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ACC 2014:CRT-D可降充血性心衰事件发生率及死亡率

2014-04-10 高晓方 译 医学论坛网

2014年美国心脏病学会年会(ACC 2014)MADIT-CRT研究表明,在QRS波增宽且无症状或有轻微症状(NYHA 分级 I/II)的收缩期充血性心力衰竭(CHF)患者中,心脏再同步治疗除颤器(CRT-D)置入与CHF事件发生率及死亡率显著降低具有相关性。 此项研究共纳入1820例CHF高危患者,并以3:2的比率随机分入CRT-D组或ICD组。利用最新优化技术对CRT房室延搁实施最佳化,以

2014年美国心脏病学会年会(ACC 2014)MADIT-CRT研究表明,在QRS波增宽且无症状或有轻微症状(NYHA 分级 I/II)的收缩期充血性心力衰竭(CHF)患者中,心脏再同步治疗除颤器(CRT-D)置入与CHF事件发生率及死亡率显著降低具有相关性。

此项研究共纳入1820例CHF高危患者,并以3:2的比率随机分入CRT-D组或ICD组。利用最新优化技术对CRT房室延搁实施最佳化,以右心室起搏最小化为目标置入单腔或双腔ICD装置。主要终点为死亡或非致命性CHF事件。评估CRT-D能否降低全因死亡率和CHF事件发生率。

结果显示,两组患者的基线特征均相似。CRT-D组患者的主要终点发生率低于ICD组(17.2%对25.3%,HR 0.66),并且主要由CHF事件减少所引起。两组患者在全因死亡率方面无显著差异。在女性、QRS持续时间≥150毫秒以及伴LBBB患者获益更为显著。CRT-D组患者的30天不良事件发生率稍高于ICD组。随访7年时,CRT-D组伴LBBB患者的全因死亡、非致命性心衰和CHF/死亡均显著减少。


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