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  • Bilchick, K. C.University of Virginia Health Syst, VA USA (författare)

Seattle Heart Failure and Proportional Risk Models Predict Benefit From Implantable Cardioverter-Defibrillators

  • Artikel/kapitelEngelska2017

Förlag, utgivningsår, omfång ...

  • Elsevier BV,2017

Nummerbeteckningar

  • LIBRIS-ID:oai:gup.ub.gu.se/254666
  • https://gup.ub.gu.se/publication/254666URI
  • https://doi.org/10.1016/j.jacc.2017.03.568DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-138236URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:135854880URI

Kompletterande språkuppgifter

  • Språk:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Funding Agencies|Thoratec (St. Jude Medical); HeartWare (Medtronic); GE Healthcare; Athena Health; National Institutes of Health [R03 HL135463]; National Cardiovascular Data Registry; National Institute on Aging [K23AG048331]; American Federation for Aging Research through the Paul B. Beeson Career Development Award Program; Yale Claude D. Pepper Older Americans Independence Center [P30AG021342]; Centers for Medicare & Medicaid Services; Boston Scientific; AstraZeneca; Novartis; Servier; Amgen; Resmed
  • BACKGROUND Recent clinical trials highlight the need for better models to identify patients at higher risk of sudden death. OBJECTIVES The authors hypothesized that the Seattle Heart Failure Model (SHFM) for overall survival and the Seattle Proportional Risk Model (SPRM) for proportional risk of sudden death, including death from ventricular arrhythmias, would predict the survival benefit with an implantable cardioverter-defibrillator (ICD). METHODS Patients with primary prevention ICDs from the National Cardiovascular Data Registry (NCDR) were compared with control patients with heart failure (HF) without ICDs with respect to 5-year survival using multivariable Cox proportional hazards regression. RESULTS Among 98,846 patients with HF (87,914 with ICDs and 10,932 without ICDs), the SHFM was strongly associated with all-cause mortality (p < 0.0001). The ICD-SPRM interaction was significant (p < 0.0001), such that SPRM quintile 5 patients had approximately twice the reduction in mortality with the ICD versus SPRM quintile 1 patients (adjusted hazard ratios [HR]: 0.602; 95% confidence interval [CI]: 0.537 to 0.675 vs. 0.793; 95% CI: 0.736 to 0.855, respectively). Among patients with SHFM-predicted annual mortality <= 5.7%, those with a SPRM-predicted risk of sudden death below the median had no reduction in mortality with the ICD (adjusted ICD HR: 0.921; 95% CI: 0.787 to 1.08; p = 0.31), whereas those with SPRM above the median derived the greatest benefit (adjusted HR: 0.599; 95% CI: 0.530 to 0.677; p < 0.0001). CONCLUSIONS The SHFM predicted all-cause mortality in a large cohort with and without ICDs, and the SPRM discriminated and calibrated the potential ICD benefit. Together, the models identified patients less likely to derive a survival benefit from primary prevention ICDs. (J Am Coll Cardiol 2017;69:2606-18) (C) 2017 by the American College of Cardiology Foundation.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Wang, Y. F.Yale New Haven Medical Centre, CT 06504 USA; Yale University, CT USA (författare)
  • Cheng, A.Johns Hopkins Medical Institute, MD 21205 USA (författare)
  • Curtis, J. P.Yale New Haven Medical Centre, CT 06504 USA; Yale University, CT USA (författare)
  • Dharmarajan, K.Yale New Haven Medical Centre, CT 06504 USA; Yale University, CT USA (författare)
  • Stukenborg, G. J.University of Virginia, VA USA (författare)
  • Shadman, R.Southern Calif Permanente Medical Grp, CA USA (författare)
  • Anand, I.University of Minnesota, MN USA (författare)
  • Lund, L. H.Karolinska Institutet (författare)
  • Dahlström, UlfLinköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)ulfda85 (författare)
  • Sartipy, U.Karolinska Institutet (författare)
  • Maggioni, A.Italian Assoc Hospital Cardiologists, Italy (författare)
  • Swedberg, Karl,1944Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,University of Gothenburg, Sweden; Imperial Coll, England(Swepub:gu)xsweka (författare)
  • O'Conner, C.Inova Healthcare Syst, VA USA (författare)
  • Levy, W. C.University of Washington, WA USA (författare)
  • University of Virginia Health Syst, VA USAYale New Haven Medical Centre, CT 06504 USA; Yale University, CT USA (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Journal of the American College of Cardiology: Elsevier BV69:21, s. 2606-26180735-10971558-3597

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