Autor: |
Michael H Picard, Jason H Wasfy, Aditya Achanta, Michael K Hidrue, Sarah Urbut, Andrea L Axtell, Adam N Berman, Yunong Zhao, Julian Chen, Sarah Gustus |
Jazyk: |
angličtina |
Rok vydání: |
2023 |
Předmět: |
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Zdroj: |
Open Heart, Vol 10, Iss 2 (2023) |
Druh dokumentu: |
article |
ISSN: |
2053-3624 |
DOI: |
10.1136/openhrt-2023-002289 |
Popis: |
Background Consensus guidelines support the use of implanted cardioverter-defibrillators (ICD) for primary prevention of sudden cardiac death in patients with either non-ischaemic or ischaemic cardiomyopathy with left ventricular ejection fraction (LVEF) ≤35%. However, evidence from trials for efficacy specifically for patients with LVEF near 35% is weak. Past trials are underpowered for this population and future trials are unlikely to be performed.Methods Patients with lowest LVEF between 30% and 35% without an ICD prior to the lowest-LVEF echo (defined as ‘time zero’) were identified by querying echocardiography data from 28 November 2001 to 9 July 2020 at the Massachusetts General Hospital linked to ICD treatment status. To assess the association between ICD and mortality, propensity score matching followed by Cox proportional hazards models considering treatment status as a time-dependent covariate was used. A secondary analysis was performed for LVEF 36%–40%.Results Initially, 526 440 echocardiograms representing 266 601 unique patients were identified. After inclusion and exclusion criteria were applied, 6109 patients remained for the analytical cohort. In bivariate unadjusted comparisons, patients who received ICDs were substantially more often male (79.8% vs 65.4%, p |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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