| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Survival benefit of primary prevention implantable cardioverter-defibrillator/cardiac resynchronization therapy with a defibrillator: Analysis of the Japan cardiac device treatment registry and Japanese cardiac registry of heart failure in cardiology. |
| 掲載誌名 | 正式名：Journal of arrhythmia 略 称：J Arrhythm ISSNコード：18804276/18804276 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 41(3),pp.e70084 |
| 著者・共著者 | Hisashi Yokoshiki, Masaya Watanabe, Sanae Hamaguchi, Hiroyuki Tsutsui, Akihiko Shimizu, Takeshi Mitsuhashi, Kohei Ishibashi, Tomoyuki Kabutoya, Yasuhiro Yoshiga, Yusuke Kondo, Taro Temma, Masahiko Takagi, Hiroshi Tada |
| 発行年月 | 2025/05 |
| 概要 | BACKGROUND:Evidence supporting the benefit from primary prevention implantable cardioverter-defibrillator (ICD)/cardiac resynchronization therapy with a defibrillator (CRT-D) for heart failure with reduced ejection fraction (HFrEF) is scarce in real-world settings.METHODS:We analyzed propensity score matched cohorts of patients eligible for Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) from Japan cardiac device treatment registry (JCDTR) and Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). The former served as the defibrillator therapy group and the latter as the conventional therapy group.RESULTS:During an average follow-up of 24 months, death occurred in 35 of 285 patients (12%) with defibrillator therapy and 65 of 285 patients (23%) with conventional therapy. Adjusted hazard ratios of all-cause death, sudden death, heart failure death, and noncardiac death in defibrillator versus conventional therapy were 0.616 (95% confidence interval [CI]: 0.402-0.943, p = 0.026), 0.274 (95% CI: 0.103-0.731, p = 0.0097), 0.362 (95% CI: 0.172-0.764, p = 0.0077) and 1.45 (95% CI: 0.711-2.949, p = 0.31). After accounting for death without appropriate defibrillator therapy as a competing risk, the cumulative incidence of first appropriate defibrillator therapy in the defibrillator therapy group was nearly identical to that of all-cause death in the conventional therapy group. Subgroup analyses indicated a lack of defibrillator benefit in patients with hypertension (p = 0.01 for interaction).CONCLUSIONS:Primary prevention ICD/CRT-D reduced the risk of all-cause mortality of patients with HFrEF eligible for SCD-HeFT compared to conventional therapy in the real-world cohort. |
| DOI | 10.1002/joa3.70084 |
| PMID | 40357355 |