[Whether to implant a defibrillator or not? The Possibility of Using the MADIT-ICD Benefit Score Calculator in Real Practice].

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Kardiologiya Pub Date : 2024-02-29 DOI:10.18087/cardio.2024.2.n2447

N N Ilov, S A Boytsov, A A Nechepurenko

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Abstract

Aim: To study the predictive capabilities of the MADIT-ICD Benefit Score calculator in assessing the benefit of implantable cardioverter defibrillator (ICD) placement for the primary prevention of sudden cardiac death (SCD).

Material and methods: This study included 388 patients with NYHA II-IV functional class chronic heart failure (CHF) with a left ventricular ejection fraction (LVEF) ≤35 % who underwent ICD placement for the primary prevention of SCD. Patients were followed up for two years to record the endpoints of first-time paroxysmal sustained ventricular tachyarrhythmia (VT) or non-arrhythmic death.

Results: According to the results of calculation with the MADIT-ICD Benefit Score calculator, 276 (71 %) patients had a high risk of VT (score ≥7) and 150 (39 %) had a high risk of non-arrhythmic death (score ≥3). 336 (94%) patients would benefit from an ICD: 148 (38 %) with a high level of probability and 218 (56 %) with a medium level of probability. According to the incidence of endpoints, VT episodes predominated in the low-ICD benefit group (36%), while the high-ICD benefit group had a relatively high incidence of non-arrhythmic death (12%).

Conclusion: The results obtained for a cohort of Russian patients with CHF and reduced LVEF indicated that the use of the MADIT-ICD Benefit Score in routine clinical practice does not improve the stratification of SCD risk compared to the traditional approach to selecting patients with CHF for ICD based on the LVEF value.

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[是否植入除颤器？在实际应用中使用 MADIT-ICD 效益评分计算器的可能性]。

目的：研究MADIT-ICD获益评分计算器在评估植入式心律转复除颤器（ICD）用于心脏性猝死（SCD）一级预防的获益方面的预测能力：该研究纳入了388名左室射血分数（LVEF）≤35%的NYHA II-IV功能分级慢性心力衰竭（CHF）患者，这些患者接受了ICD置入术，用于SCD的一级预防。对患者进行为期两年的随访，记录首次阵发性持续室性心动过速（VT）或非心律失常死亡的终点：根据 MADIT-ICD 效益评分计算器的计算结果，276 名（71%）患者有 VT 的高风险（评分≥7），150 名（39%）患者有非心律失常死亡的高风险（评分≥3）。336（94%）名患者将从 ICD 中获益：148（38%）名患者有高风险，218（56%）名患者有中风险。根据终点的发生率，VT 发作在低 ICD 受益组中占多数（36%），而高 ICD 受益组的非心律失常死亡发生率相对较高（12%）：对一组 LVEF 降低的俄罗斯 CHF 患者的研究结果表明，在常规临床实践中使用 MADIT-ICD 收益评分与根据 LVEF 值为 CHF 患者选择 ICD 的传统方法相比，并不能改善 SCD 风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.