Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(6), 674–679. https://doi.org/10.1002/clc.24022 Dr. Hossein Salehi Omran et al.
Points
- The study investigates the impact of implantable cardioverter defibrillator (ICD) insertion on survival and prognosis in patients with nonischemic dilated cardiomyopathy (DCM).
- A retrospective analysis of 120 patients with nonischemic DCM was conducted, divided into two groups: medical therapy alone and medical therapy with ICD insertion.
- Overall survival (OS) did not significantly differ between the two groups (p = 0.25).
- However, patients receiving ICD and medical therapy had a significantly lower incidence of sudden cardiac death (SCD) than those with medical therapy alone (p = 0.02).
- The findings suggest that ICD insertion as an adjunctive therapy may be beneficial in reducing SCD risk in nonischemic DCM patients, warranting further investigation and validation.
Summary
Nonischemic dilated cardiomyopathy (DCM) patients are at increased risk of arrhythmias and sudden cardiac death (SCD). To prevent SCD and improve survival, implantable cardioverter defibrillators (ICDs) have been considered in addition to standard medical treatments. This study aims to investigate the impact of ICD insertion on the survival and prognosis of patients with nonischemic DCM.
This retrospective analysis examined data from patients with nonischemic DCM treated at our hospital between January 2020 and November 2021. The patients were divided into two equal groups based on their treatment: medical therapy alone or with ICD insertion. The study assessed various demographic and clinical variables, including age, comorbidities, medical treatments, hospitalization rate, functional class, and left ventricular ejection fraction (LVEF) before and after treatment. The primary outcomes of interest were overall survival (OS) and the incidence of SCD, which were compared between the two groups.
The study included a total of 120 patients with nonischemic DCM. The mean age of the patients was 64.0 ± 12.7 years, and the mean follow-up time was 61.2 ± 15.9 months. During the follow-up period, 10 (16.7%) patients receiving medical therapy alone and 7 (11.7%) patients in the combined ICD and medical therapy group died (p = 0.25). However, when comparing the incidence of SCD between the two groups, a significant difference was observed (11.7% in the medical therapy group vs. 1.7% in the ICD and medical therapy group, p = 0.02).
This study’s findings suggest that adding an ICD to standard medical treatments significantly reduces the incidence of sudden cardiac death in patients with nonischemic DCM. While there was no statistically significant difference in overall survival between the two groups, the reduction in SCD risk highlights the potential benefit of ICD insertion as an adjunctive therapy in this population. Further investigation and larger-scale studies are warranted to validate these results and gain a deeper understanding of the long-term effects of ICD use on overall survival in nonischemic DCM patients. Nevertheless, this research provides valuable insights into potential treatment strategies that may improve outcomes in individuals with this cardiac condition.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24022
References Salehi Omran, H., Naghashzadeh, F., Irilouzadian, R., Dolatshahi, S., Hedayati Goudarzi, M. T., & Salehi Omran, M. T. (2023). The impact of implantable cardioverter defibrillator on the prognosis of nonischemic dilated cardiomyopathy patients compared with standard medical treatments. Clinical Cardiology, 46(6), 674–679. https://doi.org/10.1002/clc.24022
