Abstract:
Background:Implantable cardioverter-defibrillators (ICDs) have a role in preventing cardiac arrest in patients at risk for life-threatening ventricular arrhythmias. Purpose:To compare ICD therapy with conventional care for the primary prevention of death of various causes in adults with ischemic or nonischemic cardiomyopathy. Data Sources:MEDLINE, Cochrane Central Register of Controlled Trials, Google Scholar, and EMBASE databases, as well as several Web sites, from 1 April 1976 through 31 March 2017. Study Selection:Randomized controlled trials, published in any language, comparing ICD therapy with conventional care and reporting mortality outcomes (all-cause, sudden, any cardiac, or noncardiac) in the primary prevention setting. Data Extraction:2 independent investigators extracted study data and assessed risk of bias. Data Synthesis:Included were 11 trials involving 8716 patients: 4 (1781 patients) addressed nonischemic cardiomyopathy, 6 (4414 patients) ischemic cardiomyopathy, and 1 (2521 patients) both types of cardiomyopathy. Mean follow-up was 3.2 years. An overall reduction in all-cause mortality, from 28.26% with conventional care to 21.37% with ICD therapy (hazard ratio [HR], 0.81 [95% CI, 0.70 to 0.94]; P = 0.043), was found. The magnitude of reduction was similar in the cohorts with nonischemic (HR, 0.81 [CI, 0.72 to 0.91]) and ischemic (HR, 0.82 [CI, 0.63 to 1.06]) disease, although the latter estimate did not reach statistical significance. The rate of sudden death fell from 12.15% with conventional care to 4.39% with ICD therapy (HR, 0.41 [CI, 0.30 to 0.56]), with a similar magnitude of reduction in patients with ischemic (HR, 0.39 [CI, 0.23 to 0.68]) and those with nonischemic disease (HR, 0.44 [CI, 0.17 to 1.12]). Noncardiac and any cardiac deaths did not differ significantly by treatment. Limitation:Heterogeneous timing of ICD placement; heterogeneous pharmacologic and resynchronization co-interventions; trials conducted in different eras; adverse events and complications not reviewed. Conclusion:Overall, primary prevention with ICD therapy versus conventional care reduced the incidence of sudden and all-cause death. Primary Funding Source:None.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Kolodziejczak M,Andreotti F,Kowalewski M,Buffon A,Ciccone MM,Parati G,Scicchitano P,Uminska JM,De Servi S,Bliden KP,Kubica J,Bortone A,Crea F,Gurbel P,Navarese EPdoi
10.7326/M17-0120subject
Has Abstractpub_date
2017-07-18 00:00:00pages
103-111issue
2eissn
0003-4819issn
1539-3704pii
2633844journal_volume
167pub_type
杂志文章,meta分析,评审abstract::Computerized axial tomography permits accurate cross-sectional radiographic visualization of visceral organs. Thus, "radiographic area" of an organ slice can be calculated and converted to actual area from a standard grid printed on the roentgenogram. Because the width between slices is known, the volume of an organ s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-2-185
更新日期:1979-02-01 00:00:00
abstract::Sixty-nine out of a kindred of 100 members covering five generations were examined and studied, and 34 were hypercalcemic. Sixteen subjects were believed, on the basis of laboratory and clinical observations, to have primary hyperparathyroidism. Eight patients were subjected to exhaustive study to identify polyendocri...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-1-36
更新日期:1976-01-01 00:00:00
abstract::We studied D-penicillamine toxicity in 259 patients with systemic sclerosis treated since 1972. The average daily dose of 635 mg was given for a mean of 1.8 years. Of patients with systemic sclerosis, 47% has side effects from D-penicillamine treatment, similar to the 56% of 807 patients with rheumatoid arthritis in s...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-104-5-699
更新日期:1986-05-01 00:00:00
abstract::Hepatitis is a significant complication of the treatment of hemophilia A with factor VIII concentrates. Chronic liver disease in these patients is infrequently documented in the literature. The results of percutaneous liver biopsy, under the coverage of glycine-precipitated factor VIII, in six patients with hemophilia...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-6-703
更新日期:1977-06-01 00:00:00
abstract::Two patients developed severe hypomagnesemia, hypocalcemia, and hypokalemia as a result of renal wasting of magnesium and potassium shortly after being treated with large doses of gentamicin. When therapy with gentamicin was discontinued renal loss of magnesium and potassium ceased, and serum calcium, magnesium, and p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-82-5-646
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND:Castleman disease, an unusual condition of unknown cause consisting of a massive proliferation of lymphoid tissue, remains a clinicopathologic diagnosis. Three histologic variants (hyaline vascular, plasma-cell, and mixed) and two clinical types (localized and multicentric) of Castleman disease have been des...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-8-199804150-00010
更新日期:1998-04-15 00:00:00
abstract:OBJECTIVE:To define the incidence of and possible risk factors for invasive Haemophilus influenzae disease in adults. DESIGN:Prospective, population-based surveillance of hospital and referral bacteriology laboratories. SETTING:Metropolitan Atlanta, Georgia community. PATIENTS:All patients with H. influenzae isolate...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-10-806
更新日期:1992-05-15 00:00:00
abstract::It is well recognized that physicians' relationships with their patients can have healing effects, but the skills in this area of medical practice are understudied. This article reports on research designed to identify a core set of healing skills. The authors interviewed 50 practitioners, who were identified by their...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-149-10-200811180-00006
更新日期:2008-11-18 00:00:00
abstract:Background:Triplex vaccine was developed to enhance cytomegalovirus (CMV)-specific T cells and prevent CMV reactivation early after hematopoietic stem cell transplant (HCT). Objective:To determine the safety and efficacy of Triplex. Design:First-in-patient, phase 2 trial. (ClinicalTrials.gov: NCT02506933). Setting:3...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/M19-2511
更新日期:2020-03-03 00:00:00
abstract:OBJECTIVE:To assess the use of L-tryptophan by patients with eosinophilic fasciitis and compare this with its use by patients with progressive systemic sclerosis (scleroderma). DESIGN:Retrospective and prospective analysis. Six patients with eosinophilic fasciitis were identified retrospectively and two prospectively....
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-112-10-758
更新日期:1990-05-15 00:00:00
abstract::Kidney transplantation is safe, cost-effective, and beneficial for patients with end-stage renal disease. The number of patients who can receive transplants is severely limited by the availability of donor organs. Because most patients do not have a suitable living, related donor, transplant programs now rely on the u...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-98-4-536
更新日期:1983-04-01 00:00:00
abstract::Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavio...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-1330
更新日期:2016-01-19 00:00:00
abstract::HLA-B27 is a transplantation antigen found in a high proportion of patients with ankylosing spondylitis. Recently, an association has been shown to exist between HLA-B27 and acute uveitis, even in the absence of ankylosing spondylitis. We have examined the HLA antigen profile of 45 patients with acute nongranulomatous...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-85-5-606
更新日期:1976-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the 6-month change in cardiovascular (coronary heart disease) risk as a function of diet and drug therapy for mild hypertension. DESIGN:Collaborative randomized, controlled clinical trial to assess the efficacy of alternative regimens in treating mild hypertension. SETTING:Three university-based...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-112-2-89
更新日期:1990-01-15 00:00:00
abstract::We performed immunohistopathologic studies on biopsied lung tissue obtained from two patients with lupus pneumonitis using immunofluorescence, immunoperoxidase, electron microscopy, and acid-microelution. In both patients, immunofluorescence showed granular deposits of IgG, the third component of complement (C3), and ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-1-30
更新日期:1979-07-01 00:00:00
abstract::Low back pain is common, but a herniated intervertebral disk is the cause in only a small percentage of cases. Most symptomatic disk herniations result in clinical manifestations (pain, reflex loss, muscle weakness) that resolve with conservative therapy, and only 5% to 10% of patients require surgery. Sciatica is usu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-112-8-598
更新日期:1990-04-15 00:00:00
abstract::To characterize the role of cardiac function in septic shock, serial radionuclide cineangiographic and hemodynamic evaluations were done on 20 patients with documented septic shock. Although all patients had a normal or elevated cardiac index, 10 patients had moderate to severe depression of their ejection fraction wi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-100-4-483
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND:Tobacco use is the leading cause of preventable death in the United States. PURPOSE:To review the effectiveness and safety of pharmacotherapy and behavioral interventions for tobacco cessation. DATA SOURCES:5 databases and 8 organizational Web sites were searched through 1 August 2014 for systematic review...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/M15-0171
更新日期:2015-10-20 00:00:00
abstract::Since 1969, medications have been provided to patients at the Johns Hopkins Hospital using a computer system that controls the entire medication process from entry of physician's order to hourly drug distribution. Special envelopes containing patient and dosage information are computer generated for each dose to be ad...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-83-3-342
更新日期:1975-09-01 00:00:00
abstract::Doxorubicin (Adriamycin) was administered by continuous infusion to reduce peak plasma levels and thus lessen cardiac toxicity. Cardiotoxicity was monitored by noninvasive methods, and endomyocardial biopsy specimens were studied by electronmicroscopy. Cardiotoxicity was compared in 21 patients receiving doxorubicin i...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-2-133
更新日期:1982-02-01 00:00:00
abstract::Two hundred forty previously healthy military personnel with nonstreptococcal upper respiratory infections were prospectively studied to define the incidence and clinicopathologic characteristics of possible virus-associated glomerulonephritis. Nine patients without preceding streptococcal infection had erythrocyte ca...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-5-697
更新日期:1979-11-01 00:00:00
abstract::This paper describes the role of venous ultrasonography in the diagnosis of suspected deep venous thrombosis and pulmonary embolism. Inability to compress the common femoral or popliteal vein is usually diagnostic of a first episode of deep venous thrombosis in symptomatic patients (positive predictive value of about ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-129-12-199812150-00009
更新日期:1998-12-15 00:00:00
abstract:OBJECTIVE:To assess the efficacy and toxicity of moricizine in treating patients with serious ventricular arrhythmias and inducible sustained ventricular tachycardia. DESIGN:Uncontrolled clinical trial. SETTING:The intensive care and telemetry units of Northwestern Memorial Hospital, St. Francis Hospital and Medical ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-116-5-375
更新日期:1992-03-01 00:00:00
abstract:PURPOSE:To examine the cost-effectiveness of test-treatment strategies for patients suspected of having Lyme disease. DATA SOURCES:The medical literature was searched for information on outcomes and costs. Expert opinion was sought for information on utilities. STUDY SELECTION:Articles that described patient populati...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-1-199801010-00007
更新日期:1998-01-01 00:00:00
abstract::Bayesian inference is usually presented as a method for determining how scientific belief should be modified by data. Although Bayesian methodology has been one of the most active areas of statistical development in the past 20 years, medical researchers have been reluctant to embrace what they perceive as a subjectiv...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-12-199906150-00019
更新日期:1999-06-15 00:00:00
abstract::Very low calorie diets used to treat moderate and severe obesity produce average weight losses of 20 kg in 12 weeks. This paper reviews the development of very low calorie diets from research on fasting in the late 1950s and examines data on the amount of dietary protein needed to achieve positive nitrogen balance. Th...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-99-5-675
更新日期:1983-11-01 00:00:00
abstract::Deaths and injuries related to firearms constitute a major public health problem in the United States. In response to firearm violence and other firearm-related injuries and deaths, an interdisciplinary, interprofessional group of leaders of 8 national health professional organizations and the American Bar Association...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M15-0337
更新日期:2015-04-07 00:00:00
abstract::The cause of stroke in young patients frequently cannot be established. Eleven consecutive patients, age 50 and younger, had clinical evidence of cerebral embolization. Results of physical, radiographic, electrocardiographic, and two-dimensional echocardiographic examinations were normal in all patients. During normal...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-105-5-695
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVE:To review the incidence of reversible renal insufficiency in patients with hypertensive nephrosclerosis undergoing antihypertensive therapy. DESIGN:Retrospective analysis of 73 patients in a long-term blood pressure control study that compared the effects of an angiotensin converting enzyme (ACE) inhibitor p...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-115-7-513
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Ear involvement is not unusual in autoimmune diseases, but few data on this problem in the Sjögren syndrome are available. OBJECTIVES:To determine whether the incidence of hearing loss is increased in patients with the Sjögren syndrome and to determine what factors might be involved in the pathogenesis of S...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-126-6-199703150-00005
更新日期:1997-03-15 00:00:00