Predictors of mortality and ICD shock therapy in primary prophylactic ICD patients—A systematic review and meta-analysis

Autor: Bergau, Leonard, Tichelbäcker, Tobias, Kessel, Barbora, Lüthje, Lars, Fischer, Thomas H., Friede, Tim, Zabel, Markus
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Myocardial Ischemia
lcsh:Medicine
Vascular Medicine
Ventricular Function
Left
Endocrinology
Mathematical and Statistical Techniques
Ischemia
Risk Factors
Atrial Fibrillation
Medicine and Health Sciences
Public and Occupational Health
Prospective Studies
lcsh:Science
Diuretics
Age Factors
Drugs
Middle Aged
Prognosis
Defibrillators
Implantable
Primary Prevention
Physical Sciences
Female
Cardiomyopathies
Renal Ischemia
Statistics (Mathematics)
Arrhythmia
Research Article
Cardiomyopathy
Dilated
Endocrine Disorders
Death Rates
Cardiology
Research and Analysis Methods
Population Metrics
Diabetes Mellitus
Humans
Statistical Methods
Aged
Pharmacology
Population Biology
Prophylaxis
lcsh:R
Biology and Life Sciences
Survival Analysis
Death
Sudden
Cardiac
Metabolic Disorders
lcsh:Q
Preventive Medicine
Mathematics
Meta-Analysis
Zdroj: PLoS ONE
PLoS ONE, Vol 12, Iss 10, p e0186387 (2017)
ISSN: 1932-6203
Popis: Background There is evidence that the benefit of a primary prophylactic ICD therapy is not equal in all patients. Purpose To evaluate risk factors of appropriate shocks and all- cause mortality in patients with a primary prophylactic ICD regarding contemporary studies. Data source PubMed, LIVIVO, Cochrane CENTRAL between 2010 and 2016. Study selection Studies were eligible if at least one of the endpoints of interest were reported. Data extraction All abstracts were independently reviewed by at least two authors. The full text of all selected studies was then analysed in detail. Data synthesis Our search strategy retrieved 608 abstracts. After exclusion of unsuitable studies, 36 papers with a total patient number of 47282 were included in our analysis. All-cause mortality was significantly associated with increasing age (HR 1.41, CI 1.29–1.53), left ventricular function (LVEF; HR 1.21, CI 1.14–1.29), ischemic cardiomyopathy (ICM; HR 1.37, CI 1.14–1.66) and co-morbidities such as impaired renal function (HR 2.30, CI 1.97–2.69). Although, younger age (HR 0.96, CI 0.85–1.09), impaired LVEF (HR 1.26, CI 0.89–1.78) and ischemic cardiomyopathy (HR 2.22, CI 0.83–5.93) were associated with a higher risk of appropriate shocks, none of these factors reached statistical significance. Limitations Individual patient data were not available for most studies. Conclusion In this meta-analysis of contemporary clinical studies, all-cause mortality is predicted by a variety of clinical characteristics including LVEF. On the other hand, the risk of appropriate shocks might be associated with impaired LVEF and ischemic cardiomyopathy. Further prospective studies are required to verify risk factors for appropriate shocks other than LVEF to help select appropriate patients for primary prophylactic ICD-therapy.
Databáze: OpenAIRE
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