Introduction: The DANISH-Trial raised doubts about the effectiveness of primary prevention of sudden cardiac death by ICD-implantation among patients with non-ischemic heart failure. We sought to analyse data from the EVITA-HF registry to give an answer from real world registry data to the DANISH Trial.
Methods: 2289 patients were identified from the EVITA-HF Registry with chronic heart failure (CHF) und reduced left ventricular ejection fraction of ≤35%. The patients were divided into two groups: Patients with implanted cardioverter-defibrillator (ICD-group; mean age 66±12 years, 77% male) and without ICD (no-ICD group; mean age 67±14 years, 74% male). The subgroups were compared with regard to mortality and predictive parameters affecting survival.
Results: Patients in the non-ICD group (1912 patients) were older and showed more sever comorbidities as cancer and dementia compared to 377 patients in the ICD-group After 1-year-follow-up patients with ischemic heart disease showed a significant improved survival in the ICD-group compared to non-ICD group (89.4% vs. 77.9%, OR 0.42 [0.26-0.67]). Patients with non-ischemic cardiomyopathy did not show a difference with regard to survival between the ICD and the non-ICD group (91.9% vs. 91.7%, OR 0.97 [0.49-1.93]). The data were stable in a cox-regression model.
Conclusion: In a real-world setting patients with non-ischemic cardiomyopathy and reduced left ventricular ejection fraction does not benefit as an overall group by adding ICD therapy.