The IC-D score for predicting prophylactic cardioverter-defibrillator implantation following acute myocardial infarction
© 2021 Wiley Periodicals LLC..
BACKGROUND: A reduced left ventricular ejection fraction (LVEF) ≤35% ≥6 weeks following an acute myocardial infarction (MI) may indicate prophylactic implantation of a cardioverter-defibrillator (ICD). We sought to find predictors of absence of significant left ventricular (LV) remodeling post-MI.
METHODS: All consecutive patients hospitalized for acute MI with an LVEF ≤35% at discharge in our institution from 2010 were retrospectively included. Patients were assigned to two groups according to the persistence of an LVEF ≤35% (ICD+) or a recovery >35% (ICD-). Logistic regression was performed to build a predictive score, which was then externally validated.
RESULTS: Among a total of 1533 consecutive MI patients, 150 met inclusion criteria, 53 (35%) in the ICD+ group and 97 in the ICD group. After multivariable analyses, an LVEF ≤25% at discharge (adjusted OR 6.23 [2.47 to 17.0], p < .0001) and a CPK peak at the MI acute phase >4600 UI/L (adjusted OR 9.99 [4.27 to 25.3], p < .0001) both independently predicted non-recovery at 6 weeks. The IC-D (Increased Cpk-LV Dysfunction) score predicted persistent LVEF ≤35% with areas under curve of 0.83 and 0.73, in the study population and in a multicenter validation cohort of 150 patients, respectively (p < .0001).
CONCLUSIONS: The association of a severely reduced LVEF and a major release of myocardial necrosis biomarkers at the acute phase of MI predict unfavorable remodeling, and prophylactic ICD implantation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
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| Enthalten in: |
Pacing and clinical electrophysiology : PACE - 44(2021), 6 vom: 13. Juni, Seite 973-979 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Clementy, Nicolas [VerfasserIn] |
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| Links: |
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| Themen: |
Anticoagulants |
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| Anmerkungen: |
Date Completed 26.01.2022 Date Revised 26.01.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/pace.14244 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM32401984X |
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| 245 | 1 | 4 | |a The IC-D score for predicting prophylactic cardioverter-defibrillator implantation following acute myocardial infarction |
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| 520 | |a © 2021 Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND: A reduced left ventricular ejection fraction (LVEF) ≤35% ≥6 weeks following an acute myocardial infarction (MI) may indicate prophylactic implantation of a cardioverter-defibrillator (ICD). We sought to find predictors of absence of significant left ventricular (LV) remodeling post-MI | ||
| 520 | |a METHODS: All consecutive patients hospitalized for acute MI with an LVEF ≤35% at discharge in our institution from 2010 were retrospectively included. Patients were assigned to two groups according to the persistence of an LVEF ≤35% (ICD+) or a recovery >35% (ICD-). Logistic regression was performed to build a predictive score, which was then externally validated | ||
| 520 | |a RESULTS: Among a total of 1533 consecutive MI patients, 150 met inclusion criteria, 53 (35%) in the ICD+ group and 97 in the ICD group. After multivariable analyses, an LVEF ≤25% at discharge (adjusted OR 6.23 [2.47 to 17.0], p < .0001) and a CPK peak at the MI acute phase >4600 UI/L (adjusted OR 9.99 [4.27 to 25.3], p < .0001) both independently predicted non-recovery at 6 weeks. The IC-D (Increased Cpk-LV Dysfunction) score predicted persistent LVEF ≤35% with areas under curve of 0.83 and 0.73, in the study population and in a multicenter validation cohort of 150 patients, respectively (p < .0001) | ||
| 520 | |a CONCLUSIONS: The association of a severely reduced LVEF and a major release of myocardial necrosis biomarkers at the acute phase of MI predict unfavorable remodeling, and prophylactic ICD implantation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cardioverter-defibrillator | |
| 650 | 4 | |a myocardial infarction | |
| 650 | 4 | |a predictor | |
| 650 | 4 | |a prophylactic | |
| 650 | 4 | |a wearable | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 700 | 1 | |a Bensaid, Reda |e verfasserin |4 aut | |
| 700 | 1 | |a Bouteau, Jérémie |e verfasserin |4 aut | |
| 700 | 1 | |a Fedida, Joël |e verfasserin |4 aut | |
| 700 | 1 | |a Kiavue, Yoann |e verfasserin |4 aut | |
| 700 | 1 | |a Socie, Pierre |e verfasserin |4 aut | |
| 700 | 1 | |a Ackermann, Romain |e verfasserin |4 aut | |
| 700 | 1 | |a Goralski, Marc |e verfasserin |4 aut | |
| 700 | 1 | |a Fauchier, Laurent |e verfasserin |4 aut | |
| 700 | 1 | |a Bernard, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Angoulvant, Denis |e verfasserin |4 aut | |
| 700 | 1 | |a Babuty, Dominique |e verfasserin |4 aut | |
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