In nonischemic systolic HF, prophylactic ICDs did not reduce all-cause mortality vs. usual care at 10 y

Area of Science:

• Cardiology
• Clinical Trials
• Heart Failure Research

Background:

• Nonischemic systolic heart failure (NISHD) affects numerous patients.
• The efficacy of implantable cardioverter-defibrillators (ICDs) in NISHD remains a subject of investigation.
• Previous studies suggested potential benefits, necessitating long-term evaluation.

Purpose of the Study:

• To assess the long-term effects of ICDs on mortality in patients with NISHD.
• To provide extended follow-up data for the DANISH (The Danish Study to Assess the Efficacy of ICDs in Patients With Nonischemic Systolic Heart Failure on Mortality) trial.
• To inform clinical practice regarding ICD implantation in this specific patient population.

Main Methods:

• Long-term follow-up analysis of the DANISH trial cohort.
• Inclusion of patients diagnosed with nonischemic systolic heart failure.
• Randomized controlled trial design comparing ICD implantation versus standard care.

Main Results:

• No significant difference in all-cause mortality between the ICD and control groups after extended follow-up.
• Subgroup analyses did not reveal a significant survival benefit for ICDs in specific patient characteristics.
• The primary endpoint of mortality reduction was not met in the long term.

Conclusions:

• Long-term implantation of ICDs does not provide a significant mortality benefit for patients with nonischemic systolic heart failure.
• The findings reinforce the need for careful patient selection for ICD therapy in this population.
• Further research may explore alternative or adjunctive therapies for NISHD.