Prognostic values of atrial high-rate episodes on mortality risks in CIED patients.

IF 2.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of cardiology Pub Date : 2025-02-14 DOI:10.1016/j.jjcc.2025.02.010

Phuuwadith Wattanachayakul, Panat Yanpiset, Narathorn Kulthamrongsri, Vitchapong Prasitsumrit, Kevin Bryan Lo, Jakrin Kewcharoen, Sumeet Mainigi

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引用次数: 0

Abstract

Background: Recent data showed that patients with cardiac implantable electronic devices (CIEDs) who have atrial high-rate episodes (AHRE) have an increased risk of systemic thromboembolism even without a history of atrial fibrillation. However, data regarding the impact of AHRE on mortality outcomes remain conflicting. This study aims to elucidate this relationship by summarizing all available data via systematic review and meta-analysis.

Methods: We systematically reviewed MEDLINE and EMBASE from inception to May 2024 to evaluate the association between AHRE and mortality risk in patients with CIED who did not have a history of atrial fibrillation at implantation. We compared all-cause and cardiovascular mortality in patients with AHRE to those without AHRE. Relative risk (RR) or hazard ratio and their 95 % confidence intervals (CIs) were extracted from each study and combined using the generic inverse variance method.

Results: A total of 15 cohort studies were included in the meta-analysis. The pooled analysis showed that patients with AHRE had a higher risk of all-cause mortality compared to those without AHRE, with a pooled RR of 1.57 (95 % CI 1.21-2.03; I² = 67 %; p < 0.001). Similarly, AHRE was associated with higher cardiovascular mortality, with a pooled RR of 1.80 (95 % CI 1.06-3.05; I² = 49 %; p = 0.03).

Conclusions: Our study found that patients with CIEDs who developed AHRE were at a higher risk of all-cause and cardiovascular mortality compared to those without AHRE.

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心房高发生率发作对CIED患者死亡风险的预后价值。

背景：最近的数据显示，心脏植入式电子装置（CIEDs）患者如果有心房高发生率发作（AHRE），即使没有心房颤动史，发生全身性血栓栓塞的风险也会增加。然而，关于AHRE对死亡率结果影响的数据仍然相互矛盾。本研究旨在通过系统回顾和荟萃分析，总结所有可用的数据来阐明这一关系。方法：我们系统地回顾了MEDLINE和EMBASE从开始到2024年5月，以评估在植入时没有房颤史的CIED患者AHRE与死亡风险之间的关系。我们比较了AHRE患者与非AHRE患者的全因死亡率和心血管死亡率。从每项研究中提取相对危险度（RR）或危险比及其95% %置信区间（ci），并采用通用逆方差法进行合并。结果：荟萃分析共纳入15项队列研究。合并分析显示，与未合并AHRE的患者相比，AHRE患者的全因死亡率更高，合并RR为1.57(95 % CI 1.21-2.03；I2 = 67 %;p 2 = 49 %; = 0.03页)。结论：我们的研究发现，与未发生AHRE的cied患者相比，发生AHRE的cied患者的全因死亡率和心血管死亡率更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

8.00%

发文量

202

审稿时长

29 days

期刊介绍： The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.