Sudden Death in Cardiomyopathy Reduced With ICD Treatment

HealthDay News — For adults with ischemic or nonischemic cardiomyopathy, implantable cardioverter defibrillator (ICD) therapy is associated with reduced incidence of sudden and all-cause death compared with conventional care, according to a review published online in the Annals of Internal Medicine.

Michalina Kolodziejkczak, MD, from Nicolaus Copernicus University in Bydgoszcz, Poland, and colleagues compared ICD therapy with conventional care for the primary prevention of death using data from 11 trials involving 8,716 patients.

The researchers observed an overall reduction in all-cause mortality, from 28.26% with conventional care to 21.37%  with ICD therapy (HR, 0.81; 95% CI, 0.70 to 0.94; P =.043). 

The reduction was of similar magnitude in the cohorts with nonischemic (HR. 0.81; 95% CI, 0.72 to 0.91) and ischemic disease (HR, 0.82; 95% CI, 0.63 to 1.06). There was a decrease in the rate of sudden death, from 12.15% with conventional care to 4.39% with ICD therapy (HR, 0.41; 95% CI, 0.30 to 0.56); the reduction was of similar magnitude for patients with ischemic (HR, 0.39; 95% CI, 0.23 to 0.68) and nonischemic disease (HR, 0.44; 95% CI, 0.17 to 1.12).

“Overall, primary prevention with ICD therapy vs conventional care reduced the incidence of sudden and all-cause death,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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Kolodziejczak M, Andreotti F, Kowalewski M, et al. Implantable cardioverter-defibrillators for primary prevention in patients with ischemic or nonischemic cardiomyopathy: A systematic review and meta-analysis. [published online June 27,2017]. Ann Intern Med. doi: 10.7326/M17-0120.