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Clinical Research in Cardiology

, Volume 109, Issue 1, pp 115–123 | Cite as

Cardioverter–defibrillator does not improve short-term survival among patients with non-ischemic cardiomyopathy and reduced left ventricular ejection fraction

  • Clemens JilekEmail author
  • Thorsten Lewalter
  • Matthias Pauschinger
  • Wolfgang von Scheidt
  • Lutz Frankenstein
  • Otmar Pfister
  • Rainer Hambrecht
  • Oliver Bruder
  • Johannes Brachmann
  • Andreas Hartmann
  • Ruth Strasser
  • Matthias Hochadel
  • Jochen Senges
Original Paper

Abstract

Introduction

The DANISH trial raised doubts about the effectiveness of primary prevention of sudden cardiac death by ICD implantation among patients with non-ischemic heart failure. We sought to analyse data from the EVITA-HF registry to give an answer from real-world registry data to the DANISH trial.

Methods

1804 patients were identified from the EVITA-HF registry with chronic heart failure (CHF) due to ischemic or dilated heart disease and reduced left ventricular ejection fraction of ≤ 35%. The patients were divided into two groups: Patients with newly implanted cardioverter–defibrillator (ICD group; mean age 66 ± 12 years, 77% male) and without ICD (no-ICD group; mean age 66 ± 14 years, 77% male). The subgroups were compared with regard to mortality and predictive parameters affecting survival.

Results

Cardiovascular risk factors were similar among patients in the non-ICD group (n = 1473) compared to ICD group (n = 331). After 1-year follow-up patients with ischemic heart disease showed a significant improved survival in the ICD group compared to non-ICD group [92.1% vs. 80.6%, HR 0.37 (0.22–0.62)]. Patients with non-ischemic cardiomyopathy did not show a difference with regard to survival between the ICD and the non-ICD group [93.7% vs. 93.1%, HR 0.92 (0.43–1.97)]. The data were stable in a Cox-regression model.

Conclusion

In a real-world setting, no benefit was evident for patients with non-ischemic cardiomyopathy and reduced left ventricular ejection fraction by adding ICD therapy in a short-term follow-up of 12 months in contrast to patients with ischemic cardiomyopathy.

Graphic abstract

Keywords

Non-ischemic cardiomyopathy Sudden cardiac death Primary prevention Implantable cardioverter–defibrillator 

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Clemens Jilek
    • 1
    Email author
  • Thorsten Lewalter
    • 1
  • Matthias Pauschinger
    • 2
  • Wolfgang von Scheidt
    • 3
  • Lutz Frankenstein
    • 4
  • Otmar Pfister
    • 5
  • Rainer Hambrecht
    • 6
  • Oliver Bruder
    • 7
  • Johannes Brachmann
    • 8
  • Andreas Hartmann
    • 9
  • Ruth Strasser
    • 10
  • Matthias Hochadel
    • 11
  • Jochen Senges
    • 11
  1. 1.Peter Osypka Herzzentrum München, Internistisches Klinikum München SüdMunichGermany
  2. 2.Klinik für Kardiologie, Klinikum NürnbergNurembergGermany
  3. 3.I. Medizinische Klinik, Klinikum AugsburgAugsburgGermany
  4. 4.Klinik für Innere Medizin III: Kardiologie, Angiologie und Pneumologie, UniklinikumHeidelbergGermany
  5. 5.Klinik für KardiologieUniversitätsspital BaselBaselSwitzerland
  6. 6.Klinik für Kardiologie und Angiologie, Klinikum links der WeserBremenGermany
  7. 7.Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus EssenEssenGermany
  8. 8.Klinik für Kardiologie, Angiologie und Pneumologie, Regiomed Kliniken CoburgCoburgGermany
  9. 9.Klinik für Kardiologie, Angiologie und Internistische IntensivmedizinLeipzigGermany
  10. 10.Klinik für Innere Medizin und KardiologieUniklinikum DresdenDresdenGermany
  11. 11.Stiftung Institut für Herzinfarktforschung LudwigshafenLudwigshafenGermany

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