Key result
Implantable cardioverter-defibrillators reduced arrhythmic mortality early after acute MI, but an increase in death from other causes offset this effect, yielding neutral overall survival.
Why the study?
Does the Implantable Cardioverter-Defibrillator reduce mortality in patients early after an acute MI?
Does the Implantable Cardioverter-Defibrillator reduce mortality in patients early after an acute MI?
While ICDs reduce arrhythmic mortality early after an acute MI, this benefit is offset by an increase in non-arrhythmic deaths, leading to no overall survival benefit.
No overall survival benefit with early post-MI ICDs; leaves open optimal timing and selection for future trials.
arrhythmic mortality was reduced by the ICD, an unexpected increase in death from other causes offset this effect and caused the study to be neutral. A similar phenomenon was seen in 2 other more recent trials, the Defibrillator IN Acute Myocardial Infarction Trial (DINAMIT) and the Immediate Risk-Stratification Improves Survival (IRIS) studies that enrolled patients early after an acute MI.
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Hohnloser et al. (2013) studied this question. Implantable cardioverter-defibrillators reduced arrhythmic mortality early after acute MI, but an increase in death from other causes offset this effect, yielding neutral overall survival.
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