PMID- 29307459 OWN - NLM STAT- MEDLINE DCOM- 20190501 LR - 20190501 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 121 IP - 5 DP - 2018 Mar 1 TI - Long-Term Survival With Implantable Cardioverter-Defibrillator in Different Symptomatic Functional Classes of Heart Failure. PG - 615-620 LID - S0002-9149(17)31857-X [pii] LID - 10.1016/j.amjcard.2017.11.032 [doi] AB - The ACC/AHA/HRS (American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society) guidelines recommend implantable cardioverter-defibrillator (ICD) therapy primary prevention in all patients with severely reduced left ventricular ejection fraction (/= II). We therefore aimed to evaluate the long-term survival benefit of primary ICD therapy among postmyocardial infarction patients with and without heart failure (HF) symptoms who were enrolled in MADIT-II (Multicenter Automatic Defibrillator Implantation Trial II). We classified 1,164 MADIT-II patient groups according to the baseline NYHA class (NYHA I [n = 442], NYHA II [n = 425], and NYHA III [n = 297]); patients with NYHA IV were excluded. Multivariate Cox proportional hazards regression modeling was performed to compare the mortality reduction with ICD versus non-ICD therapy during 8 years of follow-up between the 3 NYHA groups. The median (interquartile range) follow-up time was 7.6 (3.5 to 9) years. At 8 years of follow-up, the cumulative probability of mortality in the non-ICD treatment arm was 57% for NYHA I, 57% for NYHA II, and 76% for NYHA III (p <0.001). Multivariate models demonstrated similar long-term mortality risk reduction with ICD compared with the non-ICD treatment arm regardless of HF symptoms: NYHA I (HR = 0.63, 0.46 to 0.85, p = 0.003), NYHA II (HR = 0.68, 0.50 to 0.93, p = 0.017), and NYHA III (HR = 0.68, 0.50 to 0.94, p = 0.018); p for NYHA class by treatment arm interaction >0.10. In conclusion, primary ICD therapy provides consistent long-term survival benefit among patients with previous myocardial infarction and severe left ventricular dysfunction, regardless of HF symptoms. CI - Copyright (c) 2017 Elsevier Inc. All rights reserved. FAU - Biton, Yitschak AU - Biton Y AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York; Heart Institute, Sheba Medical Center, Ramat Gan, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: yitschak.biton@heart.rochester.edu. FAU - Rosero, Spencer AU - Rosero S AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York. FAU - Moss, Arthur AU - Moss A AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York. FAU - Zareba, Wojciech AU - Zareba W AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York. FAU - Kutyifa, Valentina AU - Kutyifa V AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York. FAU - Baman, Jayson AU - Baman J AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York; Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Barsheshet, Alon AU - Barsheshet A AD - Heart Institute, Sheba Medical Center, Ramat Gan, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. FAU - McNitt, Scott AU - McNitt S AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York. FAU - Polonsky, Bronislava AU - Polonsky B AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York. FAU - Goldenberg, Ilan AU - Goldenberg I AD - Division of Cardiology, Heart Research Follow-Up Program, Department of Medicine, University of Rochester Medical Center, Rochester, New York; Heart Institute, Sheba Medical Center, Ramat Gan, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20171211 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM CIN - Am J Cardiol. 2018 Jul 1;122(1):182. PMID: 29680169 MH - Aged MH - Death, Sudden, Cardiac/prevention & control MH - *Defibrillators, Implantable MH - Female MH - Heart Failure/*mortality/physiopathology/*therapy MH - Humans MH - Male MH - Middle Aged MH - Primary Prevention MH - Survival Rate EDAT- 2018/01/09 06:00 MHDA- 2019/05/02 06:00 CRDT- 2018/01/09 06:00 PHST- 2017/09/08 00:00 [received] PHST- 2017/11/16 00:00 [revised] PHST- 2017/11/20 00:00 [accepted] PHST- 2018/01/09 06:00 [pubmed] PHST- 2019/05/02 06:00 [medline] PHST- 2018/01/09 06:00 [entrez] AID - S0002-9149(17)31857-X [pii] AID - 10.1016/j.amjcard.2017.11.032 [doi] PST - ppublish SO - Am J Cardiol. 2018 Mar 1;121(5):615-620. doi: 10.1016/j.amjcard.2017.11.032. Epub 2017 Dec 11.