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真实临床实践中的 ICD 治疗效果。奥洛穆茨 ICD 注册研究。

Effectiveness of ICD therapy in real clinical practice. The Olomouc ICD Registry.

机构信息

Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic.

Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O. BOX 60, 128 01 Praha 2, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023 Sep;167(3):225-235. doi: 10.5507/bp.2021.071. Epub 2021 Dec 17.

Abstract

BACKGROUND

Clinical parameters linked to a low benefit of ICD implantation and increased mortality risks are needed for an individualized assessment of potential benefits and risks of ICD implantation.

METHODS

Analysis of a prospective registry of all patients hospitalized from 2009 to 2019 in a single centre for a first implantation of any type of ICD.

RESULTS

A total of 2,681 patients were included in the registry. Until the end of follow-up (38.4 ± 29.1 months), 682 (25.4%) patients died. The one-year mortality in all patients, the one-year CV mortality, the three-year mortality in all patients, and the three-year CV mortality were 7.8%, 5.7%, 20.6%, and 14.8%, respectively. There was a statistically significant difference when the subgroups were compared according to the type of cardiomyopathy. No significant difference was found between primary and secondary prevention and between the types of devices. Male gender, age ≥ 75 years, diabetes mellitus, and atrial fibrillation were associated with a significantly increased mortality risk.

CONCLUSION

In an analysis of a long-term follow-up of 2,681 ICD patients, we found no mortality difference between patients with ischemic or non-ischemic cardiomyopathy and in the device type. A higher mortality risk was found in men, patients older than 75 years, diabetics, and those with atrial fibrillation.

摘要

背景

需要将与 ICD 植入低获益和增加死亡风险相关的临床参数用于个体化评估 ICD 植入的潜在获益和风险。

方法

对 2009 年至 2019 年期间在单一中心因首次植入任何类型 ICD 而住院的所有患者进行前瞻性登记的分析。

结果

该登记共纳入 2681 例患者。在随访结束时(38.4±29.1 个月),682 例(25.4%)患者死亡。所有患者的 1 年死亡率、1 年心血管死亡率、所有患者的 3 年死亡率和 3 年心血管死亡率分别为 7.8%、5.7%、20.6%和 14.8%。根据心肌病的类型对亚组进行比较时,存在统计学显著差异。原发性和继发性预防以及器械类型之间没有发现显著差异。男性、年龄≥75 岁、糖尿病和心房颤动与死亡率显著增加相关。

结论

在对 2681 例 ICD 患者的长期随访分析中,我们发现缺血性或非缺血性心肌病患者之间以及器械类型之间的死亡率没有差异。男性、年龄大于 75 岁、糖尿病和心房颤动患者的死亡率风险更高。

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