Implantable cardioverter-defibrillator therapy was associated with a 31% lower risk of all-cause mortality compared to no ICD (HR 0.69; 95% CI 0.50-0.96; P=0.03).
Cohort (n=965)
Does implantable cardioverter-defibrillator (ICD) therapy reduce all-cause mortality in primary prevention patients with ischemic and nonischemic cardiomyopathies (ejection fraction <=35%)?
ICD therapy for primary prevention in patients with left ventricular systolic dysfunction is associated with reduced all-cause mortality, even among older patients and those with major comorbidities.
Hazard Ratio: 0.69 (95% CI 0.5–0.96)
p-value: p=0.03
BACKGROUND: Although implantable cardioverter-defibrillators (ICDs) reduce mortality in primary prevention patients with left ventricular systolic dysfunction, recent studies have questioned their overall role in clinical practice, especially in older patients and those with major comorbid conditions. METHODS AND RESULTS: In a prospective cohort of 965 patients with ischemic and nonischemic cardiomyopathies (ejection fraction or=75), ischemic etiology, ejection fraction (>25% versus 0.05). Incremental cost-effectiveness ratios for ICD therapy were similar between patients aged >or=75 years and younger patients but rose slightly in those with multiple comorbid conditions. CONCLUSIONS: Routine use of ICDs in primary prevention patients with left ventricular systolic dysfunction was associated with lower all-cause mortality, even among older patients and those with major comorbid conditions. Although their use needs to be individualized, our findings suggest that these groups should not be routinely excluded from ICD treatment.
Chan et al. (Thu,) conducted a cohort in Ischemic and nonischemic cardiomyopathies (n=965). Implantable cardioverter-defibrillators (ICDs) vs. No ICD was evaluated on All-cause mortality (HR 0.69, 95% CI 0.50-0.96, p=0.03). Implantable cardioverter-defibrillator therapy was associated with a 31% lower risk of all-cause mortality compared to no ICD (HR 0.69; 95% CI 0.50-0.96; P=0.03).