CARE HF LTFU: 心力衰竭心脏再同步化治疗的长期随访研究

2010-09-09 MedSci原创 MedSci原创

   引言: 早在2005年公布的CARE-HF研究证实心脏再同步化治疗(CRT)可显著降低伴有心室收缩不同步的心力衰竭患者死亡率。目前少有CRT患者的长期随访数据,本文报道该试验中患者的长期随访结果。     方法:病例入选工作开始于2000年末,截至2003年3月。在2005年公布主要研究结果后,研究者被要求告知患者结果,对于具有适应证患者植

   引言: 早在2005年公布的CARE-HF研究证实心脏再同步化治疗(CRT)可显著降低伴有心室收缩不同步的心力衰竭患者死亡率。目前少有CRT患者的长期随访数据,本文报道该试验中患者的长期随访结果。

    方法:病例入选工作开始于2000年末,截至2003年3月。在2005年公布主要研究结果后,研究者被要求告知患者结果,对于具有适应证患者植入CRT,随后征得患者同意进行长期随访至2009年9月30日。

    结果:最初入选的813例患者中,343例(42%)于再次征求随访前死亡,111例(14%)失访,50例(6%)拒绝参加长期随访,最终共309例(38%)同意和接受长期随访。最初分配至对照组的患者中,大多数存活者在再次征求随访前接受了 CRT治疗。222例最初接受药物治疗的患者和192例CRT组患者死亡。与最初入选对照组患者相比,最初入选CRT组患者死亡危险比为0.768 (95% CI:0.633~0.931,P = 0.007)。未发现亚组间的相互作用。

    结论:CARE-HF研究随机期间观察到的CRT降低死亡率的获益,在长期随访中依然保持。CARE- HF研究完成后对于合适的患者植入CRT可防止生存曲线的离散。研究人群中位年龄66岁,但无论是66岁以下,还是66岁以上,CRT治疗均可获益。对于年龄<66岁,存在中至重度心力衰竭合并心脏不同步的患者,中位生存时间大约5年,CRT可将其延长到8年以上。该组患者应用CRT-D较单纯 CRT获益更大。

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    2015-09-27 maria

    If my problem was a Death Star, this article is a photon toerpdo.

    0

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    2015-08-06 hlycom3356

    期待有更多研究

    0

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    2010-10-02 habb

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