PMID- 15950580
OWN - NLM
STAT- MEDLINE
DCOM- 20050825
LR  - 20071115
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 95
IP  - 12
DP  - 2005 Jun 15
TI  - Implantable cardioverter-defibrillator efficacy in patients with heart failure 
      and left ventricular dysfunction (from the MADIT II population).
PG  - 1487-91
AB  - The Multicenter Automatic Defibrillator Implantation Trial II demonstrated a 
      significant 31% reduction in the risk of mortality in postinfarction patients 
      with low ejection fraction (EF < or =30%). Recently, results from the Sudden 
      Death in Heart Failure Trial indicated that a subgroup of patients with New York 
      Heart Association (NYHA) class III heart failure had less benefit from an 
      implantable cardioverter-defibrillator (ICD) than patients with less advanced 
      heart failure. This study evaluates the association between NYHA class, EF, and 
      blood urea nitrogen (BUN) levels as measures of heart failure and left 
      ventricular dysfunction, and ICD benefit in reducing mortality as well as the 
      association of these parameters with ICD therapy for ventricular 
      tachyarrhythmias. NYHA class I was identified in 442 patients (36%), class II in 
      425 (35%), and class III in 350 patients (29%). EF < or =20% was present in 472 
      patients (38%), EF of 21% to 25% in 359 patients (29%), and EF of 26% to 30% in 
      401 patients (33%). BUN < or =25 mg/dl was present in 850 patients (70%) and >25 
      mg/dl in 368 patients (30%). Patients with higher NYHA class and BUN had higher 
      mortality (34%) and a higher risk of arrhythmic events (33% to 35%) than patients 
      in lower functional groups (16% to 20%). EF did not differentiate the risk. There 
      was no evidence for significant interactions between mortality, ICD therapy, and 
      tested parameters. In conclusion, patients with more advanced heart failure have 
      a higher risk of mortality and arrhythmic events than patients with less severe 
      disease. However, there is no significant difference in the benefit from ICD 
      therapy among the above subgroups of patients in the Multicenter Automatic 
      Defibrillator Implantation Trial.
FAU - Zareba, Wojciech
AU  - Zareba W
AD  - Heart Research Follow-up Program, Cardiology Unit, Department of Medicine, 
      University of Rochester Medical Center, Rochester, New York 14642-8653, USA. 
      wojciech_zareba@urmc.rochester.edu
FAU - Piotrowicz, Katarzyna
AU  - Piotrowicz K
FAU - McNitt, Scott
AU  - McNitt S
FAU - Moss, Arthur J
AU  - Moss AJ
CN  - MADIT II Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Arrhythmias, Cardiac/etiology/mortality/therapy
MH  - Blood Urea Nitrogen
MH  - Death, Sudden, Cardiac/epidemiology/etiology/prevention & control
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/blood/complications/mortality/*therapy
MH  - Humans
MH  - Male
MH  - *Multicenter Studies as Topic
MH  - *Randomized Controlled Trials as Topic
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Survival Rate/trends
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/blood/complications/mortality/*therapy
EDAT- 2005/06/14 09:00
MHDA- 2005/08/27 09:00
CRDT- 2005/06/14 09:00
PHST- 2004/12/28 00:00 [received]
PHST- 2005/02/10 00:00 [revised]
PHST- 2005/02/09 00:00 [accepted]
PHST- 2005/06/14 09:00 [pubmed]
PHST- 2005/08/27 09:00 [medline]
PHST- 2005/06/14 09:00 [entrez]
AID - S0002-9149(05)00481-9 [pii]
AID - 10.1016/j.amjcard.2005.02.021 [doi]
PST - ppublish
SO  - Am J Cardiol. 2005 Jun 15;95(12):1487-91. doi: 10.1016/j.amjcard.2005.02.021.