PMID- 27561197
OWN - NLM
STAT- MEDLINE
DCOM- 20170524
LR  - 20170524
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 118
IP  - 8
DP  - 2016 Oct 15
TI  - Outcome of Primary Prevention Implantable Cardioverter Defibrillator Therapy 
      According to New York Heart Association Functional Classification.
PG  - 1225-1232
LID - S0002-9149(16)31246-2 [pii]
LID - 10.1016/j.amjcard.2016.07.037 [doi]
AB  - We aimed to assess if the outcome of primary prevention implantable cardioverter 
      defibrillators (ICDs) without cardiac resynchronization therapy is dependent on 
      New York Heart Association (NYHA) class. Among the participants of Defibrillateur 
      Automatique Implantable-Prevention Primaire (DAI-PP; NCT01992458) multicenter 
      cohort study, 155 patients in NYHA class I, 504 in NYHA class II, and 188 in NYHA 
      class III had a QRS width <120 ms and were implanted with an ICD without cardiac 
      resynchronization therapy and, thus, were eligible for the purpose of this 
      analysis. Total and specific mortalities and the incidence of appropriate 
      therapies were assessed for every NYHA. During 2,606 patient-years (3.1 +/- 
      2.1 years), 104 (12.3%) subjects died and 188 (22.2%) experienced appropriate 
      therapies. After adjustment, overall mortality increased with NYHA class 
      (adjusted hazard ratio [HR] 1.63, 95% confidence interval [CI] 1.11 to 2.41, p = 
      0.014), driven by an increase in cardiovascular death. Conversely, incidence of 
      appropriate ICD intervention was comparable among the 3 NYHA groups (NYHA class I 
      7.43, NYHA class II 7.91, and NYHA class III 12.10 per 100 patient-years; HR 
      1.19, 95% CI 0.89 to 1.59, p = 0.231). Incidence of ICD-unresponsive sudden death 
      was very low and also comparable (NYHA class I 0.22, NYHA class II 0.36, and NYHA 
      class III 0.83 per 100 patient-years (HR 6.34, 95% CI 0.32 to 124.49, p = 0.224). 
      No significant differences were observed in the other specific modes of death. In 
      conclusion, although patients in NYHA class III have higher overall mortality, 
      they experience a comparable incidence of appropriate ICD therapies. The low 
      incidence of ICD-unresponsive sudden death in all assessed NYHA classes also 
      supports the efficacy of ICDs, irrespective of NYHA class.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Providencia, Rui
AU  - Providencia R
AD  - Clinique Pasteur, Toulouse, France; Barts Heart Centre, Barts Health NHS Trust, 
      London, United Kingdom.
FAU - Boveda, Serge
AU  - Boveda S
AD  - Clinique Pasteur, Toulouse, France. Electronic address: 
      sboveda@clinique-pasteur.com.
FAU - Defaye, Pascal
AU  - Defaye P
AD  - CHU Michallon, Grenoble, France.
FAU - Segal, Oliver
AU  - Segal O
AD  - Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom.
FAU - Algalarrondo, Vincent
AU  - Algalarrondo V
AD  - CHU Antoine Beclere, Clamart, France.
FAU - Sadoul, Nicolas
AU  - Sadoul N
AD  - CHU Brabois, Nancy, France.
FAU - Lambiase, Pier
AU  - Lambiase P
AD  - Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom; Institute of 
      Cardiovascular Sciences, University College of London, London, United Kingdom.
FAU - Piot, Olivier
AU  - Piot O
AD  - Centre Cardiologique du Nord, Saint Denis, France.
FAU - Klug, Didier
AU  - Klug D
AD  - CHRU Lille, Lille, France.
FAU - Perier, Marie-Cecile
AU  - Perier MC
AD  - Hopital Europeen Georges Pompidou, Paris, France.
FAU - Bouzeman, Abdeslam
AU  - Bouzeman A
AD  - Clinique Pasteur, Toulouse, France.
FAU - Barra, Sergio
AU  - Barra S
AD  - Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom.
FAU - Bories, Marie-Cecile
AU  - Bories MC
AD  - Hopital Europeen Georges Pompidou, Paris, France.
FAU - Gras, Daniel
AU  - Gras D
AD  - Nouvelles Cliniques Nantaises, Nantes, France.
FAU - Fauchier, Laurent
AU  - Fauchier L
AD  - CHU Trousseau, Tours, France.
FAU - Bordachar, Pierre
AU  - Bordachar P
AD  - CHU Haut Leveque, Bordeaux, France.
FAU - Babuty, Dominique
AU  - Babuty D
AD  - CHU Trousseau, Tours, France.
FAU - Deharo, Jean-Claude
AU  - Deharo JC
AD  - CHU La Timone, Marseille, France.
FAU - Leclercq, Christophe
AU  - Leclercq C
AD  - Cardiology Department, CHU Pontchaillou, Rennes, France.
FAU - Marijon, Eloi
AU  - Marijon E
AD  - Hopital Europeen Georges Pompidou, Paris, France.
CN  - DAI-PP Investigators
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20160729
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Cause of Death
MH  - Cohort Studies
MH  - Death, Sudden, Cardiac/etiology/*prevention & control
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Heart Failure/complications/mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Multivariate Analysis
MH  - *Primary Prevention
MH  - Proportional Hazards Models
MH  - Severity of Illness Index
EDAT- 2016/08/27 06:00
MHDA- 2017/05/26 06:00
CRDT- 2016/08/27 06:00
PHST- 2016/04/24 00:00 [received]
PHST- 2016/07/10 00:00 [revised]
PHST- 2016/07/10 00:00 [accepted]
PHST- 2016/08/27 06:00 [pubmed]
PHST- 2017/05/26 06:00 [medline]
PHST- 2016/08/27 06:00 [entrez]
AID - S0002-9149(16)31246-2 [pii]
AID - 10.1016/j.amjcard.2016.07.037 [doi]
PST - ppublish
SO  - Am J Cardiol. 2016 Oct 15;118(8):1225-1232. doi: 10.1016/j.amjcard.2016.07.037. 
      Epub 2016 Jul 29.