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ABSTRACT: Background
There is evidence that the benefit of a primary prophylactic ICD therapy is not equal in all patients.Purpose
To evaluate risk factors of appropriate shocks and all- cause mortality in patients with a primary prophylactic ICD regarding contemporary studies.Data source
PubMed, LIVIVO, Cochrane CENTRAL between 2010 and 2016.Study selection
Studies were eligible if at least one of the endpoints of interest were reported.Data extraction
All abstracts were independently reviewed by at least two authors. The full text of all selected studies was then analysed in detail.Data synthesis
Our search strategy retrieved 608 abstracts. After exclusion of unsuitable studies, 36 papers with a total patient number of 47282 were included in our analysis. All-cause mortality was significantly associated with increasing age (HR 1.41, CI 1.29-1.53), left ventricular function (LVEF; HR 1.21, CI 1.14-1.29), ischemic cardiomyopathy (ICM; HR 1.37, CI 1.14-1.66) and co-morbidities such as impaired renal function (HR 2.30, CI 1.97-2.69). Although, younger age (HR 0.96, CI 0.85-1.09), impaired LVEF (HR 1.26, CI 0.89-1.78) and ischemic cardiomyopathy (HR 2.22, CI 0.83-5.93) were associated with a higher risk of appropriate shocks, none of these factors reached statistical significance.Limitations
Individual patient data were not available for most studies.Conclusion
In this meta-analysis of contemporary clinical studies, all-cause mortality is predicted by a variety of clinical characteristics including LVEF. On the other hand, the risk of appropriate shocks might be associated with impaired LVEF and ischemic cardiomyopathy. Further prospective studies are required to verify risk factors for appropriate shocks other than LVEF to help select appropriate patients for primary prophylactic ICD-therapy.
SUBMITTER: Bergau L
PROVIDER: S-EPMC5645142 | biostudies-literature | 2017
REPOSITORIES: biostudies-literature
Bergau Leonard L Tichelbäcker Tobias T Kessel Barbora B Lüthje Lars L Fischer Thomas H TH Friede Tim T Zabel Markus M
PloS one 20171017 10
<h4>Background</h4>There is evidence that the benefit of a primary prophylactic ICD therapy is not equal in all patients.<h4>Purpose</h4>To evaluate risk factors of appropriate shocks and all- cause mortality in patients with a primary prophylactic ICD regarding contemporary studies.<h4>Data source</h4>PubMed, LIVIVO, Cochrane CENTRAL between 2010 and 2016.<h4>Study selection</h4>Studies were eligible if at least one of the endpoints of interest were reported.<h4>Data extraction</h4>All abstract ...[more]