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Background: Recent MADIT II and SCD-HeFT trials have led to an expansion of indications for use of prophylactic Implantable Cardioverter Defibrillator (ICD) in patients with severe left-ventricular impairment. This therapy has not been fully adopted in our health care system, mainly due to its high cost. Objective: To assess total mortality of SCD-HeFT-like patients from our daily practice who are under stable, optimal medical treatment and who have not received an ICD; and to compare it to that of the placebo arm of the SCD-HeFT Trial. Methods: SCD-HeFT-like patients identified from office medical records were included in our study. Total mortality was assessed by telephone contact. Statistical analysis was performed by Student's t-Test, Mann-Whitney Test or χ2 test, depending on the type of variable. Cumulative mortality rates were calculated according to the Kaplan-Meier method. Results: Our study comprised 102 patients (seventy-four of which were men) with a median age of 64 years, and an overall median ejection fraction of 25%. We found no differences between our patients and SCD-HeFT patients across these 3 variables. Over a 19.6-month follow-up period, 21 patients died (20.6%) vs 28.8% of the SCD-HeFT patients. This difference was not statistically significant (p = 0.08). Conclusion: SCD-HeFT-like patients from our practice had no difference in mortality rate than patients enrolled in the placebo arm of the SCD-HeFT trial. These results suggest that the SCD-HeFT population is representative of our patients.


Documento: Artículo
Título:Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death
Autor:Hadid, C.; Avellana, P.; Di Toro, D.; Gomez, C.F.; Visser, M.; Prieto, N.
Filiación:Hospital Donación Francisco Santojanni, Buenos Aires, Argentina
Arcos, 2252 4 B, Belgrano, 1428, Buenos Aires, Argentina
Palabras clave:Death, sudden; Defibrillators, implantable; Heart failure, congestive/mortality; adult; aged; article; clinical practice; congestive heart failure; controlled study; defibrillator; disease severity; female; follow up; health care cost; health care system; heart left ventricle failure; human; long term care; major clinical study; male; mortality; teleconsultation; treatment outcome; Aged; Argentina; Death, Sudden, Cardiac; Defibrillators, Implantable; Epidemiologic Methods; Female; Heart Failure; Humans; Male; Middle Aged; Placebo Effect; Randomized Controlled Trials as Topic; Treatment Outcome; Ventricular Dysfunction, Left
Página de inicio:311
Página de fin:315+339-344
Título revista:Arquivos Brasileiros de Cardiologia
Título revista abreviado:Arq. Bras. Cardiol.


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---------- APA ----------
Hadid, C., Avellana, P., Di Toro, D., Gomez, C.F., Visser, M. & Prieto, N. (2008) . Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death . Arquivos Brasileiros de Cardiologia, 90(5), 311-315+339-344.
---------- CHICAGO ----------
Hadid, C., Avellana, P., Di Toro, D., Gomez, C.F., Visser, M., Prieto, N. "Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death " . Arquivos Brasileiros de Cardiologia 90, no. 5 (2008) : 311-315+339-344.
---------- MLA ----------
Hadid, C., Avellana, P., Di Toro, D., Gomez, C.F., Visser, M., Prieto, N. "Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death " . Arquivos Brasileiros de Cardiologia, vol. 90, no. 5, 2008, pp. 311-315+339-344.
---------- VANCOUVER ----------
Hadid, C., Avellana, P., Di Toro, D., Gomez, C.F., Visser, M., Prieto, N. Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death . Arq. Bras. Cardiol. 2008;90(5):311-315+339-344.