Effectiveness of the 2014 European Society of Cardiology guideline on sudden cardiac death in hypertrophic cardiomyopathy: a systematic review and meta-analysis.

Autor:	O'Mahony C; The Inherited Cardiac Diseases Unit, Barts Heart Centre, St Bartholomew's Hospital, London, UK.; UCL Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London, London, UK.; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART)., Akhtar MM; The Inherited Cardiac Diseases Unit, Barts Heart Centre, St Bartholomew's Hospital, London, UK.; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART).; UCL Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London, London, UK., Anastasiou Z; Department of Statistical Science, University College London, London, UK., Guttmann OP; The Inherited Cardiac Diseases Unit, Barts Heart Centre, St Bartholomew's Hospital, London, UK.; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART).; UCL Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London, London, UK., Vriesendorp PA; Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands., Michels M; Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands., Magrì D; Clinical and Molecular Medicine, University 'La Sapienza', Rome, Italy., Autore C; Clinical and Molecular Medicine, University 'La Sapienza', Rome, Italy., Fernández A; Department of Cardiology, Favaloro Foundation University Hospital, Institute of Cardiology and Cardiovascular Surgery, Buenos Aires, Argentina., Ochoa JP; Department of Cardiology, Favaloro Foundation University Hospital, Institute of Cardiology and Cardiovascular Surgery, Buenos Aires, Argentina.; GRINCAR (Cardiovascular Research Group), University of A Coruña, A Coruña, Spain.; Scientific Department, Health In Code, A Coruña, Spain., Leong KMW; Imperial College Healthcare NHS Trust, London, UK., Varnava AM; Imperial College Healthcare NHS Trust, London, UK., Monserrat L; Scientific Department, Health In Code, A Coruña, Spain.; Cardiology Department and Research Unit, A Coruña University Hospital, Galician Health Service, A Coruña, Spain., Anastasakis A; Unit of Inherited Cardiovascular Diseases, First Department of Cardiology, University of Athens, Athens, Greece., Garcia-Pavia P; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART).; Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.; University Francisco de Vitoria (UFV), Madrid, Spain.; Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Rapezzi C; Department of Specialised, Experimental and Diagnostic Medicine, Institute of Cardiology, University of Bologna, Bologna, Italy., Biagini E; Department of Specialised, Experimental and Diagnostic Medicine, Institute of Cardiology, University of Bologna, Bologna, Italy., Gimeno JR; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART).; Cardiac Department, University Hospital Virgen Arrixaca, La Alberca (Murcia), Spain., Limongelli G; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART).; Monaldi Hospital, Second University of Naples, Naples, Italy., Omar RZ; Department of Statistical Science, University College London, London, UK., Elliott PM; The Inherited Cardiac Diseases Unit, Barts Heart Centre, St Bartholomew's Hospital, London, UK.; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART).; UCL Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London, London, UK.
Jazyk:	angličtina
Zdroj:	Heart (British Cardiac Society) [Heart] 2019 Apr; Vol. 105 (8), pp. 623-631. Date of Electronic Publication: 2018 Oct 26.
DOI:	10.1136/heartjnl-2018-313700
Abstrakt:	Objective: In 2014, the European Society of Cardiology (ESC) recommended the use of a novel risk prediction model (HCM Risk-SCD) to guide use of implantable cardioverter defibrillators (ICD) for the primary prevention of sudden cardiac death (SCD) in patients with hypertrophic cardiomyopathy (HCM). We sought to determine the performance of HCM Risk-SCD by conducting a systematic review and meta-analysis of articles reporting on the prevalence of SCD within 5 years of evaluation in low, intermediate and high-risk patients as defined by the 2014 guidelines (predicted risk <4%, 4%-<6% and ≥6%, respectively). Methods: The protocol was registered with PROSPERO (registration number: CRD42017064203). MEDLINE and manual searches for papers published from October 2014 to December 2017 were performed. Longitudinal, observational cohorts of unselected adult patients, without history of cardiac arrest were considered. The original HCM Risk-SCD development study was included a priori. Data were pooled using a random effects model. Results: Six (0.9%) out of 653 independent publications identified by the initial search were included. The calculated 5-year risk of SCD was reported in 7291 individuals (70% low, 15% intermediate; 15% high risk) with 184 (2.5%) SCD endpoints within 5 years of baseline evaluation. Most SCD endpoints (68%) occurred in patients with an estimated 5-year risk of ≥4% who formed 30% of the total study cohort. Using the random effects method, the pooled prevalence of SCD endpoints was 1.01% (95% CI 0.52 to 1.61) in low-risk patients, 2.43% (95% CI 1.23 to 3.92) in intermediate and 8.4% (95% CI 6.68 to 10.25) in high-risk patients. Conclusions: This meta-analysis demonstrates that HCM Risk-SCD provides accurate risk estimations that can be used to guide ICD therapy in accordance with the 2014 ESC guidelines. Registration Number: PROSPERO CRD42017064203;Pre-results. Competing Interests: Competing interests: MMA reports being supported by an unrestricted educational grant from Sanofi Genzyme, outside the submitted work. LM is an employee and a stakeholder of Health in Code SL. All other authors have nothing to disclose. (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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