Premium
Are MADIT II Criteria for Implantable Cardioverter Defibrillator Implantation Appropriate for Chinese Patients?
Author(s) -
SIU CHUNGWAH,
PONG VINCENT,
HO HEEHWA,
LIU SHASHA,
LAU CHUPAK,
LI SHEUNGWAI,
TSE HUNGFAT
Publication year - 2010
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2009.01609.x
Subject(s) - medicine , implantable cardioverter defibrillator , cardiology , hazard ratio , sudden cardiac death , cohort , ejection fraction , myocardial infarction , confidence interval , heart failure
MADIT II Criteria for Implantable Cardioverter. Background: MADIT‐II demonstrated that prophylactic implantation of an implantable cardioverter‐defibrillator (ICD) device prevents sudden cardiac death (SCD) in patients with myocardial infarction (MI) and impaired left ventricular ejection fraction (LVEF). It remains unclear whether the MADIT‐II criteria for ICD implantation are appropriate for Chinese patients.Methods and Results:We compared the clinical characteristics and outcome for a cohort of consecutive Chinese patients who satisfied MADIT‐II criteria for ICD implantation with the original published MADIT‐II population. Seventy consecutive patients who satisfied MADIT‐II criteria but did not undergo ICD implantation (age: 67 years, male: 77%) were studied. Their baseline demographics were comparable with the original MADIT‐II cohort with the exception of a higher incidence of diabetes mellitus. After follow‐up of 35 months, most deaths (78%) were due to cardiac causes (72% due to SCD). The 2‐year SCD rate (10.0%) was comparable with that of the MADIT‐II conventional group (12.1%), but higher than the MADIT‐II defibrillator group (4.9%). Similarly, the 2‐year non‐SCD rate was 3.0%, also comparable with the MADIT‐II conventional group (4.6%), but lower than the MADIT‐II defibrillator group (7.0%). Cox regression analysis revealed that advance NYHA function class (Hazard Ratio [HR]: 3.5, 95% Confidence Interval [CI]: 1.48–8.24, P = 0.004) and the lack of statin therapy (HR: 3.7, 95%CI: 1.35–10.17, P = 0.011) were independent predictors for mortality in the MADIT‐II eligible patients.Conclusion:Chinese patients who satisfy MADIT‐II criteria for ICD implantation are at similar risk of SCD and non‐SCD as the original MADIT‐II subjects. Implantation of an ICD in Chinese patients is appropriate. (J Cardiovasc Electrophysiol, Vol. 21, pp. 231–235, March 2010)