Heart failure & cardiomyopathies
Redefining the risk of major arrhythmic events in non-ischaemic cardiomyopathy: insights from the DERIVATE-NICM study
Authors' conclusion
The presence of midwall LGE, but also the location of scar, confers an added and independent MAACE risk to a large NICM population influencing the choice of treatment.
Study context
- Population
- Non-ischaemic cardiomyopathy (NICM) patients with chronic heart failure and left ventricular ejection fraction (LVEF) < 50% evaluated for primary sudden cardiac death prevention therapy
- Participants
- 1,384 patients
- Exposure
- DERIVATE Risk Score 2.0 when compared with previously published DERIVATE Risk Score 1.0
- Outcome
- Major adverse arrhythmic cardiac events (MAACEs)
- Follow-up
- Median 959 days
Main finding
As reported in the abstract
MAACE occurred
128 (9.2%) patients
Observational data: associations, not effects.
Further findings
Independent predictors of MAACE (multivariate analyses)
| Estimate | P value | ||
|---|---|---|---|
| Male gender | HR 1.605 (95% CI 1.051–2.451) | P = 0.028 | |
| Presence and location of midwall LGE | weighted HR 1.066 (95% CI 1.045–1.086) | P < 0.001 | |
| 0.512Ratio (log scale) |
| Outcome | HR (per point %) (95% CI) | P value | |
|---|---|---|---|
| Independent predictors of MAACE (multivariate analyses)LVEF per point % | 0.977 (0.961–0.993) | P = 0.005 | |
| 0.512Hazard ratio (log scale) |
| Outcome | Net reclassification improvement (95% CI) | P value |
|---|---|---|
| Additional prognostic value vs. transthoracic echocardiography-LVEF cut-off of 35%Higher with DERIVATE Risk Score 2.0 · These findings were confirmed in the validation cohort. | 54.52% (36.52–72.52%) | P < 0.001 |
Original publication
Redefining the risk of major arrhythmic events in non-ischaemic cardiomyopathy: insights from the DERIVATE-NICM study. Eur Heart J Cardiovasc Imaging. Published 29 July 2025. doi:10.
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