Abstract:
OBJECTIVES:The aim of this study was to compare the effectiveness of the implantable cardioverter defibrillator (ICD) and medical strategies for prevention of arrhythmic events and death. BACKGROUND:The ICD is a potential strategy to reduce mortality in patients at risk of sudden death. METHODS:The MEDLINE, EMBASE, and Cochrane Library electronic databases were searched from January 1966 to April 2002. All published randomized controlled trials comparing ICD implantation with medical therapy were reviewed. Four independent reviewers extracted data on all-cause mortality, nonarrhythmic death, and arrhythmic death using a standardized protocol. RESULTS:Nine studies including over 5,000 patients were synthesized using both fixed-effects and random-effects models. The primary and secondary prevention trials showed a significant benefit of the ICD with respect to arrhythmic death, with relative risks (RR) of 0.34 and 0.50, respectively (both p < 0.001). The mortality benefit of the ICD was entirely attributable to a reduction in arrhythmic death (all trials: p < 0.00001). Whereas the secondary prevention trials exhibited a robust decrease in all-cause ICD mortality (RR 0.75; p < 0.001), the pooled primary prevention trials demonstrated decreased all-cause ICD mortality (RR 0.66; p < 0.05) which was dependent on selected individual trials. The disparity in ICD-related mortality reductions in the primary prevention trials was related to variability in the incidence of arrhythmic death between individual studies. CONCLUSIONS:Although the ICD decreases the risk of arrhythmic death, its impact on all-cause mortality is related to the underlying risk of arrhythmia-related death relative to competing causes. Given the cost of the device strategy, policies of targeted intervention based on the future risk of arrhythmia are warranted.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Lee DS,Green LD,Liu PP,Dorian P,Newman DM,Grant FC,Tu JV,Alter DAdoi
10.1016/s0735-1097(03)00253-5subject
Has Abstractpub_date
2003-05-07 00:00:00pages
1573-82issue
9eissn
0735-1097issn
1558-3597pii
S0735109703002535journal_volume
41pub_type
杂志文章,meta分析abstract::In 26 consecutive cases with acquired immunodeficiency syndrome (AIDS) the main cardiac findings were Kaposi's sarcoma in 2 cases, microfocal myocardial abscess in 1, subendocardial infarct necrosis in 2, contraction band necrosis in 13, lymphocytic myocarditis in 9, intramyocardial lymphocytic infiltrates without myo...
journal_title:Journal of the American College of Cardiology
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abstract:OBJECTIVES:We aimed to compare the effects of upstream tirofiban versus downstream high-dose bolus (HDB) tirofiban and abciximab on tissue level perfusion and troponin I release in high-risk non-ST-segment elevation acute coronary syndrome (ACS) patients treated with percutaneous coronary intervention (PCI). BACKGROUN...
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pub_type: 杂志文章,随机对照试验
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更新日期:2006-02-07 00:00:00
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doi:10.1016/0735-1097(96)00223-9
更新日期:1996-09-01 00:00:00
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doi:10.1016/j.jacc.2010.11.045
更新日期:2011-04-26 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-09-10 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-04-01 00:00:00
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更新日期:2015-12-15 00:00:00
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更新日期:2016-09-27 00:00:00
abstract::Cardiac electrophysiologic alterations were evaluated 1 to 8 months after partial supracoronary aortic constriction in cats. This procedure induced left ventricular systolic hypertension and hypertrophy with marked connective tissue infiltration. In situ, premature ventricular complexes were observed during or after v...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(83)80275-7
更新日期:1983-09-01 00:00:00
abstract::The results of recatheterization were assessed in a select group of 95 patients enrolled in the Mansfield Scientific Aortic Valvuloplasty Registry to determine whether any procedural or patient-related variables at baseline predicted either initial immediate or follow-up (6.2 +/- 3.3 months) results. At the follow-up ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(91)90853-2
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVES:We sought to evaluate the feasibility and validity of a new method to quantify the hyperemic response of the forearms that can be incorporated into a rest myocardial perfusion protocol. BACKGROUND:Evaluation of the hyperemic response could provide useful clinical information in the detection and risk strati...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.02.064
更新日期:2004-10-06 00:00:00
abstract::In 72 drug abusers surgically treated for acute infective endocarditis, 14 patients (19%) required surgical procedures on two valves. The predominant infecting organisms were Staphylococcus aureus and Pseudomonas aeruginosa (29%). In contrast to single valve infection, congestive heart failure was the most common oper...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(84)80393-9
更新日期:1984-10-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0735-1097(94)90641-6
更新日期:1994-03-15 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.11.071
更新日期:2005-06-07 00:00:00
abstract:OBJECTIVES:We sought to determine the predictive ability of troponin I (TnI) in a heterogeneous group of patients with chest pain admitted from the emergency department (ED) for exclusion of myocardial infarction (MI). BACKGROUND:Previous studies in high-risk patients demonstrated that troponin elevations are associat...
journal_title:Journal of the American College of Cardiology
pub_type: 评论,杂志文章
doi:10.1016/s0735-1097(00)00943-8
更新日期:2000-11-15 00:00:00
abstract::The onset and resolution of electrical and functional measures of regional myocardial ischemia were examined in nine conscious dogs during control exercise and exercise after beta-receptor blockade. The dogs had been instrumented with an ameroid constrictor and were studied when no regional dysfunction was evident at ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80353-4
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the incidence of bleeding, vascular, and ischemic complications using three different heparin regimens after successful intervention. BACKGROUND:The ideal dose and duration of heparin infusion after successful coronary intervention is unknown. METHODS:Patients wer...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0735-1097(99)00195-3
更新日期:1999-08-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80381-3
更新日期:1986-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90434-8
更新日期:1989-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(03)00921-5
更新日期:2003-09-17 00:00:00
abstract:BACKGROUND:The pathophysiology of cardiomyopathy associated with premature ventricular contractions (PVCs) remains unclear. OBJECTIVES:This study prospectively explored cardiomyopathy development in a swine model of paced ectopic beats. METHODS:A total of 35 swine underwent pacemaker implantation. A group exposed to ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2018.09.059
更新日期:2018-12-11 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.04.090
更新日期:2007-09-11 00:00:00
abstract:OBJECTIVES:The aims of this study were to determine whether chronic or acute impairment of flow mediated vasodilation (FMD) in the brachial artery of smokers can be restored or preserved by the antioxidant vitamin E. BACKGROUND:Transient impairment of endothelial function after heavy cigarette smoking and chronic endo...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0735-1097(99)00542-2
更新日期:2000-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2016.10.073
更新日期:2017-01-31 00:00:00
abstract:OBJECTIVES:This study sought to assess the diagnostic value of optical coherence tomography (OCT) in patients with suspected spontaneous coronary artery dissection (SCAD). BACKGROUND:SCAD is a rare but challenging clinical entity. METHODS:Following a prospective protocol, OCT was performed in 17 consecutive patients ...
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pub_type: 杂志文章
doi:10.1016/j.jacc.2011.08.082
更新日期:2012-03-20 00:00:00
abstract::To determine predictors of inducible sustained ventricular tachycardia or fibrillation by programmed electrical stimulation in patients with coronary artery disease and ventricular tachyarrhythmias, 14 clinical and angiographic variables were analyzed in 60 consecutive patients. All patients had angiographically docum...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90605-0
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to investigate whether multiple biomarkers contribute to improved coronary heart disease (CHD) risk prediction in post-menopausal women compared with assessment using traditional risk factors (TRFs) only. BACKGROUND:The utility of newer biomarkers remains uncertain when added to pr...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2009.12.047
更新日期:2010-05-11 00:00:00
abstract:OBJECTIVES:We sought to determine the outcomes of patients with cardiogenic shock (CS) complicating non-ST-segment elevation acute myocardial infarction (MI). BACKGROUND:Such patients represent a high-risk (ST-segment depression) or low-risk (normal or nonspecific electrocardiographic findings) group for whom optimal ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0735-1097(00)00888-3
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVES:We sought to examine the age and gender distribution of coronary artery calcium (CAC) by diabetes status in a large cohort of asymptomatic individuals. BACKGROUND:Among individuals with diabetes, coronary artery disease (CAD) is a major cause of morbidity and mortality. Electron-beam tomography (EBT) quanti...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(02)02975-3
更新日期:2003-03-19 00:00:00