Valeria Calvi1, Gabriele Zanotto2, Antonio D'Onofrio3, Caterina Bisceglia4, Saverio Iacopino5, Carlo Pignalberi6, Ennio C Pisanò7, Francesco Solimene8, Massimo Giammaria9, Mauro Biffi10, Giampiero Maglia11, Massimiliano Marini12, Gaetano Senatore13, Stefano Pedretti14, Giovanni B Forleo15, Vincenzo E Santobuono16, Antonio Curnis17, Antonio Dello Russo18, Antonio Rapacciuolo19, Fabio Quartieri20, Patrizia Bertocchi21, Fabrizio Caravati22, Michele Manzo23, Davide Saporito24, Daniela Orsida25, Matteo Santamaria26, Giuseppe Bottaro27, Daniele Giacopelli28, Alessio Gargaro28, Paolo Della Bella4. 1. Policlinico G. Rodolico, Az. O.U. Policlinico - V. Via S. Sofia 78, 95123, Catania, Emanuele, Italy. valeria.calvi@unict.it. 2. Ospedale Mater Salutis, Legnago, Italy. 3. Ospedale Monaldi, Napoli, Italy. 4. Ospedale San Raffaele, Milano, Italy. 5. , Villa Maria Care&Research, Cotignola, RA, Italy. 6. Ospedale San Filippo Neri, Roma, Italy. 7. , Ospedale Vito Fazzi, Lecce, Italy. 8. Clinica Montevergine, Mercogliano, AV, Italy. 9. Ospedale Maria Vittoria, Torino, Italy. 10. Policlinico Sant'Orsola-Malpighi, Bologna, Italy. 11. Azienda Ospedaliera Pugliese Ciaccio, Catanzaro, Italy. 12. Ospedale Santa Chiara, Trento, Italy. 13. Ospedale di Ciriè, Ciriè, TO, Italy. 14. Ospedale Sant'Anna, ASST Lariana, San Fermo della Battaglia, CO, Italy. 15. Ospedale Luigi Sacco, Milano, Italy. 16. Azienda Ospedaliero Universitaria Consorziale Policlinico Di Bari, Bari, Italy. 17. Spedali Civili, Brescia, Italy. 18. Ospedali Riuniti, Ancona, Italy. 19. Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy. 20. Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. 21. Ospedale di Desio, Desio, Italy. 22. ASST Dei Sette Laghi, Ospedale di Circolo, Varese, Italy. 23. Azienda Ospedaliera Universitaria S.Giovanni Di Dio E Ruggi D'Aragona, Salerno, Italy. 24. Ospedale Degli Infermi, Rimini, Italy. 25. Ospedale Sant'Antonio Abate, Gallarate, Italy. 26. Gemelli Molise Hospital, Campobasso, Italy. 27. Policlinico G. Rodolico, Az. O.U. Policlinico - V. Via S. Sofia 78, 95123, Catania, Emanuele, Italy. 28. BIOTRONIK Italia, Vimodrone, MI, Italy.
Abstract
PURPOSE: The purpose of this study was to assess the available mortality risk stratification models for implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) patients. METHODS: We conducted a review of mortality risk stratification models and tested their ability to improve prediction of 1-year survival after implant in a database of patients who received a remotely controlled ICD/CRT-D device during routine care and included in the independent Home Monitoring Expert Alliance registry. RESULTS: We identified ten predicting models published in peer-reviewed journals between 2000 and 2021 (Parkash, PACE, MADIT, aCCI, CHA2DS2-VASc quartiles, CIDS, FADES, Sjoblom, AAACC, and MADIT-ICD non-arrhythmic mortality score) that could be tested in our database as based on common demographic, clinical, echocardiographic, electrocardiographic, and laboratory variables. Our cohort included 1,911 patients with left ventricular dysfunction (median age 71, 18.3% female) from sites not using any risk stratification score for systematic patient screening. Patients received an ICD (53.8%) or CRT-D (46.2%) between 2011 and 2017, after standard physician evaluation. There were 56 deaths within 1-year post-implant, with an all-cause mortality rate of 2.9% (95% confidence interval [CI], 2.3-3.8%). Four predicting models (Parkash, MADIT, AAACC, and MADIT-ICD non-arrhythmic mortality score) were significantly associated with increased risk of 1-year mortality with hazard ratios ranging from 3.75 (CI, 1.31-10.7) to 6.53 (CI 1.52-28.0, p ≤ 0.014 for all four). Positive predictive values of 1-year mortality were below 25% for all models. CONCLUSION: In our analysis, the models we tested conferred modest incremental predicting power to ordinary screening methods.
PURPOSE: The purpose of this study was to assess the available mortality risk stratification models for implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) patients. METHODS: We conducted a review of mortality risk stratification models and tested their ability to improve prediction of 1-year survival after implant in a database of patients who received a remotely controlled ICD/CRT-D device during routine care and included in the independent Home Monitoring Expert Alliance registry. RESULTS: We identified ten predicting models published in peer-reviewed journals between 2000 and 2021 (Parkash, PACE, MADIT, aCCI, CHA2DS2-VASc quartiles, CIDS, FADES, Sjoblom, AAACC, and MADIT-ICD non-arrhythmic mortality score) that could be tested in our database as based on common demographic, clinical, echocardiographic, electrocardiographic, and laboratory variables. Our cohort included 1,911 patients with left ventricular dysfunction (median age 71, 18.3% female) from sites not using any risk stratification score for systematic patient screening. Patients received an ICD (53.8%) or CRT-D (46.2%) between 2011 and 2017, after standard physician evaluation. There were 56 deaths within 1-year post-implant, with an all-cause mortality rate of 2.9% (95% confidence interval [CI], 2.3-3.8%). Four predicting models (Parkash, MADIT, AAACC, and MADIT-ICD non-arrhythmic mortality score) were significantly associated with increased risk of 1-year mortality with hazard ratios ranging from 3.75 (CI, 1.31-10.7) to 6.53 (CI 1.52-28.0, p ≤ 0.014 for all four). Positive predictive values of 1-year mortality were below 25% for all models. CONCLUSION: In our analysis, the models we tested conferred modest incremental predicting power to ordinary screening methods.
Authors: Anne Christine Ruwald; Michael Vinther; Gunnar H Gislason; Jens Brock Johansen; Jens Cosedis Nielsen; Helen Høgh Petersen; Sam Riahi; Christian Jons Journal: Eur J Heart Fail Date: 2016-12-01 Impact factor: 15.534
Authors: Susanne S Pedersen; Krista C van den Broek; Ruud A M Erdman; Luc Jordaens; Dominic A M J Theuns Journal: Europace Date: 2010-08-18 Impact factor: 5.214