Cardiovascular Disease Laboratory, Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Sichuan Province, China.
Clin Cardiol. 2022 Dec;45(12):1163-1170. doi: 10.1002/clc.23907. Epub 2022 Sep 3.
The implantable cardiac defibrillator (ICD) is common for the management of nonischemic cardiomyopathy (NICM). Mortality is a crucial issue for patients with NICM. We can understand the mortality events of ICD versus medicine treatment via a systemic review and meta-analysis of randomized clinical trials. The comparison between ICD treatment and medicine treatment was performed to find if the ICD treatment can be associated with lower relative risk and hazard ratio of mortality than the medicine treatment. In addition, the different kinds of mortality events were analyzed for the ICD treatment. After a restricted selection, 9 studies with a total of 4001 NICM patients were enrolled. The focused outcome was the events of all-cause mortality, sudden cardiac death, and cardiovascular death. The results showed that ICD treatment might be associated with lower relative risk and hazard ratio of all-cause mortality and sudden cardiac death. However, the relative risk and hazard ratio of cardiovascular mortality was not significantly different between ICD treatment and medicine treatment. In the current meta-analysis, the ICD treatment might show a lower relative risk and hazard ratio of all-cause mortality and sudden cardiac death when compared with medicine treatment. However, no significant differences were observed in cardiovascular mortality between ICD and medicine treatment.
植入式心脏除颤器（ICD）常用于治疗非缺血性心肌病（NICM）。对于 NICM 患者来说，死亡率是一个关键问题。我们可以通过对随机临床试验的系统评价和荟萃分析来了解 ICD 治疗与药物治疗的死亡率事件。对 ICD 治疗与药物治疗进行比较，以确定 ICD 治疗是否与死亡率的相对风险和危险比低于药物治疗相关。此外，还分析了 ICD 治疗的不同类型的死亡率事件。经过严格筛选，共纳入了 9 项研究，共 4001 名 NICM 患者。重点关注的结局是全因死亡率、心源性猝死和心血管死亡率事件。结果表明，ICD 治疗可能与全因死亡率和心源性猝死的相对风险和危险比降低相关。然而，ICD 治疗与药物治疗之间心血管死亡率的相对风险和危险比没有显著差异。在目前的荟萃分析中，与药物治疗相比，ICD 治疗可能显示出较低的全因死亡率和心源性猝死的相对风险和危险比。然而，ICD 与药物治疗之间在心血管死亡率方面没有观察到显著差异。
