Differential multivariable risk prediction of appropriate shock versus competing mortality - A prospective cohort study to estimate benefits from ICD therapy

We prospectively investigated combinations of risk stratifiers including multiple EP diagnostics in a cohort study of ICD patients. For 672 enrolled patients, we collected history, LVEF, EP study and T-wave alternans testing, 24-h Holter, NT-proBNP, and the eGFR. All-cause mortality and first approp...

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Bibliographic Details
Published in:International journal of cardiology 2018-12, Vol.272, p.102-107
Main Authors: Bergau, Leonard, Willems, Rik, Sprenkeler, David J., Fischer, Thomas H., Flevari, Panayota, Hasenfuß, Gerd, Katsaras, Dimitrios, Kirova, Aleksandra, Lehnart, Stephan E., Lüthje, Lars, Röver, Christian, Seegers, Joachim, Sossalla, Samuel, Dunnink, Albert, Sritharan, Rajevaa, Tuinenburg, Anton E., Vandenberk, Bert, Vos, Marc A., Wijers, Sofieke C., Friede, Tim, Zabel, Markus
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arrhythmias, Cardiac - blood
Arrhythmias, Cardiac - mortality
Arrhythmias, Cardiac - therapy
Cohort Studies
Death, Sudden, Cardiac - epidemiology
Death, Sudden, Cardiac - prevention & control
Defibrillators - adverse effects
Defibrillators - trends
Defibrillators, Implantable - adverse effects
Defibrillators, Implantable - trends
Female
Follow-Up Studies
Humans
Implantable cardioverter defibrillator
Male
Middle Aged
Mortality
Mortality - trends
Multivariate Analysis
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Prospective Studies
Risk Factors
Sudden cardiac death
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Summary:We prospectively investigated combinations of risk stratifiers including multiple EP diagnostics in a cohort study of ICD patients. For 672 enrolled patients, we collected history, LVEF, EP study and T-wave alternans testing, 24-h Holter, NT-proBNP, and the eGFR. All-cause mortality and first appropriate ICD shock were predefined endpoints. The 635 patients included in the final analyses were 63 ± 13 years old, 81% were male, LVEF averaged 40 ± 14%, 20% were inducible at EP study, 63% had a primary prophylactic ICD. During follow-up over 4.3 ± 1.5 years, 108 patients died (4.0% per year), and appropriate shock therapy occurred in n = 96 (3.9% per year). In multivariate regression, age (p 
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2018.06.103