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Sudden cardiac death after myocardial infarction: individual participant data from pooled cohorts
N. Peek, G. Hindricks, A. Akbarov, JGP. Tijssen, DA. Jenkins, Z. Kapacee, LM. Parkes, RJ. van der Geest, E. Longato, D. Sprague, Y. Taleb, M. Ong, CA. Miller, AS. Shamloo, C. Albert, P. Barthel, S. Boveda, F. Braunschweig, JB. Johansen, N. Cook,...
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, metaanalýza
Grantová podpora
R01 HL165840
NHLBI NIH HHS - United States
No. 847999
European Union's Horizon 2020
NLK
Free Medical Journals
od 1996 do Před 1 rokem
Open Access Digital Library
od 1996-01-01
- MeSH
- defibrilátory implantabilní * MeSH
- elektrokardiografie MeSH
- hodnocení rizik metody MeSH
- infarkt myokardu * mortalita komplikace MeSH
- lidé MeSH
- náhlá srdeční smrt * prevence a kontrola epidemiologie etiologie MeSH
- tepový objem * fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
BACKGROUND AND AIMS: Risk stratification of sudden cardiac death after myocardial infarction and prevention by defibrillator rely on left ventricular ejection fraction (LVEF). Improved risk stratification across the whole LVEF range is required for decision-making on defibrillator implantation. METHODS: The analysis pooled 20 data sets with 140 204 post-myocardial infarction patients containing information on demographics, medical history, clinical characteristics, biomarkers, electrocardiography, echocardiography, and cardiac magnetic resonance imaging. Separate analyses were performed in patients (i) carrying a primary prevention cardioverter-defibrillator with LVEF ≤ 35% [implantable cardioverter-defibrillator (ICD) patients], (ii) without cardioverter-defibrillator with LVEF ≤ 35% (non-ICD patients ≤ 35%), and (iii) without cardioverter-defibrillator with LVEF > 35% (non-ICD patients >35%). Primary outcome was sudden cardiac death or, in defibrillator carriers, appropriate defibrillator therapy. Using a competing risk framework and systematic internal-external cross-validation, a model using LVEF only, a multivariable flexible parametric survival model, and a multivariable random forest survival model were developed and externally validated. Predictive performance was assessed by random effect meta-analysis. RESULTS: There were 1326 primary outcomes in 7543 ICD patients, 1193 in 25 058 non-ICD patients ≤35%, and 1567 in 107 603 non-ICD patients >35% during mean follow-up of 30.0, 46.5, and 57.6 months, respectively. In these three subgroups, LVEF poorly predicted sudden cardiac death (c-statistics between 0.50 and 0.56). Considering additional parameters did not improve calibration and discrimination, and model generalizability was poor. CONCLUSIONS: More accurate risk stratification for sudden cardiac death and identification of low-risk individuals with severely reduced LVEF or of high-risk individuals with preserved LVEF was not feasible, neither using LVEF nor using other predictors.
Albert Einstein College of Medicine Bronx NY
Arrhythmia and Robotic Electrophysiology Unit La Paz University Hospital Madrid Spain
Aston Medical School Aston University Aston Triangle Birmingham UK
Boston Scientific Corporation St Paul MN USA
Brigham and Women's Hospital Harvard Medical School Boston MA USA
Cardiology Heart Rhythm Management Department Clinique Pasteur Toulouse France
Cardiology University Hospitals Leuven Leuven Belgium
Center for Cardiac Arrhythmias of Genetic Origin IRCCS Istituto Auxologico Italiano Milan Italy
Centre for Health Economics University of York York UK
Clinical Epidemiology and Biostatistics The AMC Amsterdam The Netherlands
Département de Cardiologie CHRU de Nancy Nancy France
Department of Cardiology Aarhus University Hospital Aarhus Denmark
Department of Cardiology Amsterdam UMC location University of Amsterdam Amsterdam The Netherlands
Department of Cardiology Karolinska University Hospital Stockholm Sweden
Department of Cardiology Rambam Health Care Campus Haifa Israel
Department of Cardiology Smidt Heart Institute Cedars Sinai Medical Center Los Angeles CA USA
Department of Cardiology University Hospital Basel University Basel Basel Switzerland
Department of Cardiovascular Imaging Centro Cardiologico Monzino IRCCS Milan Italy
Department of Cardiovascular Sciences University of Leuven Leuven Belgium
Department of Clinical Medicine Aarhus University Aarhus Denmark
Department of Electrophysiology Heart Center Leipzig Strumpellstr 39 04289 Leipzig Germany
Department of Information Engineering University of Padova Padova Italy
Department of Internal Medicine 1 Cardiology Olomouc University Hospital Moravia Czech Republic
Department of Medical Statistics University Medical Center Göttingen Göttingen Germany
Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden
Department of Radiology Leiden University Medical Center Leiden The Netherlands
Division of Cardiology European Georges Pompidou Hospital Paris France
Division of Cardiology Johns Hopkins University School of Medicine Baltimore MD USA
Heart Center Leipzig at the University of Leipzig Leipzig Germany
Hospital Clinic University of Barcelona Catalonia Spain
Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic
Institute of Clinical and Experimental Medicine University Hospital Olomouc Moravia Czech Republic
Klinikum rechts der Isar Technische Universität München Munich Germany
Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds Leeds UK
Medical and Surgical Department of Cardiology Georges Pompidou European Hospital Paris France
School of Medicine Northwestern University Feinberg Chicago USA
Service de Cardiologie et Maladies Vasculaires CHU Pontchaillou Rennes France
University of Rochester Medical Center Clinical Cardiovascular Research Center Rochester NY USA
Citace poskytuje Crossref.org
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