Your browser doesn't support javascript.
loading
Regional disparities and risk factors of mortality among patients at high risk of sudden cardiac death in emerging countries: a nonrandomized controlled trial.
Zhao, Shuang; Ching, Chi-Keong; Huang, Dejia; Liu, Yen-Bin; Rodriguez-Guerrero, Diego A; Hussin, Azlan; Kim, Young-Hoon; Van Dorn, Brian; Zhou, Xiaohong; Singh, Balbir; Zhang, Shu.
Afiliación
  • Zhao S; State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 Beilishi Rd, Xicheng District, Beijing, 100037, China.
  • Ching CK; National Heart Centre Singapore, Outram District, Singapore, Singapore.
  • Huang D; West China Hospital, Chengdu, China.
  • Liu YB; National Taiwan University Hospital, Taipei City, Taiwan, China.
  • Rodriguez-Guerrero DA; Instituto de Cardiología Fundación Cardioinfantil, Centro Internacional de Arritmias, Bogotá, Colombia.
  • Hussin A; Universidad de La Sabana, Bogota, Colombia.
  • Kim YH; Institut Jantung Negara, Kuala Lumpur, Malaysia.
  • Van Dorn B; Korea University Medical Center, Seoul, Republic of Korea.
  • Zhou X; Medtronic Inc., Mounds View, MN, USA.
  • Singh B; Medtronic Inc., Mounds View, MN, USA.
  • Zhang S; Pan Max Hospital, Delhi, India.
BMC Med ; 22(1): 130, 2024 Mar 22.
Article en En | MEDLINE | ID: mdl-38519982
ABSTRACT

BACKGROUND:

Comprehensive data on patients at high risk of sudden cardiac death (SCD) in emerging countries are lacking. The aim was to deepen our understanding of the SCD phenotype and identify risk factors for death among patients at high risk of SCD in emerging countries.

METHODS:

Patients who met the class I indication for implantable cardioverter-defibrillator (ICD) implantation according to guideline recommendations in 17 countries and regions underrepresented in previous trials were enrolled. Countries were stratified by the WHO regional classification. Patients were or were not implanted with an ICD at their discretion. The outcomes were all-cause mortality and SCD.

RESULTS:

We enrolled 4222 patients, and 3889 patients were included in the analysis. The mean follow-up period was 21.6 ± 10.2 months. There were 433 (11.1%) instances of all-cause mortality and 117 (3.0%) cases of SCD. All-cause mortality was highest in primary prevention (PP) patients from Southeast Asia and secondary prevention (SP) patients from the Middle East and Africa. The SCD rates among PP and SP patients were both highest in South Asia. Multivariate Cox regression modelling demonstrated that in addition to the independent predictors identified in previous studies, both geographic region and ICD use were associated with all-cause mortality in patients with high SCD risk. Primary prophylactic ICD implantation was associated with a 36% (HR = 0.64, 95% CI 0.531-0.802, p < 0.0001) lower all-cause mortality risk and an 80% (HR = 0.20, 95% CI = 0.116-0.343, p < 0.0001) lower SCD risk.

CONCLUSIONS:

There was significant heterogeneity among patients with high SCD risk in emerging countries. The influences of geographic regions on patient characteristics and outcomes were significant. Improvement in increasing ICD utilization and uptake of guideline-directed medical therapy in emerging countries is urgent. TRIAL REGISTRATION ClinicalTrials.gov, NCT02099721.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Desfibriladores Implantables Límite: Humans País/Región como asunto: Africa / Asia Idioma: En Revista: BMC Med Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Desfibriladores Implantables Límite: Humans País/Región como asunto: Africa / Asia Idioma: En Revista: BMC Med Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido