Key result
Non-ischemic cardiomyopathy was associated with a significantly higher 2-year risk of appropriate ICD therapy (27.7%) compared to ischemic cardiomyopathy (12.2%) in patients receiving primary prophylactic ICDs.
Why the study?
Following negative results from the DANISH study regarding ICD efficacy in patients with NICM and reduced LVEF, this study aimed to determine the efficacy of primary prophylactic ICDs in NICM.
Does primary prophylactic ICD implantation yield different rates of appropriate ICD therapy in patients with non-ischemic cardiomyopathy compared to ischemic cardiomyopathy?
Observational (n=264)
Yes
Does primary prophylactic ICD implantation yield different rates of appropriate ICD therapy in patients with non-ischemic cardiomyopathy compared to ischemic cardiomyopathy?
In a Japanese real-world cohort, patients with non-ischemic cardiomyopathy receiving primary prophylactic ICDs had a significantly higher rate of appropriate ICD therapy compared to those with ischemic cardiomyopathy, suggesting ICDs remain highly relevant for this population.
Answers are grounded in this paper and cite their sources.
Supports the continued utility of primary prevention ICDs in non-ischemic cardiomyopathy;.
BACKGROUND: In 2016, the DANISH study reported negative results regarding the efficacy of implantable cardioverter-defibrillators (ICDs) in patients with non-ischemic cardiomyopathy (NICM) and reduced left ventricular ejection fraction (LVEF). In this study we determined the efficacy of using ICDs for primary prophylaxis in patients with NICM. METHODS AND RESULTS: We selected 1,274 patients with underlying cardiac disease who were enrolled in the Nippon Storm Study. We analyzed the data of 451 patients with LVEF ≤35% due to NICM or ischemic cardiomyopathy (ICM) who underwent ICD implantation for primary prophylaxis (men, 78%; age, 65±12 years; LVEF, 25±6.4%; cardiac resynchronization therapy, 73%; ICM, 33%). After propensity score matching, we compared the baseline covariates between groups: NICM (132 patients) and ICM (132 patients). The 2-year appropriate ICD therapy risks were 27.7% and 12.2% in the NICM and ICM groups, respectively (hazard ratio, 0.390 [95% confidence interval, 0.218-0.701]; P=0.002). CONCLUSIONS: This subanalysis of propensity score-matched patients from the Nippon Storm Study revealed that the risk of appropriate ICD therapy was significantly higher in patients with NICM than in those with ICM.
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Kondo et al. (2023) conducted an observational in Cardiomyopathy with reduced LVEF requiring primary prophylactic ICD (n=264). Non-ischemic cardiomyopathy (NICM) vs. Ischemic cardiomyopathy (ICM) was evaluated on 2-year appropriate ICD therapy risk (HR 0.390, 95% CI 0.218-0.701, p=0.002). Non-ischemic cardiomyopathy was associated with a significantly higher 2-year risk of appropriate ICD therapy (27.7%) compared to ischemic cardiomyopathy (12.2%) in patients receiving primary prophylactic ICDs.
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