Heart failure & cardiomyopathies
Implantable Cardioverter-Defibrillators in Ischaemic Versus Non-Ischaemic Heart Failure: Insights from the VICTORIA Trial
Authors' conclusion
Among patients with HFrEF with recent decompensation, presence of an ICD was associated with a reduction in SCD, but did not translate to a reduction in the risk of cardiovascular or all-cause death.
Study context
- Population
- Patients with HFrEF and recent heart failure (HF) decompensation, by HF aetiology (ischaemic vs non-ischaemic)53.6% ischaemic
- Participants
- 5,040 patients
- Comparison
- Pre-existing ICD vs no ICD
- ICDn = 1,399
- Primary endpoint
- SCD, CV death (including SCD) and all-cause death
- Follow-up
- Median 10.8 months
Methodological detailspropensity-score adjusted
- Propensity-score adjusted
Primary result
As reported in the abstract
SCD, CV death, all-cause death
ICD vs No ICDAdjusted hazard ratio (95% CI)
SCD
0.64(0.43–0.96)
CV death
0.99(0.83–1.18)
All-cause death
1.02(0.87–1.19)
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| SCD by HF aetiology (subgroup)ICDvs No ICDIschaemic HF | 0.61 (0.38–0.98) | |
| SCD by HF aetiology (subgroup)ICDvs No ICDNon-ischaemic HF | 0.72 (0.36–1.43) | |
| SCD in women with ischaemic HF (subgroup) | 0.2 (0.05–0.82) | |
| 0.050.21520Adjusted hazard ratio (log scale) |
- Sudden cardiac death (SCD) by HF aetiology (subgroup): interaction P = 0.69
- SCD in women with ischaemic HF (subgroup): interaction P = 0.029
ICD use, women vs men
- ICD use in women vs men
- 16.4% vs. 26.8%
SCD by AF (subgroup)
- AF modulated ICD effect on SCD; no benefit with AF
- Interaction P = 0.015
Original publication
Implantable Cardioverter-Defibrillators in Ischaemic Versus Non-Ischaemic Heart Failure: Insights from the VICTORIA Trial. Eur J Heart Fail. Published 20 June 2025. doi:10.
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