In propensity score-matched Japanese patients with non-ischemic heart failure, the incidence of appropriate ICD therapy was significantly higher in those receiving secondary prophylaxis (31.7%) compared to primary prophylaxis (21.4%).
Observational (n=252)
Yes
Does the indication for ICD therapy (secondary vs. primary prophylaxis) affect the incidence of appropriate ICD therapy and electrical storm in patients with non-ischemic heart failure?
In Japanese patients with non-ischemic heart failure, appropriate ICD therapy and electrical storms occur more frequently in those receiving secondary versus primary prophylaxis, though primary prophylaxis patients still face a considerable 21.4% rate of appropriate therapy.
Absolute Event Rate: 31.7% vs 21.4%
p-value: p=0.044
BACKGROUND: The prospective observational Nippon Storm Study aggregated clinical data from Japanese patients receiving implantable cardioverter-defibrillator (ICD) therapy. This study investigated the usefulness of prophylactic ICD therapy in patients with non-ischemic heart failure (NIHF) enrolled in the study. METHODS AND RESULTS: We analyzed 540 NIHF patients with systolic dysfunction (left ventricular ejection fraction <50%). Propensity score matching was used to select patient subgroups for comparison; 126 patients were analyzed in each of the primary (PP) and secondary (SP) prophylaxis groups. The incidence of appropriate ICD therapy during follow-up in the PP and SP groups was 21.4% and 31.7%, respectively (P=0.044). The incidence of electrical storm (ES) was higher in SP than PP patients (P=0.024). Cox proportional hazard analysis revealed that increased serum creatinine in SP patients (hazard ratio HR 1.18; 95% confidence interval CI 1.02-1.33; P=0.013) and anemia in PP patients (HR 0.92; 95% CI 0.86-0.98; P=0.008) increased the likelihood of appropriate ICD therapy, whereas long-lasting atrial fibrillation in PP patients (HR, 0.64 95% CI, 0.45-0.91, P=0.013) decreased that likelihood. CONCLUSIONS: In propensity score-matched Japanese NIHF patients, the incidence of appropriate ICD therapy and ES was significantly higher in SP than PP patients. Impaired renal function in SP patients and anemia in PP patients increased the likelihood of appropriate ICD therapy, whereas long-lasting atrial fibrillation reduced that likelihood in PP patients.
Sasaki et al. (Tue,) conducted a observational in Non-ischemic heart failure with systolic dysfunction (n=252). Secondary prophylaxis ICD therapy vs. Primary prophylaxis ICD therapy was evaluated on Incidence of appropriate ICD therapy (p=0.044). In propensity score-matched Japanese patients with non-ischemic heart failure, the incidence of appropriate ICD therapy was significantly higher in those receiving secondary prophylaxis (31.7%) compared to primary prophylaxis (21.4%).
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