Prophylactic implantable cardioverter-defibrillators significantly reduced all-cause mortality compared with medical therapy in patients with non-ischaemic cardiomyopathy (RR 0.79; 95% CI 0.68-0.92; P=0.002).
Meta-Analysis (n=3,128)
Does prophylactic implantable cardioverter-defibrillator placement reduce all-cause mortality in patients with non-ischaemic cardiomyopathy?
Prophylactic ICD placement significantly reduces all-cause mortality in patients with non-ischaemic cardiomyopathy compared to medical therapy alone.
Relative Risk: 0.79 (95% CI 0.68–0.92)
p-value: p=0.002
Aim: Primary prophylactic implantable cardioverter defibrillators (ICDs) have demonstrated a clear all-cause mortality benefit in patients with ischaemic cardiomyopathy, with less compelling evidence supporting its use in patients with non-ischaemic cardiomyopathy (NICM). We performed a meta-analysis of randomized controlled trials (RCTs) evaluating the role of ICD for reduction in total mortality in NICM patients. Methods and results: An electronic search on PubMed, the Cochrane Library, and EMBASE databases was performed to identify the RCTs evaluating the role of prophylactic ICD placement in NICM patients. Mantel-Haenszel risk ratio (RR) fixed-effects model was used to summarize data across treatment arms. Random-effects model was used if heterogeneity (I2) ≥ 25. Patients with cardiac resynchronization therapy pacemaker (CRT-P) were included in the control group. Six RCTs, with a total of 3128 patients and a mean follow-up period of 48 ± 22 months comparing ICD with medical therapy in NICM were included in this analysis. There was a significant reduction in all-cause mortality in the ICD group compared with the medical therapy group RR 0.79, 95% confidence interval (95% CI) 0.68-0.92; P = 0.002. No publication bias was noted. Conclusion: Currently available evidence demonstrates that the use of ICD provides a clear and significant reduction in all-cause mortality among patients with NICM.
Romero et al. (Fri,) conducted a meta-analysis in Non-ischaemic cardiomyopathy (n=3,128). Implantable cardioverter-defibrillator (ICD) vs. Medical therapy (including CRT-P) was evaluated on All-cause mortality (RR 0.79, 95% CI 0.68-0.92, p=0.002). Prophylactic implantable cardioverter-defibrillators significantly reduced all-cause mortality compared with medical therapy in patients with non-ischaemic cardiomyopathy (RR 0.79; 95% CI 0.68-0.92; P=0.002).