Author + information
- Wally A. Omar,
- Akhil Parashar,
- Rohan Khera and
- Ambarish Pandey
Background: While ICD therapy improves survival in heart failure patients with ischemic cardiomyopathy, its usefulness in those with non-ischemic cardiomyopathy (NICM) is less well established. We sought to determine whether ICD therapy reduces all-cause mortality in patients with NICM using updated medical literature by performing a study level meta-analysis.
Methods: A comprehensive computerized literature search of medical databases was conducted. Randomized controlled trials (RCT) for primary prevention were included in the final analysis to minimize heterogeneity and obtain robust pooled estimates. The primary efficacy outcome was all-cause mortality among patients with NICM randomized to ICD versus optimal medical therapy in primary prevention studies. We used random effects modeling to conduct a meta-analysis of the primary outcome from included studies.
Results: Six studies enrolling 2970 NICM patients were identified. The pooled analysis revealed a significant reduction in all-cause mortality (Figure 1) among patients randomized to ICD versus optimal medical therapy without ICD (risk ratio: 0.79; 95% confidence interval: 0.66-0.91; P = 0.003). In meta-regression analysis, there was no association between proportional use of beta-blockers or ACE-inhibitors and risk-reduction with ICD use.
Conclusions: ICD therapy significantly reduces mortality in patients with NICM in the pooled analysis of primary prevention randomized trials.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Developments in HFpEF and Arryhthmias
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1250-291
- 2017 American College of Cardiology Foundation