PMID- 22176998 OWN - NLM STAT- MEDLINE DCOM- 20120424 LR - 20181201 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 109 IP - 5 DP - 2012 Mar 1 TI - How can optimization of medical treatment avoid unnecessary implantable cardioverter-defibrillator implantations in patients with idiopathic dilated cardiomyopathy presenting with "SCD-HeFT criteria?". PG - 729-35 LID - 10.1016/j.amjcard.2011.10.033 [doi] AB - To assess the proportion and long-term outcomes of patients with idiopathic dilated cardiomyopathy and potential indications for implantable cardioverter-defibrillator before and after optimization of medical treatment, 503 consecutive patients with idiopathic dilated cardiomyopathy were evaluated from 1988 to 2006. A total of 245 patients (49%) satisfied the "Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) criteria," defined as a left ventricular ejection fraction of 0.35 or NYHA class I), 125 were evaluated after 5.5 +/- 2 months. Of these 227 patients, 13 (10%) developed "SCD-HeFT criteria" (group B1), 111 (89%) remained without "SCD-HeFT criteria" (group B2), and 1 (1%) had worsened to NYHA class IV. The 10-year mortality/heart transplantation and sudden death/sustained ventricular arrhythmia rate was 57% and 37% in group A1, 23% and 20% in group A2 (p <0.001 for mortality/heart transplantation and p = 0.014 for sudden death/sustained ventricular arrhythmia vs group A1), 45% and 41% in group B1 (p = NS vs group A1), 16% and 14% in group B2 (p = NS vs group A2), respectively. In conclusion, two thirds of patients with idiopathic dilated cardiomyopathy and "SCD-HeFT criteria" at presentation did not maintain implantable cardioverter-defibrillator indications 3 to 9 months later with optimal medical therapy. Their long-term outcome was excellent, similar to that observed for patients who had never met the "SCD-HeFT criteria." CI - Copyright A(c) 2012 Elsevier Inc. All rights reserved. FAU - Zecchin, Massimo AU - Zecchin M AD - Cardiovascular Department, Ospedali Riuniti and University of Trieste, Italy. massimo.zecchin@alice.it FAU - Merlo, Marco AU - Merlo M FAU - Pivetta, Alberto AU - Pivetta A FAU - Barbati, Giulia AU - Barbati G FAU - Lutman, Cristina AU - Lutman C FAU - Gregori, Dario AU - Gregori D FAU - Serdoz, Laura Vitali AU - Serdoz LV FAU - Bardari, Stefano AU - Bardari S FAU - Magnani, Silvia AU - Magnani S FAU - Di Lenarda, Andrea AU - Di Lenarda A FAU - Proclemer, Alessandro AU - Proclemer A FAU - Sinagra, Gianfranco AU - Sinagra G LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20111215 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) RN - Idiopathic dilation cardiomyopathy SB - IM CIN - Am J Cardiol. 2012 Jul 1;110(1):161-2. PMID: 22704297 MH - Adrenergic beta-Antagonists/administration & dosage/*therapeutic use MH - Adult MH - Angiotensin-Converting Enzyme Inhibitors/administration & dosage/*therapeutic use MH - Cardiomyopathy, Dilated/diagnosis/mortality/*therapy MH - Defibrillators, Implantable/*statistics & numerical data MH - Dose-Response Relationship, Drug MH - Electrocardiography, Ambulatory MH - Female MH - Follow-Up Studies MH - Humans MH - Italy/epidemiology MH - Male MH - Retrospective Studies MH - Risk Factors MH - Survival Rate/trends MH - Time Factors MH - Treatment Outcome MH - Unnecessary Procedures/*statistics & numerical data EDAT- 2011/12/20 06:00 MHDA- 2012/04/25 06:00 CRDT- 2011/12/20 06:00 PHST- 2011/07/23 00:00 [received] PHST- 2011/10/25 00:00 [revised] PHST- 2011/10/25 00:00 [accepted] PHST- 2011/12/20 06:00 [entrez] PHST- 2011/12/20 06:00 [pubmed] PHST- 2012/04/25 06:00 [medline] AID - S0002-9149(11)03207-3 [pii] AID - 10.1016/j.amjcard.2011.10.033 [doi] PST - ppublish SO - Am J Cardiol. 2012 Mar 1;109(5):729-35. doi: 10.1016/j.amjcard.2011.10.033. Epub 2011 Dec 15.