PMID- 31270031
OWN - NLM
STAT- MEDLINE
DCOM- 20200221
LR  - 20200221
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 124
IP  - 4
DP  - 2019 Aug 15
TI  - The Benefit of Prophylactic Implantable Cardioverter Defibrillator Implantation 
      in Asymptomatic Heart Failure Patients With a Reduced Ejection Fraction.
PG  - 560-566
LID - S0002-9149(19)30593-4 [pii]
LID - 10.1016/j.amjcard.2019.05.026 [doi]
AB  - Recommendations for prophylactic implantable cardioverter defibrillator (ICD) 
      implantation in asymptomatic heart failure patients with a reduced left 
      ventricular ejection fraction (LVEF) differ between guidelines. Evidence on the 
      risk of appropriate device therapy (ADT) and death in New York Heart Association 
      (NYHA) class I patients is scarce. Aim of this study is to evaluate ADT and 
      mortality in NYHA-I primary prevention ICD patients with a LVEF </=35%. A 
      retrospective cohort was studied, including 572 patients with LVEF </=35% who 
      received a prophylactic ICD with or without resynchronization therapy (CRT-D). To 
      evaluate the incidence of ADT and mortality, NYHA-I was compared with NYHA-II-III 
      using Cox regression analysis. During a follow-up of 4.1 +/- 2.4 years, 33% of the 
      NYHA-I patients received ADT compared with 20% of the NYHA-II-III patients 
      (hazard ratio 1.5, 95% confidence interval 1.04 to 2.31, p = 0.03). No 
      differences in mortality were observed (hazard ratio 0.70, 95% confidence 
      interval 0.49 to 1.07, p = 0.10). Additional analyses showed no difference in 
      time to ADT excluding CRT patients (ICD-NYHA-I patients vs ICD-NYHA-II-III 
      patients, p = 0.17) and comparing ischemic and nonischemic cardiomyopathy NYHA-I 
      patients (p = 0.13). Multivariable Cox regression analyses showed that NYHA class 
      was the strongest independent predictor of ADT. In conclusion, primary prevention 
      NYHA-I ICD patients showed a higher incidence of ADT compared with NYHA-II-III 
      ICD patients. These results strongly suggest that primary prevention NYHA-I 
      patients with a LVEF </=35% are likely to benefit from ICD therapy and should not 
      be excluded from a potentially life-saving therapy.
CI  - Copyright (c) 2019 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - van der Lingen, Anne-Lotte C J
AU  - van der Lingen ACJ
AD  - Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, 
      the Netherlands.
FAU - Timmer, Stefan A J
AU  - Timmer SAJ
AD  - Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, 
      the Netherlands.
FAU - Allaart, Laurens J H
AU  - Allaart LJH
AD  - Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, 
      the Netherlands.
FAU - Rijnierse, Mischa T
AU  - Rijnierse MT
AD  - Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, 
      the Netherlands.
FAU - van de Ven, Peter M
AU  - van de Ven PM
AD  - Department of Epidemiology and Biostatistics, Amsterdam Cardiovascular Sciences, 
      Amsterdam, the Netherlands.
FAU - van Rossum, Albert C
AU  - van Rossum AC
AD  - Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, 
      the Netherlands.
FAU - Kemme, Michiel J B
AU  - Kemme MJB
AD  - Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, 
      the Netherlands.
FAU - van Halm, Vokko P
AU  - van Halm VP
AD  - Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, 
      the Netherlands.
FAU - Allaart, Cornelis P
AU  - Allaart CP
AD  - Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, 
      the Netherlands. Electronic address: cp.allaart@amsterdamumc.nl.
LA  - eng
PT  - Journal Article
DEP - 20190529
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - *Asymptomatic Diseases
MH  - Cardiac Resynchronization Therapy Devices
MH  - Death, Sudden, Cardiac/*prevention & control
MH  - *Defibrillators, Implantable
MH  - Electric Countershock/*statistics & numerical data
MH  - Female
MH  - Heart Failure/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Primary Prevention
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - *Stroke Volume
EDAT- 2019/07/05 06:00
MHDA- 2020/02/23 06:00
CRDT- 2019/07/05 06:00
PHST- 2019/03/07 00:00 [received]
PHST- 2019/05/06 00:00 [revised]
PHST- 2019/05/16 00:00 [accepted]
PHST- 2019/07/05 06:00 [pubmed]
PHST- 2020/02/23 06:00 [medline]
PHST- 2019/07/05 06:00 [entrez]
AID - S0002-9149(19)30593-4 [pii]
AID - 10.1016/j.amjcard.2019.05.026 [doi]
PST - ppublish
SO  - Am J Cardiol. 2019 Aug 15;124(4):560-566. doi: 10.1016/j.amjcard.2019.05.026. 
      Epub 2019 May 29.