Eur Heart J:植入型心律转复除颤器日常远程监控效果如何?

2017-05-12 xing.T MedSci原创

在这三个试验的汇总分析中,HM可以降低全因死亡率和全因死亡与WHF住院的复合终点。WHF和CV终点的绝对风险也以类似的程度降低表明HM的效益是由心力衰竭加重的预防所驱动。

植入型心律转复除颤器的远程监控可以改善临床结局。最近的一项纳入了三项采用每日传输的特异性远程监控系统[Biotronik 家庭监控(HM)]的随机对照试验(TRUST,ECOST,IN-TIME)的荟萃分析证明可以改善生存。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员进行了患者级别的分析通过采用适当的时间事件统计来验证这个结果,并进一步调查临床终点。

来自于TRUST、ECOST和IN-TIME患者的个人数据被合并来计算HM随访1年与常规随访后终点的绝对风险。全因死亡率分析涉及所有三个试验(2405例患者)。其他终点包括两个实验ECOST和IN-TIME(1078例患者),其中由一个独立的实施盲法的终点委员会裁定住院和死亡的根本原因。

研究人员发现HM组患者1年死亡的绝对风险降低了1.9%(95%可信区间为0.1%-3.8%;P=0.037),同等的风险比为0.62。同样地,全因死亡或因心衰加重住院(WHF)的联合终点也明显减少(减少了5.6%;P=0.007;风险比为0.64)。全因死亡率或心血管(CV)住院的联合终点也以类似的程度减少(4.1%;P=0.13;风险比为0.85),但无统计学意义。

在这三个试验的汇总分析中,HM可以降低全因死亡率和全因死亡与WHF住院的复合终点。WHF和CV终点的绝对风险也以类似的程度降低表明HM的效益是由心力衰竭加重的预防所驱动。

原始出处:

Gerhard Hindricks,et al. Daily remote monitoring of implantable cardioverter-defibrillators: insights from the pooled patient-level data from three randomized controlled trials (IN-TIME, ECOST, TRUST). Eur Heart J. https://doi.org/10.1093/eurheartj/ehx015

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createdBy=9c9d37794363, createdName=12498d2fm63(暂无昵称), createdTime=Tue May 30 03:03:00 CST 2017, time=2017-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2047814, encodeId=fdf7204e8143a, content=<a href='/topic/show?id=2ce79445562' target=_blank style='color:#2F92EE;'>#远程监控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94455, encryptionId=2ce79445562, topicName=远程监控)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Oct 11 04:03:00 CST 2017, time=2017-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=198422, encodeId=d19d19842276, content=典型的互联网?, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKe6JIArctUjibbaEn6NUN1ib6aTJzVBeoOauj5VGppSU08TUic40qrrxVFCkEhWkCZLfajqxZtMUoSQ/0, createdBy=93b52023248, createdName=杏峰, createdTime=Mon May 15 15:45:13 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562524, encodeId=c662156252489, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520362, encodeId=238e1520362fa, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, 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11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356270, encodeId=653c13562e0f9, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197737, encodeId=364c19e7374b, content=电子监控?学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2017-05-15 杏峰

    典型的互联网?

    0

  5. 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11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356270, encodeId=653c13562e0f9, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197737, encodeId=364c19e7374b, content=电子监控?学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun May 14 00:57:28 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197667, encodeId=6dc319e66776, content=地方医院,不过多学习吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Sat May 13 21:18:47 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-05-14 slcumt
  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun May 14 00:57:28 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197667, encodeId=6dc319e66776, content=地方医院,不过多学习吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Sat May 13 21:18:47 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-05-14 jiyangfei
  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKe6JIArctUjibbaEn6NUN1ib6aTJzVBeoOauj5VGppSU08TUic40qrrxVFCkEhWkCZLfajqxZtMUoSQ/0, createdBy=93b52023248, createdName=杏峰, createdTime=Mon May 15 15:45:13 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562524, encodeId=c662156252489, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520362, encodeId=238e1520362fa, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62645, encryptionId=7a736264553, topicName=植入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=832411313664, createdName=jiyangfei, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1439132, encodeId=0f891439132e1, content=<a href='/topic/show?id=8e3a98396f2' target=_blank style='color:#2F92EE;'>#除颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98396, encryptionId=8e3a98396f2, topicName=除颤)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356270, encodeId=653c13562e0f9, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197737, encodeId=364c19e7374b, content=电子监控?学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun May 14 00:57:28 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197667, encodeId=6dc319e66776, content=地方医院,不过多学习吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Sat May 13 21:18:47 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-05-14 zhouqu_8
  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKe6JIArctUjibbaEn6NUN1ib6aTJzVBeoOauj5VGppSU08TUic40qrrxVFCkEhWkCZLfajqxZtMUoSQ/0, createdBy=93b52023248, createdName=杏峰, createdTime=Mon May 15 15:45:13 CST 2017, time=2017-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562524, encodeId=c662156252489, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520362, encodeId=238e1520362fa, content=<a href='/topic/show?id=7a736264553' target=_blank style='color:#2F92EE;'>#植入#</a>, 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11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356270, encodeId=653c13562e0f9, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun May 14 11:03:00 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197737, encodeId=364c19e7374b, content=电子监控?学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun May 14 00:57:28 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197667, encodeId=6dc319e66776, content=地方医院,不过多学习吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Sat May 13 21:18:47 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-05-14 zhaojie88
  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun May 14 00:57:28 CST 2017, time=2017-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=197667, encodeId=6dc319e66776, content=地方医院,不过多学习吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Sat May 13 21:18:47 CST 2017, time=2017-05-13, status=1, ipAttribution=)]
    2017-05-14 惠映实验室

    电子监控?学习了。

    0

  10. 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    2017-05-13 林3301

    地方医院,不过多学习吧

    0

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