Heart failure & cardiomyopathies

Cardiac Magnetic Resonance for Prophylactic Implantable-Cardioverter Defibrillator Therapy in Ischemic Cardiomyopathy: The DERIVATE-ICM International Registry

JACC Cardiovasc ImagingPublished Prospective multicentre registry

Main finding · MAACEResult — go to the resultNRI 31.7%

Authors' conclusion

The DERIVATE-ICM registry is a large multicenter registry showing the additional value of CMR to stratify the risk for MAACE in a large cohort of patients with ICM compared with standard of care.

Study context

Population
Patients with ischemic cardiomyopathy, chronic HF and TTE-LVEF <50%
Participants
861 patients
Exposure
Cardiac magnetic resonance (CMR) vs TTE for implantable cardioverter-defibrillator (ICD) indication
Outcome
Major adverse arrhythmic cardiac events (MAACE)
Follow-up
Median 1,054 days
Methodological detailsprognostic cohort study, international, multicenter, multivendor
  • Prognostic cohort study
  • International
  • Multicenter
  • Multivendor

Main finding

MAACE

Net reclassification improvement (NRI)

31.7%

P = 0.007

As reported in the abstract

Major adverse arrhythmic cardiac events (MAACE) occurred
88 (10.2%)
LV end-diastolic volume index, HR (95% CI 1.000-1.011), P = 0.05
1.007
CMR-LVEF, HR (95% CI 0.945-0.999), P = 0.045
0.972
Late gadolinium enhancement (LGE) mass, HR (95% CI 1.002-1.018), P = 0.015
1.010

Observational data: associations, not effects.

Original publication

Cardiac Magnetic Resonance for Prophylactic Implantable-Cardioverter Defibrillator Therapy in Ischemic Cardiomyopathy: The DERIVATE-ICM International Registry. JACC Cardiovasc Imaging. Published 24 May 2023. doi:10.1016/j.jcmg.2023.03.015

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