Cardiovasc Diabetol:合并糖尿病对ICD植入患者死亡率及治疗的影响

2022-08-04 MedSci原创 MedSci原创

糖尿病与ICD植入患者的死亡风险增加有关

根据国际糖尿病联盟最新公布的数据,2021年全球糖尿病成年患者人数达到5.37亿,约670万人死于糖尿病或糖尿病并发症,占全因死亡率的12.2%。糖尿病患者合并心血管疾病的风险和死亡风险均更高。

心力衰竭(HF)是器质性心脏病的终末期临床表现,已成为世界范围内的主要公共卫生问题。糖尿病对植入式心律转复除颤器 (ICD) 治疗的死亡率和风险的影响仍存在争议,缺乏综合评估。该研究进行了系统评价和荟萃分析以解决这一争议。

研究人员系统地检索了PubMed, Embase, Web of Science和Cochrane Library数据库以收集相关文献。使用固定和随机效应模型来估计风险比 (HR)。


有无糖尿病对ICD植入患者全因死亡率和心源性死亡率的影响

该分析纳入了36篇报道,共162780位ICD植入患者。与非糖尿病ICD植入患者相比,糖尿病ICD植入患者的全因死亡率更高(HR 1.45)。亚组分析显示,采用二级预防的糖尿病患者的全因死亡风险可能更高(HR 1.89,p=0.03)。患有糖尿病的ICD植入患者的心源性死亡风险也较高(HR 1.68)。但是,糖尿病对ICD治疗的风险没有明显影响,包括适当或不适当的治疗、适当或不适当的电击和适当的抗心动过速起搏 (ATP)。最后,糖尿病与不适当ATP风险降低有关(HR 0.56)。

综上,糖尿病与ICD植入患者的死亡风险增加有关,特别是在二级预防患者中,但不会显著影响ICD治疗的风险,提示患有糖尿病的ICD植入者死亡风险升高可能不是由心律失常引起的。

 

原始出处:

Liu, H., Hu, J., Zhuo, W. et al. Influence of diabetes on mortality and ICD therapies in ICD recipients: a systematic review and meta-analysis of 162,780 patients. Cardiovasc Diabetol 21, 143 (2022). https://doi.org/10.1186/s12933-022-01580-y

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    2023-07-10 yilong5287542
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    2022-12-30 docwu2019
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    2022-09-28 quxin068
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    2022-08-07 麻辣香薰

    学习了

    0

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    2022-08-05 jiyangfei

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