Application and comparison of the FADES, MADIT, and SHFM-D risk models for risk stratification of prophylactic implantable cardioverter-defibrillator treatment
Key result
The SHFM-D risk model was superior to FADES and MADIT for predicting non-benefit of prophylactic ICD treatment, with a C-statistic of 0.75 vs 0.66 and 0.69 (all P<0.001).
Why the study?
Does the SHFM-D risk model improve prediction of non-benefit of prophylactic ICD treatment compared to FADES and MADIT models in patients receiving prophylactic ICDs?
Population
1,969 patients receiving a prophylactic implantable cardioverter-defibrillator at a single center, mean age…
Comparison
Risk stratification using the SHFM-D risk model vs Risk stratification using the FADES and MADIT…
Design
Cohort
Follow-up
median 4.5 ± 3.9 years
Authors
Discussion
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Member takes
Implication
SHFM-D may aid identification of ICD non-benefit; hypothesis-generating and requires prospective validation before practice change.
Study Design
Type
Cohort (n=1,969)
Multicenter
No
Structured PICO
Does the SHFM-D risk model improve prediction of non-benefit of prophylactic ICD treatment compared to FADES and MADIT models in patients receiving prophylactic ICDs?
P
Population
1,969 patients receiving a prophylactic implantable cardioverter-defibrillator (ICD) at a single center, mean age 63 ± 11 years, 79% male.
I
Intervention
Risk stratification using the SHFM-D risk model
C
Comparator
Risk stratification using the FADES and MADIT risk models
O
Outcome
Non-benefit of ICD treatment, defined as mortality without prior ventricular arrhythmias requiring ICD interventionhard clinical
Main Result
Effect estimate: C-statistic 0.75 (SHFM-D), 0.69 (MADIT), 0.66 (FADES)
p-value: p=<0.001
The SHFM-D risk model provides superior predictive and discriminatory value compared to FADES and MADIT for identifying patients who will not benefit from prophylactic ICD implantation.
Cite This Study
Heijden et al. (2017) conducted a cohort in Prophylactic implantable cardioverter-defibrillator (ICD) treatment (n=1,969). SHFM-D risk model vs. FADES and MADIT risk models was evaluated on Non-benefit of ICD treatment, defined as mortality without prior ventricular arrhythmias requiring ICD intervention (C-statistic 0.75 (SHFM-D), 0.69 (MADIT), 0.66 (FADES), p=<0.001). The SHFM-D risk model was superior to FADES and MADIT for predicting non-benefit of prophylactic ICD treatment, with a C-statistic of 0.75 vs 0.66 and 0.69 (all P<0.001).