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Cardioverter-defibrillator reduces mortality risk in eligible ischemic and non-ischemic cardiomyopathy patients: Sub-analysis of the multi-center Improve SCA study.
Singh, Balbir; Hsieh, Yu-Cheng; Liu, Yen-Bin; Lin, Kuo-Hung; Joung, Boyoung; Rodriguez, Diego A; Chasnoits, Alexandr R; Huang, Dejia; Zhang, Shu; O'Brien, Janet E; Lexcen, Daniel R; Cerkvenik, Jeffrey; Van Dorn, Brian; Ching, Chi-Keong.
Afiliação
  • Singh B; Department of Cardiology, Pan Max Hospital, New Delhi, India. Electronic address: drbalbirs@gmail.com.
  • Hsieh YC; Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; National Chung Hsing University School of Medicine, Taichung, Taiwan.
  • Liu YB; Division of Cardiology, Internal Medicine Department, National Taiwan University Hospital, Taipei, Taiwan.
  • Lin KH; Department of Cardiology, China Medical Center University Hospital, Taichung, Taiwan.
  • Joung B; Cardiology Division, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
  • Rodriguez DA; Instituto de Cardiología, Fundación Cardio Infantil, Centro Internacional de Arritmias, Bogotá, Colombia; Universidad de la Sabana, Chía, Columbia.
  • Chasnoits AR; Department of Roentgen-Endovascular Surgery, Republican Scientific and Practical Centre Cardiology, Minsk, Belarus.
  • Huang D; Department of Cardiovascular Medicine, West China Hospital, Cardiology, Chengdu, China.
  • Zhang S; The Cardiac Arrhythmia Center, Fuwai Cardiovascular Hospital, Beijing, China.
  • O'Brien JE; Cardiac Rhythm Management, Medtronic Inc., Mounds View, Minnesota, USA.
  • Lexcen DR; Cardiac Rhythm Management, Medtronic Inc., Mounds View, Minnesota, USA.
  • Cerkvenik J; Cardiac Rhythm Management, Medtronic Inc., Mounds View, Minnesota, USA.
  • Van Dorn B; Cardiac Rhythm Management, Medtronic Inc., Mounds View, Minnesota, USA.
  • Ching CK; Department of Cardiology, National Heart Centre of Singapore, Outram District, Singapore.
Indian Heart J ; 75(2): 115-121, 2023.
Article em En | MEDLINE | ID: mdl-36736459
BACKGROUND & OBJECTIVE: Despite the burden of sudden cardiac arrest (SCA) worldwide, implantable cardioverter-defibrillators (ICDs) are underutilized, particularly in Asia, Latin America, Eastern Europe, the Middle East, and Africa. The Improve SCA trial demonstrated that primary prevention (PP) patients in these regions benefit from an ICD or a cardiac resynchronization therapy defibrillator (CRT-D). We aimed to compare the rate of device therapy and mortality among ischemic and non-ischemic cardiomyopathy (ICM and NICM) PP patients who met guideline indications for ICD therapy and had an ICD/CRT-D implanted. METHODS: Improve SCA was a prospective, non-randomized, non-blinded multicenter trial that enrolled patients from the above-mentioned regions. All-cause mortality and device therapy were examined by cardiomyopathy (ICM vs NICM) and implantation status. Cox proportional hazards methods were used, adjusting for factors affecting mortality risk. RESULTS: Of 1848 PP NICM patients, 1007 (54.5%) received ICD/CRT-D, while 303 of 581 (52.1%) PP ICM patients received an ICD/CRT-D. The all-cause mortality rate at 3 years for NICM patients with and without an ICD/CRT-D was 13.1% and 18.3%, respectively (HR 0.51, 95% CI 0.38-0.68, p < 0.001). Similarly, all-cause mortality at 3 years in ICM patients was 13.8% in those with a device and 19.9% in those without an ICD/CRT-D (HR 0.54, 95% CI 0.33-.0.88, p = 0.011). The time to first device therapy, time to first shock, and time to first antitachycardia pacing (ATP) therapy were not significantly different between groups (p ≥ 0.263). CONCLUSIONS: In this large data set of patients with a guideline-based PP ICD indication, defibrillator device implantation conferred a significant mortality benefit in both NICM and ICM patients. The rate of appropriate device therapy was also similar in both groups. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02099721.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Desfibriladores Implantáveis / Cardiomiopatias Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Desfibriladores Implantáveis / Cardiomiopatias Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2023 Tipo de documento: Article