Clinical prediction model for death prior to appropriate therapy in primary prevention implantable cardioverter defibrillator patients with ischaemic heart disease: the FADES risk score

Rees, Johannes B. van; Borleffs, C. Jan Willem; Welsenes, Guido H. van; Velde, Enno T. van der; Bax, Jeroen J.; Erven, Lieselot van; Putter, Hein; Bom, Johanna G. van der; Schalij, Martin J.

doi:10.1136/heartjnl-2011-300632

Cited by 49 publications

(33 citation statements)

References 35 publications

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“…Thus it could be anticipated that they would have a worse prognosis. This finding is consistent with other studies of ICD patients who have found DM to be an independent risk factor for mortality [25][26][27].…”

Section: Discussionsupporting

confidence: 83%

176-54: Characteristics and Outcomes of Diabetic Patients with an Implantable Cardioverter Defibrillator in a Real World Setting: Results From the Israeli ICD Registry

Steiner¹,

Goldenberg²,

Suleiman

et al. 2016

EP Europace

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Aims: There are limited data regarding the effect of diabetes mellitus (DM) on the risks of both appropriate and inappropriate implantable cardioverter defibrillator (ICD) therapy. The present study was designed to compare the outcome of appropriate and inappropriate ICD therapy in patients with or without DM. Methods and results:The risk of a first appropriate ICD therapy for ventricular tachyarrhythmias (including anti tachycardia pacing and shock) was compared between 764 DM and 1346 non-DM patients enrolled in the national Israeli ICD registry. We also compared the risks of inappropriate ICD therapy, and death or cardiac hospitalization between diabetic and non-diabetic patients. Diabetic patients were older, were more likely to have ischemic cardiomyopathy, lower ejection fraction, atrial fibrillation, and other co-morbidities. The 3-year cumulative incidence of appropriate ICD therapy was similar in the DM and non-DM groups (12 and 13%, respectively, p = 0.983). Multivariate analysis showed that DM did not affect the risk of appropriate ICD therapy (HR = 1.07, 95% CI 0.78-1.47, p = 0.694) or inappropriate therapy (HR = 0.72, 95% CI 0.42-1.23, p = 0.232). However, DM was associated with a 31% increased risk for death or cardiac hospitalization (p = 0.005). Results were similar in subgroup analyses including ICD and defibrillators with cardiac resynchronization therapy function recipients, primary or secondary prevention indication for an ICD. Conclusions:Despite a significant excess of cardiac hospitalizations and mortality in the diabetic population, there was no difference in the rate of ICD treatments, suggesting that the outcome difference is not related to arrhythmias.

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Section: Discussionsupporting

confidence: 83%

176-54: Characteristics and Outcomes of Diabetic Patients with an Implantable Cardioverter Defibrillator in a Real World Setting: Results From the Israeli ICD Registry

Steiner¹,

Goldenberg²,

Suleiman

et al. 2016

EP Europace

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“…The clinical parameters associated with death before appropriate ICD therapy in patients with ischaemic heart disease who had an ICD inserted for primary prevention were assessed in a retrospective cohort study of 900 patients 111. The investigators found that New York Heart Association (NYHA) functional class ≥ III, advanced age, diabetes mellitus, LVEF ≤25%, and a history of smoking were significant independent predictors of death without appropriate ICD therapy, and suggested that this information may facilitate a more patient tailored risk estimation.…”

Section: Ventricular Arrhythmias and Sudden Cardiac Deathmentioning

confidence: 99%

Almanac 2013: cardiac arrhythmias and pacing

Liew

2013

Heart

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Important advances have been made in the past few years in the fields of clinical cardiac electrophysiology and pacing. Researchers and clinicians have a greater understanding of the pathophysiological mechanisms underlying atrial fibrillation (AF), which has transpired into improved methods of detection, risk stratification, and treatments. The introduction of novel oral anticoagulants has provided clinicians with alternative options in managing patients with AF at moderate to high thromboembolic risk and further data has been emerging on the use of catheter ablation for the treatment of symptomatic AF. Another area of intense research in the field of cardiac arrhythmias and pacing is in the use of cardiac resynchronisation therapy (CRT) for the treatment of patients with heart failure. Following the publication of major landmark randomised controlled trials reporting that CRT confers a survival advantage in patients with severe heart failure and improves symptoms, many subsequent studies have been performed to further refine the selection of patients for CRT and determine the clinical characteristics associated with a favourable response. The field of sudden cardiac death and implantable cardioverter defibrillators also continues to be actively researched, with important new epidemiological and clinical data emerging on improved methods for patient selection, risk stratification, and management. This review covers the major recent advances in these areas related to cardiac arrhythmias and pacing.

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“…Although, according to the large studies mentioned earlier, high mortality risk can be expected to point out patients at low benefit, one could take it to a higher analytical level by trying to identify death prior to ICD discharge as the ideal endpoint for nonbenefit. At our center, we developed a tool to identify patients with ischemic heart disease who, although currently indicated for ICD treatment, will have a high risk of dying prior to actually receiving a potentially life-saving ICD shock [17]. In this study, a total of 900 primary prevention ICD patients with ischemic heart disease were followed up for 669 days (IQR 363-1322 days).…”

Section: Routine Clinical Practice: Identification Of Primary Preventmentioning

confidence: 99%

Primary prevention implantable cardioverter–defibrillator treatment: how to identify patients most likely to benefit?

Thijssen

Rees

Schalij

et al. 2012

Expert Review of Cardiovascular Therapy

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Clinical prediction model for death prior to appropriate therapy in primary prevention implantable cardioverter defibrillator patients with ischaemic heart disease: the FADES risk score

Abstract: The risk of death without prior appropriate ICD therapy can be predicted in primary prevention ICD patients with ischaemic heart disease, which facilitates patient-tailored risk estimation.

Cited by 49 publications

References 35 publications

176-54: Characteristics and Outcomes of Diabetic Patients with an Implantable Cardioverter Defibrillator in a Real World Setting: Results From the Israeli ICD Registry

176-54: Characteristics and Outcomes of Diabetic Patients with an Implantable Cardioverter Defibrillator in a Real World Setting: Results From the Israeli ICD Registry

Almanac 2013: cardiac arrhythmias and pacing

Primary prevention implantable cardioverter–defibrillator treatment: how to identify patients most likely to benefit?

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