Author + information
- Hemindermeet Singh,
- Ameer Kabour,
- Abdur Khan,
- Sonia Ali Malik,
- Owais Khawaja,
- Haris Riaz,
- Wade Lee,
- Mark Richards,
- Johan Aasbo and
- Faraz khan Luni
Background: Implantation of an implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death (SCD) is controversial in view of the recent DANISH trial which suggested no benefit with ICD for primary prevention in patients with non-ischemic cardiomyopathy (NICMP).
Methods: We conducted a meta analysis of randomized control trials studying the role of ICD in primary prevention of SCD in patients with NICMP. Only randomized control trials which studied adults >18 years and included mortality in their end points were included. Observational studies or studies which did not mention all cause mortality in their end point were excluded. Only six studies were identified after the application of inclusion or exclusion criteria.
Results: Pooling of these randomized trials showed a statistically significant benefit of using ICDs in patients with NICMP [OR 0.76 (0.64, 0.91), I2=0%]. Sensitivity analysis did not show a statistically significant mortality benefit of ICD in NICMP in trials which had adequate beta blocker, ACE, ARB and aldosterone receptor blocker (ALDRB) use [OR 0.70 (0.41, 1.19), I2=70%].
Conclusions: Our analysis demonstrates a mortality benefit with ICD in patients with NICMP. ICDs are useful and associated with net mortality benefits in patients who are not on optimal medical therapy especially patients who are not on ALD RB.
Moderated Poster Contributions
Heart Failure and Cardiomyopathies Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 10:30 a.m.-10:40 a.m.
Session Title: Why Can't We Be Friends? Controversies in Heart Failure Management
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1137M-07
- 2017 American College of Cardiology Foundation