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Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death.

Abstract：

BACKGROUND:Recent MADIT II and SCD-HeFT trials have led to an expansion of indications for use of prophylactic Implantable Cardioverter Defibrillator (ICD) in patients with severe left-ventricular impairment. This therapy has not been fully adopted in our health care system, mainly due to its high cost. OBJECTIVE:To assess total mortality of SCD-HeFT-like patients from our daily practice who are under stable, optimal medical treatment and who have not received an ICD; and to compare it to that of the placebo arm of the SCD-HeFT Trial. METHODS:SCD-HeFT-like patients identified from office medical records were included in our study. Total mortality was assessed by telephone contact. Statistical analysis was performed by Student's t-Test, Mann-Whitney Test or chi2 test, depending on the type of variable. Cumulative mortality rates were calculated according to the Kaplan-Meier method. RESULTS:Our study comprised 102 patients (seventy-four of which were men) with a median age of 64 years, and an overall median ejection fraction of 25%. We found no differences between our patients and SCD-HeFT patients across these 3 variables. Over a 19.6-month follow-up period, 21 patients died (20.6%) vs. 28.8% of the SCD-HeFT patients. This difference was not statistically significant (p = 0.08). CONCLUSION:SCD-HeFT-like patients from our practice had no difference in mortality rate than patients enrolled in the placebo arm of the SCD-HeFT trial. These results suggest that the SCD-HeFT population is representative of our patients.

journal_name

Arq Bras Cardiol

journal_title

Arquivos brasileiros de cardiologia

authors

Hadid C,Avellana P,Di Toro D,Gomez CF,Visser M,Prieto N

doi

10.1590/s0066-782x2008000500006

subject

Has Abstract

pub_date

2008-05-01 00:00:00

pages

311-5

issue

5

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2008000500006

journal_volume

90

pub_type

杂志文章

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