Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II

Emily P. Zeitler, Sana M. Al-Khatib, Daniel J. Friedman, Joo Yoon Han, Jeanne E. Poole, Gust H. Bardy, J. Thomas Bigger, Alfred E. Buxton, Arthur J. Moss, Kerry L. Lee, Paul Dorian, Riccardo Cappato, Alan H. Kadish, Peter J. Kudenchuk, Daniel B. Mark, Lurdes Y.T. Inoue, Gillian D. Sanders

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: No precise tools exist to predict appropriate shocks in patients with a primary prevention ICD. We sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). Methods: Using patient-level data from the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) and the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), we identified patients with any appropriate shock. Clinical and demographic variables were included in a logistic regression model to predict appropriate shocks. Results: There were 1,463 patients randomized to an ICD, and 285 (19%) had ≥1 appropriate shock over a median follow-up of 2.59 years. Compared with patients without appropriate ICD shocks, patients who received any appropriate shock tended to have more severe heart failure. In a multiple logistic regression model, predictors of appropriate shocks included NYHA class (NYHA II vs. I: OR 1.65, 95% CI 1.07–2.55; NYHA III vs. I: OR 1.74, 95% CI 1.10–2.76), lower LVEF (per 1% change) (OR 1.04, 95% CI 1.02–1.06), absence of beta-blocker therapy (OR 1.61, 95% CI 1.23–2.12), and single chamber ICD (OR 1.67, 95% CI 1.13–2.45). Conclusion: In this meta-analysis of patient level data from MADIT-II and SCD-HeFT, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.

Original languageEnglish
Pages (from-to)1345-1351
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume28
Issue number11
DOIs
Publication statusPublished - Nov 1 2017

Fingerprint

Defibrillators
Sudden Cardiac Death
Multicenter Studies
Meta-Analysis
Shock
Heart Failure
Implantable Defibrillators
Logistic Models
Primary Prevention
Demography

Keywords

  • implantable cardioverter defibrillator
  • meta-analysis
  • primary prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Zeitler, E. P., Al-Khatib, S. M., Friedman, D. J., Han, J. Y., Poole, J. E., Bardy, G. H., ... Sanders, G. D. (2017). Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II. Journal of Cardiovascular Electrophysiology, 28(11), 1345-1351. https://doi.org/10.1111/jce.13307

Predicting appropriate shocks in patients with heart failure : Patient level meta-analysis from SCD-HeFT and MADIT II. / Zeitler, Emily P.; Al-Khatib, Sana M.; Friedman, Daniel J.; Han, Joo Yoon; Poole, Jeanne E.; Bardy, Gust H.; Bigger, J. Thomas; Buxton, Alfred E.; Moss, Arthur J.; Lee, Kerry L.; Dorian, Paul; Cappato, Riccardo; Kadish, Alan H.; Kudenchuk, Peter J.; Mark, Daniel B.; Inoue, Lurdes Y.T.; Sanders, Gillian D.

In: Journal of Cardiovascular Electrophysiology, Vol. 28, No. 11, 01.11.2017, p. 1345-1351.

Research output: Contribution to journalArticle

Zeitler, EP, Al-Khatib, SM, Friedman, DJ, Han, JY, Poole, JE, Bardy, GH, Bigger, JT, Buxton, AE, Moss, AJ, Lee, KL, Dorian, P, Cappato, R, Kadish, AH, Kudenchuk, PJ, Mark, DB, Inoue, LYT & Sanders, GD 2017, 'Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II', Journal of Cardiovascular Electrophysiology, vol. 28, no. 11, pp. 1345-1351. https://doi.org/10.1111/jce.13307
Zeitler, Emily P. ; Al-Khatib, Sana M. ; Friedman, Daniel J. ; Han, Joo Yoon ; Poole, Jeanne E. ; Bardy, Gust H. ; Bigger, J. Thomas ; Buxton, Alfred E. ; Moss, Arthur J. ; Lee, Kerry L. ; Dorian, Paul ; Cappato, Riccardo ; Kadish, Alan H. ; Kudenchuk, Peter J. ; Mark, Daniel B. ; Inoue, Lurdes Y.T. ; Sanders, Gillian D. / Predicting appropriate shocks in patients with heart failure : Patient level meta-analysis from SCD-HeFT and MADIT II. In: Journal of Cardiovascular Electrophysiology. 2017 ; Vol. 28, No. 11. pp. 1345-1351.
@article{f6642993d6874d8591e2bf038f4d3268,
title = "Predicting appropriate shocks in patients with heart failure: Patient level meta-analysis from SCD-HeFT and MADIT II",
abstract = "Background: No precise tools exist to predict appropriate shocks in patients with a primary prevention ICD. We sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). Methods: Using patient-level data from the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) and the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), we identified patients with any appropriate shock. Clinical and demographic variables were included in a logistic regression model to predict appropriate shocks. Results: There were 1,463 patients randomized to an ICD, and 285 (19{\%}) had ≥1 appropriate shock over a median follow-up of 2.59 years. Compared with patients without appropriate ICD shocks, patients who received any appropriate shock tended to have more severe heart failure. In a multiple logistic regression model, predictors of appropriate shocks included NYHA class (NYHA II vs. I: OR 1.65, 95{\%} CI 1.07–2.55; NYHA III vs. I: OR 1.74, 95{\%} CI 1.10–2.76), lower LVEF (per 1{\%} change) (OR 1.04, 95{\%} CI 1.02–1.06), absence of beta-blocker therapy (OR 1.61, 95{\%} CI 1.23–2.12), and single chamber ICD (OR 1.67, 95{\%} CI 1.13–2.45). Conclusion: In this meta-analysis of patient level data from MADIT-II and SCD-HeFT, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.",
keywords = "implantable cardioverter defibrillator, meta-analysis, primary prevention",
author = "Zeitler, {Emily P.} and Al-Khatib, {Sana M.} and Friedman, {Daniel J.} and Han, {Joo Yoon} and Poole, {Jeanne E.} and Bardy, {Gust H.} and Bigger, {J. Thomas} and Buxton, {Alfred E.} and Moss, {Arthur J.} and Lee, {Kerry L.} and Paul Dorian and Riccardo Cappato and Kadish, {Alan H.} and Kudenchuk, {Peter J.} and Mark, {Daniel B.} and Inoue, {Lurdes Y.T.} and Sanders, {Gillian D.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1111/jce.13307",
language = "English",
volume = "28",
pages = "1345--1351",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Predicting appropriate shocks in patients with heart failure

T2 - Patient level meta-analysis from SCD-HeFT and MADIT II

AU - Zeitler, Emily P.

AU - Al-Khatib, Sana M.

AU - Friedman, Daniel J.

AU - Han, Joo Yoon

AU - Poole, Jeanne E.

AU - Bardy, Gust H.

AU - Bigger, J. Thomas

AU - Buxton, Alfred E.

AU - Moss, Arthur J.

AU - Lee, Kerry L.

AU - Dorian, Paul

AU - Cappato, Riccardo

AU - Kadish, Alan H.

AU - Kudenchuk, Peter J.

AU - Mark, Daniel B.

AU - Inoue, Lurdes Y.T.

AU - Sanders, Gillian D.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background: No precise tools exist to predict appropriate shocks in patients with a primary prevention ICD. We sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). Methods: Using patient-level data from the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) and the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), we identified patients with any appropriate shock. Clinical and demographic variables were included in a logistic regression model to predict appropriate shocks. Results: There were 1,463 patients randomized to an ICD, and 285 (19%) had ≥1 appropriate shock over a median follow-up of 2.59 years. Compared with patients without appropriate ICD shocks, patients who received any appropriate shock tended to have more severe heart failure. In a multiple logistic regression model, predictors of appropriate shocks included NYHA class (NYHA II vs. I: OR 1.65, 95% CI 1.07–2.55; NYHA III vs. I: OR 1.74, 95% CI 1.10–2.76), lower LVEF (per 1% change) (OR 1.04, 95% CI 1.02–1.06), absence of beta-blocker therapy (OR 1.61, 95% CI 1.23–2.12), and single chamber ICD (OR 1.67, 95% CI 1.13–2.45). Conclusion: In this meta-analysis of patient level data from MADIT-II and SCD-HeFT, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.

AB - Background: No precise tools exist to predict appropriate shocks in patients with a primary prevention ICD. We sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). Methods: Using patient-level data from the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) and the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), we identified patients with any appropriate shock. Clinical and demographic variables were included in a logistic regression model to predict appropriate shocks. Results: There were 1,463 patients randomized to an ICD, and 285 (19%) had ≥1 appropriate shock over a median follow-up of 2.59 years. Compared with patients without appropriate ICD shocks, patients who received any appropriate shock tended to have more severe heart failure. In a multiple logistic regression model, predictors of appropriate shocks included NYHA class (NYHA II vs. I: OR 1.65, 95% CI 1.07–2.55; NYHA III vs. I: OR 1.74, 95% CI 1.10–2.76), lower LVEF (per 1% change) (OR 1.04, 95% CI 1.02–1.06), absence of beta-blocker therapy (OR 1.61, 95% CI 1.23–2.12), and single chamber ICD (OR 1.67, 95% CI 1.13–2.45). Conclusion: In this meta-analysis of patient level data from MADIT-II and SCD-HeFT, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.

KW - implantable cardioverter defibrillator

KW - meta-analysis

KW - primary prevention

UR - http://www.scopus.com/inward/record.url?scp=85033492192&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85033492192&partnerID=8YFLogxK

U2 - 10.1111/jce.13307

DO - 10.1111/jce.13307

M3 - Article

AN - SCOPUS:85033492192

VL - 28

SP - 1345

EP - 1351

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 11

ER -