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Assessment of myocardial scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation

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Mentions: During a median follow-up of 24 months, 39 patients experienced the prespecified primary endpoint of death or appropriate ICD discharge for sustained ventricular tachyarrhythmia. Whereas the rate of adverse events steadily increased with decreasing LVEF, a sharp step-up was observed for scar size >5% of LV mass (HR=5.2 [95% CI, 2.0-13.3]). On multivariable Cox proportional hazards analysis, including LVEF and electrophysiological-study results, scar size (as continuous variable or dichotomized at 5%) was an independent predictor of adverse outcome. Among patients with LVEF >30%, those with significant scarring (>5%) had higher risk than those with minimal-or-no (less than or equal to 5%) scarring (HR=6.3 [1.4-28.0]). Those with LVEF >30% and significant scarring had similar risk to patients with LVEF less than or equal to 30% (p=0.56). (Figure 1) Among patients with LVEF less than or equal to 30%, those with significant scarring again had higher risk than those with minimal-or-no scarring (HR=3.9 [1.2-13.1]). Those with LVEF less than or equal to 30% and minimal scarring had similar risk to patients with LVEF >30% (p=0.71). (Figure 2)


Assessment of myocardial scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3106660&req=5

Mentions: During a median follow-up of 24 months, 39 patients experienced the prespecified primary endpoint of death or appropriate ICD discharge for sustained ventricular tachyarrhythmia. Whereas the rate of adverse events steadily increased with decreasing LVEF, a sharp step-up was observed for scar size >5% of LV mass (HR=5.2 [95% CI, 2.0-13.3]). On multivariable Cox proportional hazards analysis, including LVEF and electrophysiological-study results, scar size (as continuous variable or dichotomized at 5%) was an independent predictor of adverse outcome. Among patients with LVEF >30%, those with significant scarring (>5%) had higher risk than those with minimal-or-no (less than or equal to 5%) scarring (HR=6.3 [1.4-28.0]). Those with LVEF >30% and significant scarring had similar risk to patients with LVEF less than or equal to 30% (p=0.56). (Figure 1) Among patients with LVEF less than or equal to 30%, those with significant scarring again had higher risk than those with minimal-or-no scarring (HR=3.9 [1.2-13.1]). Those with LVEF less than or equal to 30% and minimal scarring had similar risk to patients with LVEF >30% (p=0.71). (Figure 2)

View Article: PubMed Central - HTML

No MeSH data available.