Relation of multicenter automatic defibrillator implantation trial implantable cardioverter-defibrillator score with long-term cardiovascular events in patients with implantable cardioverter-defibrillator

Abstract

OBJECTIVE: To test the hypothesis that multicenter automatic defibrillator implantation trial (MADIT) - implantable cardioverter-defibrillator (ICD) scores predict replacement requirement and appropriate shock in a mixed population includingboth primary and secondary prevention and long-term adverse cardiovascular events.METHODS: The study has a retrospective design. Patients who were implanted with ICD in the cardiology clinic of AtatürkUniversity Faculty of Medicine between 2000 and 2013 were included in the study. For this purpose, 1394 patients who wereimplanted with a device in our clinic were reviewed. Then, those who were implanted with permanent pacemaker (n=1005),cardiac resynchronization treatment (CRT) (n=45) and CRT-ICD (n=198) were excluded.RESULTS: A total of 146 patients (98 males, 67.1%) with a mean age of 61.1 (±14.8) years were recruited. The medianfollow-up time was 21.5 months (mean 30.6±25.9 months; minimum 4 months, and maximum 120 months). The medianMADIT-ICD scores in the patients were 2. MADIT-ICD scores were categorized as low in 15.1%, intermediate in 57.5%, andhigh score in 27.4% of patients. Accordingly, MADIT-ICD scores (1.29 [1.00–1.68], p=0.050), hemoglobin (0.86 [0.75–0.99],p=0.047), and left ventricular ejection fraction (EF) (0.97 [0.94–0.99], p=0.023) were determined as independent predictorsof major adverse cardiovascular events in the long-term follow-up of ICD-implanted population.CONCLUSION: In this study, we showed that there was an independent association of long-term adverse cardiovascularevents with MADIT-ICD score, hemoglobin, and EF in patients implanted with ICD.