■左心室(LV)收缩功能障碍患者的冠状动脉血运重建后心脏性猝死(SCD)的风险尚未得到完全表征。本研究旨在评估此类患者血运重建后SCD的发生率和时间过程。还评估了血运重建后3个月内SCD的决定因素。
■一项射血分数降低(EF≤40%)患者的队列研究,进行了血运重建。据估计,SCD的发生率是由于其他原因导致死亡的竞争性风险。
■2317例患者入选。中位随访时间为3.5年,504例死亡中有162例(32.1%)是由于SCD。在血运重建后的前3个月,SCD的风险最高。发病率为0.37%/月。事件发生率降至0.12%/月,0.08%/月,0.09%/月,0.14%/月,3-6个月为0.19%/月,6-12个月,1-3年,3-5年,5-10年,分别。室性心动过速/室颤病史(危险比[HR],5.55;95%置信区间[CI],1.33-23.19;p=0.019)和三重血管疾病(HR,3.90;95%CI,1.38-11.05;p=0.010)与3个月内SCD的风险相关。然而,术前EF(以5%递增)不是预测性的(HR每增加5%,0.98;95%CI,0.62-1.55;p=0.935)。
■对于左心室功能障碍的患者,在血运重建后的前3个月,SCD的风险最高.需要进一步的风险分类和治疗策略。
■注册名称:缺血性心力衰竭患者的冠状动脉血运重建和预防心源性猝死。注册号:ChiCTR2100044378.
UNASSIGNED: The risk of sudden cardiac death (SCD) after coronary
revascularization in patients with left ventricular (LV) systolic dysfunction has not been characterized completely. This study aims to evaluate the incidence and time course of SCD after
revascularization in such patients. The determinants of SCD within 3 months after
revascularization were also assessed.
UNASSIGNED: A cohort study of patients with reduced ejection fraction (EF ≤ 40%), who underwent revascularization was performed. The incidence of SCD was estimated to account for the competing risk of deaths due to other causes.
UNASSIGNED: 2317 patients were enrolled. With a median follow-up of 3.5 years, 162 (32.1%) of the 504 deaths were due to SCD. The risk of SCD was highest in the first 3 months after
revascularization, with an incidence rate of 0.37%/month. The event rate decreased to 0.12%/month, 0.08%/month, 0.09%/month, 0.14%/month, and 0.19%/month at 3-6 months, 6-12 months, 1-3 years, 3-5 years, and 5-10 years, respectively. A history of ventricular tachycardia/ventricular fibrillation (hazard ratio [HR], 5.55; 95% confidence interval [CI], 1.33-23.19; p = 0.019) and triple vessel disease (HR, 3.90; 95% CI, 1.38-11.05; p = 0.010) were associated with the risk of SCD within 3 months. However, preoperative EF (in 5% increments) was not predictive (HR per 5% increase, 0.98; 95% CI, 0.62-1.55; p = 0.935).
UNASSIGNED: For patients with LV dysfunction, the risk of SCD was the highest during the first 3 months after revascularization. Further risk classification and treatment strategy are warranted.
UNASSIGNED: The name of the registry: Coronary
Revascularization in Patients with Ischemic Heart Failure and Prevention of Sudden Cardiac Death. Registration number: ChiCTR2100044378.