International External Validation Study of the 2014 European Society of Cardiology Guidelines on Sudden Cardiac Death Prevention in Hypertrophic Cardiomyopathy (EVIDENCE-HCM).
Autor: O´Mahony, C.; Jichi, F.; Ommen, S. R.; García Pavía, Pablo
Resumen: BACKGROUND: Identification of people with hypertrophic
cardiomyopathy (HCM) who are at risk of sudden cardiac death (SCD)
and require a prophylactic implantable cardioverter defibrillator is
challenging. In 2014, the European Society of Cardiology proposed a
new risk stratification method based on a risk prediction model (HCM
Risk-SCD) that estimates the 5-year risk of SCD. The aim was to externally
validate the 2014 European Society of Cardiology recommendations in a
geographically diverse cohort of patients recruited from the United States,
Europe, the Middle East, and Asia.
METHODS: This was an observational, retrospective, longitudinal
cohort study.
RESULTS: The cohort consisted of 3703 patients. Seventy three (2%)
patients reached the SCD end point within 5 years of follow-up (5-year
incidence, 2.4% [95% confidence interval {CI}, 1.9–3.0]). The validation
study revealed a calibration slope of 1.02 (95% CI, 0.93–1.12), C-index
of 0.70 (95% CI, 0.68–0.72), and D-statistic of 1.17 (95% CI, 1.05–1.29).
In a complete case analysis (n= 2147; 44 SCD end points at 5 years),
patients with a predicted 5-year risk of <4% (n=1524; 71%) had an
observed 5-year SCD incidence of 1.4% (95% CI, 0.8–2.2); patients with
a predicted risk of ≥6% (n=297; 14%) had an observed SCD incidence of
8.9% (95% CI, 5.96–13.1) at 5 years. For every 13 (297/23) implantable
cardioverter defibrillator implantations in patients with an estimated
5-year SCD risk ≥6%, 1 patient can potentially be saved from SCD.
CONCLUSIONS: This study confirms that the HCM Risk-SCD model
provides accurate prognostic information that can be used to target
implantable cardioverter defibrillator therapy in patients at the highest
risk of SCD.
Identificador universal: http://hdl.handle.net/10641/1539
Fecha: 2018
Ficheros en el ítem
Ficheros | Tamaño | Formato | Ver |
---|---|---|---|
submission_final.pdf | 845.1Kb | Ver/ |
Este ítem aparece en la(s) siguiente(s) colección(ones)
- MEDICINA [789]