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SCD-HeFT: Benefits of ICD persist long term in chronic HF patients
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BOSTON — After approximately 11 years of follow-up, all-cause mortality was lower in patients who were randomly assigned to receive an implantable cardioverter defibrillator vs. placebo, according to long-term data from SCD-HeFT.
Original results of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) associated ICDs with a significant reduction in all-cause mortality, with an HR of 0.77 and an absolute risk reduction of 7.2% vs. placebo, researcher Jeanne Poole, MD, of the University of Washington in Seattle, said during a presentation at the Heart Rhythm Society’s 33rd Annual Scientific Sessions. To assess long-term outcomes, Poole and colleagues analyzed data on the surviving patients from 2003. Mortality data were available for 91% of the 2,521 patients enrolled in the original trial for a median follow-up period of 11 years.
Most notably, Poole said, results linked ICDs to a substantial decrease in all-cause mortality (HR=0.87; P=.028). Twelve-year mortality rate was 64% in those originally assigned placebo and 59% in those assigned ICD, indicating an absolute risk reduction of 5%.
Among patients who were NYHA Class II at enrollment, those in the ICD group experienced a significant reduction in all-cause mortality vs. those in the placebo group. This reduction, however, was not noted among ICD patients who were NYHA Class III (HR=1.06), Poole said.
The researchers also found a significant decrease in all-cause mortality for patients with ischemic etiology of HF who received the ICD compared with those who had ischemic cause of HF in the placebo arm (HR=0.81; P=.001). Results revealed a reduction in all-cause mortality in patients with nonischemic HF early in the trial, although this benefit diminished over time (HR=0.97).
Amiodarone was not associated with an improvement in survival when compared with placebo, according to Poole.
“ICD therapy used in patients with moderate HF and reduced systolic function significantly reduces mortality for at least 11 years from the time of initial device implantation,” Poole said. – by Melissa Foster
For more information:
- Bardy G. LB01-5. Presented at: the Heart Rhythm Society’s 33rd Annual Scientific Sessions; May 9-12, 2012; Boston.
Disclosure: Dr. Poole and colleagues report no relevant financial disclosures.