo, Okumura Ken
Department of Medicine, Division of Cardiovascular Medicine, Jichi Medical University Shimotsuke Japan.
Cardiology and Vascular Medicine, Hoshi General Hospital Koriyama Japan.
Circ Rep. 2021 Jan 14;3(2):69-76. doi: 10.1253/circrep.CR-20-0122.
There has been no large multicenter clinical trial on the prognosis of implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy with a defibrillator (CRT-D) in Japanese patients with coronary artery disease (CAD). The aim of the present study was to compare differences in the prognoses of Japanese patients with CAD between primary and secondary prevention, and to identify potential predictors of prognosis. We investigated 392 CAD patients (median age 69 years, 90% male) treated with ICD/CRT-D enrolled in the Japan Implantable Devices in CAD (JID-CAD) Registry. The primary endpoint was all-cause death, and the secondary endpoint was appropriate ICD therapies. Endpoints were assessed by dividing patients into primary prevention (n=165) and secondary prevention (n=227) groups. The mean (±SD) follow-up period was 2.1±0.9 years. The primary endpoint was similar in the 2 groups (P=0.350). The mortality rate in Japanese patients with CAD who underwent ICD/CRT-D implantation as primary prevention was not lower than that of patients who underwent ICD/CRT-D implantation as secondary prevention, despite the lower cardiac function in the patients undergoing ICD/CRT-D implantation as primary prevention.
目前尚无关于日本冠心病(CAD)患者植入式心律转复除颤器(ICD)或心脏再同步化治疗除颤器(CRT-D)预后的大型多中心临床试验。本研究的目的是比较日本CAD患者一级预防和二级预防在预后方面的差异,并确定预后的潜在预测因素。我们调查了392例接受ICD/CRT-D治疗的CAD患者(中位年龄69岁,90%为男性),这些患者均纳入了日本CAD植入式器械注册研究(JID-CAD)。主要终点是全因死亡,次要终点是ICD的合理治疗。通过将患者分为一级预防组(n = 165)和二级预防组(n = 227)来评估终点。平均(±标准差)随访期为2.1±0.9年。两组的主要终点相似(P = 0.350)。尽管接受ICD/CRT-D植入作为一级预防的患者心功能较低,但接受ICD/CRT-D植入作为一级预防的日本CAD患者的死亡率并不低于接受ICD/CRT-D植入作为二级预防的患者。