دورية أكاديمية
أعرض في EDS

Seattle proportional risk model in GISSI-HF: Estimated benefit of ICD in patients with EF less than 50.

التفاصيل البيبلوغرافية
العنوان: Seattle proportional risk model in GISSI-HF: Estimated benefit of ICD in patients with EF less than 50.
المؤلفون: Bockus LB; Department of Medicine,University of Washington, Seattle, WA., Shadman R; Department of Cardiology, Southern California Permanente Medical Group, Los Angeles, CA., Poole JE; Department of Medicine,University of Washington, Seattle, WA., Dardas TF; Department of Medicine,University of Washington, Seattle, WA., Lucci D; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Florence, Italy., Meessen J; Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milano, Italy., Latini R; Department of Acute Brain and Cardiovascular Injury, Institute for Pharmacological Research Mario Negri IRCCS, Milano, Italy., Maggioni A; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Florence, Italy., Levy WC; Department of Medicine,University of Washington, Seattle, WA. Electronic address: levywc@uw.edu.
المصدر: American heart journal [Am Heart J] 2024 May 31; Vol. 275, pp. 35-44. Date of Electronic Publication: 2024 May 31.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 0370465 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6744 (Electronic) Linking ISSN: 00028703 NLM ISO Abbreviation: Am Heart J Subsets: MEDLINE
أسماء مطبوعة: Original Publication: St. Louis, MO : Mosby
مستخلص: Background: The Seattle Proportional Risk Model (SPRM) estimates the proportion of sudden cardiac death (SCD) in heart failure (HF) patients, identifying those most likely to benefit from implantable cardioverter-defibrillator (ICD) therapy (those with ≥50% estimated proportion of SCD). The GISSI-HF trial tested fish oil and rosuvastatin in HF patients. We used the SPRM to evaluate its accuracy in this cohort in predicting potential ICD benefit in patients with EF ≤50% and an SPRM-predicted proportion of SCD either ≥50% or <50%.
Methods: The SPRM was estimated in patients with EF ≤50% and in a logistic regression model comparing SCD with non-SCD.
Results: We evaluated 6,750 patients with EF ≤50%. There were 1,892 all-cause deaths, including 610 SCDs. Fifty percent of EF ≤35% patients and 43% with EF 36% to 50% had an SPRM of ≥50%. The SPRM (OR: 1.92, P < 0.0001) accurately predicted the risk of SCD vs non-SCD with an estimated proportion of SCD of 44% vs the observed proportion of 41% at 1 year. By traditional criteria for ICD implantation (EF ≤35%, NYHA class II or III), 64.5% of GISSI-HF patients would be eligible, with an estimated ICD benefit of 0.81. By SPRM >50%, 47.8% may be eligible, including 30.2% with EF >35%. GISSI-HF participants with EF ≤35% with SPRM ≥50% had an estimated ICD HR of 0.64, comparable to patients with EF 36% to 50% with SPRM ≥50% (HR: 0.65).
Conclusions: The SPRM discriminated SCD vs non-SCD in GISSI-HF, both in patients with EF ≤35% and with EF 36% to 50%. The comparable estimated ICD benefit in patients with EF ≤35% and EF 36% to 50% supports the use of a proportional risk model for shared decision making with patients being considered for primary prevention ICD therapy.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
تواريخ الأحداث: Date Created: 20240602 Latest Revision: 20240613
رمز التحديث: 20240614
DOI: 10.1016/j.ahj.2024.05.014
PMID: 38825218
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-6744
DOI:10.1016/j.ahj.2024.05.014