Worldwide differences in primary prevention implantable cardioverter defibrillator utilization and outcomes in hypertrophic cardiomyopathy
Main finding · Primary prevention ICD implantationResult — go to the resultHazard ratio 2.27 CI 1.89–2.74Authors' conclusion
Primary prevention ICDs are implanted more frequently in patients with HCM in US vs. non-US sites across the spectrum of SCD risk. There was a lower rate of appropriate ICD therapy in US sites, consistent with a lower-risk population, and no significant difference in SCD in US vs. non-US patients who did not receive an ICD.
Study context
- Population
- Patients with hypertrophic cardiomyopathy in the Sarcomeric Human Cardiomyopathy Registry
- Participants
- 2,650 vs 2,660
- Exposure
- US vs non-US tertiary hypertrophic cardiomyopathy (HCM) centres
- USn = 2,650
- Non-USn = 2,660reference
- Outcome
- Primary prevention ICD implantation rates
Methodological detailsmulticentre, international registry
- Multicentre
- International registry
Main finding
Primary prevention ICD implantation
Hazard ratio
2.27
CI 1.89–2.74
US vs Non-US
HR 2.27 (CI 1.89–2.74)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| Primary prevention ICD implantation, high 5-year SCD risk (≥6%) by HCM risk-SCD score (subgroup) | 3.27 (1.76–6.05) | |
| Appropriate ICD therapy among ICD recipients | 0.52 (0.28–0.97) | |
| SCD/resuscitated cardiac arrest among non-recipients of ICDs | 1.21 (0.74–1.97) | |
| 0.10.31310Hazard ratio (log scale) |
Traditional sudden cardiac death (SCD) risk factors in implantable cardioverter defibrillator (ICD) recipients
- US ICD recipients had fewer traditional SCD risk factors
Original publication
Worldwide differences in primary prevention implantable cardioverter defibrillator utilization and outcomes in hypertrophic cardiomyopathy. Eur Heart J. Published 7 September 2021. doi:10.
Summarised from the published abstract; every number is checked against it