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首页> 外文期刊>The American Journal of Cardiology >Determinants of all-cause mortality in different age groups in patients with severe systolic left ventricular dysfunction receiving an implantable cardioverter defibrillator (from the Italian ClinicalService Multicenter Observational Project)
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Determinants of all-cause mortality in different age groups in patients with severe systolic left ventricular dysfunction receiving an implantable cardioverter defibrillator (from the Italian ClinicalService Multicenter Observational Project)

机译：接受植入式心脏复律除颤器的严重收缩期左心室功能不全患者不同年龄组全因死亡率的决定因素（来自意大利临床服务多中心观测项目）

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摘要

Heart failure (HF) is a common condition in elderly patients. Despite great improvements in medical therapy, HF mortality remains high. Implantable cardioverter defibrillator (ICD) significantly lengthens the survival rate of subjects with severe HF, but little evidence exists on its effect in elderly persons. Aim of this study was to compare the age-related determinants of prognosis in a large population of patients with ICD. We divided all patients who underwent an ICD implantation in 117 Italian centers of the "ClinicalService Project" into 3 age groups (65, 65 to 74, ≥75 years), and collected clinical and instrumental variables at baseline and during follow-up (median length: 27 months). Between 2004 and 2011, 6,311 patients were enrolled (5,174 men; left ventricular ejection fraction 29% ± 9%); 1,510 subjects were ≥75 years (23.9%; mean age 78 ± 3 years). The prevalence of co-morbidities increased with age. HF was most frequently due to coronary artery disease in the elderly, who also showed the worst New York Heart Association class. At multivariate analysis, older age, coronary artery disease, chronic obstructive pulmonary disease, chronic renal failure, diabetes, complex ventricular arrhythmias, and left ventricular ejection fraction were significant predictors of all-cause mortality. After adjustment, the hazard ratioage group for mortality was 22.6% less than at univariate analysis. When groups were analyzed separately, age alone predicted mortality in the oldest. In conclusion, a large proportion of our population was aged ≥75 years. Mortality was related to age and several co-morbidities, except for the oldest patients in whom age alone resulted predictive.
机译：心力衰竭（HF）是老年患者的常见病。尽管药物治疗取得了很大进步，但心衰死亡率仍然很高。植入式心脏复律除颤器（ICD）可以显着延长患有严重HF的患者的生存率，但很少有证据表明其对老年人有疗效。这项研究的目的是比较大量ICD患者的年龄相关决定因素。我们将117个意大利“临床服务项目”中心接受ICD植入的所有患者分为3个年龄段（<65岁，65岁至74岁，≥75岁），并在基线和随访期间收集了临床和仪器变量（中位长度：27个月）。在2004年至2011年之间，共招募了6,311名患者（5,174名男性;左心室射血分数29％±9％）; 1,510名受试者≥75岁（23.9％;平均年龄78±3岁）。合并症的患病率随年龄增长而增加。 HF最常归因于老年人的冠状动脉疾病，而后者也表现出最差的纽约心脏协会等级。在多变量分析中，年龄，冠状动脉疾病，慢性阻塞性肺疾病，慢性肾功能衰竭，糖尿病，复杂性室性心律失常和左室射血分数是所有原因死亡率的重要预测指标。调整后，死亡率的危险比分组比单变量分析低22.6％。当分别对各组进行分析时，仅年龄就能预测最老的死亡率。总之，我们人口中的很大一部分年龄≥75岁。死亡率与年龄和多种合并症有关，但最年长的患者仅靠年龄即可预测结果。

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