August 25, 2009Circulation221 citationsOpen Access
View Full PaperMaximizing Survival Benefit With Primary Prevention Implantable Cardioverter-Defibrillator Therapy in a Heart Failure Population
Structured PICO
Does single-lead ICD therapy reduce mortality in moderately symptomatic heart failure patients with EF ≤35% across different baseline risk profiles?
P
Population
Moderately symptomatic heart failure patients with an ejection fraction ≤35% from the primary prevention Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)
I
Intervention
Single-lead implantable cardioverter-defibrillator (ICD) therapy
C
Comparator
Placebo
O
Outcome
Total mortality and sudden cardiac death (SCD) at 4 yearshard clinical
A clinical risk prediction model identifies heart failure patients who derive substantial survival benefit from primary prevention ICDs and those at highest risk who derive no benefit.
Abstract
BACKGROUND: Although implantable cardioverter-defibrillator (ICD) therapy reduces mortality in moderately symptomatic heart failure patients with an ejection fraction 20%), no benefit of ICD treatment was seen. Projected over each patient's predicted lifespan, ICD treatment added 6.3, 4.1, 3.0, 1.9, and 0.2 additional years of life in the lowest- to highest-risk groups, respectively. CONCLUSIONS: A clinical risk prediction model identified subsets of moderately symptomatic heart failure patients in SCD-HeFT in whom single-lead ICD therapy was of no benefit and other subsets in which benefit was substantial.
Cite This Study
Levy et al. (Tue,) studied this question.