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Implantable Cardioverter-Defibrillators for Primary Prevention of Sudden Cardiac Death in CKD: A Meta-analysis of Patient-Level Data From 3 Randomized.

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Presentation on theme: "Implantable Cardioverter-Defibrillators for Primary Prevention of Sudden Cardiac Death in CKD: A Meta-analysis of Patient-Level Data From 3 Randomized."— Presentation transcript:

1 Implantable Cardioverter-Defibrillators for Primary Prevention of Sudden Cardiac Death in CKD: A Meta-analysis of Patient-Level Data From 3 Randomized Trials  Patrick H. Pun, MD, MHS, Sana M. Al-Khatib, MD, MHS, Joo Yoon Han, BS, Rex Edwards, BA, Gust H. Bardy, MD, J. Thomas Bigger, MD, Alfred E. Buxton, MD, Arthur J. Moss, MD, Kerry L. Lee, PhD, Richard Steinman, AB, Paul Dorian, MD, Al Hallstrom, PhD, Riccardo Cappato, MD, Alan H. Kadish, MD, Peter J. Kudenchuk, MD, Daniel B. Mark, MD, MPH, Paul L. Hess, MD, Lurdes Y.T. Inoue, PhD, Gillian D. Sanders, PhD  American Journal of Kidney Diseases  Volume 64, Issue 1, Pages (July 2014) DOI: /j.ajkd Copyright © 2014 National Kidney Foundation, Inc. Terms and Conditions

2 Figure 1 Study selection and patient inclusion within selected studies. Abbreviations: AVID, Antiarrhythmics Versus Implantable Defibrillators; CABG-PATCH, Coronary Artery Bypass Graft Patch; CASH, Cardiac Arrest Study Hamburg; CHF, congestive heart failure; DEFINITE, Defibrillators in Non-ischemic Cardiomyopathy Treatment Evaluation; DINAMIT, Defibrillator in Acute Myocardial Infarction Trial; ICD, implantable cardioverter-defibrillator; LVEF, left ventricular ejection fraction; MADIT, Multicenter Automatic Defibrillator Implantation Trial; MUSTT, Multicenter Unsustained Tachycardia Trial; NYHA, New York Heart Association; RCT, randomized controlled trial; SCD-HeFT, Sudden Cardiac Death in Heart Failure Trial. American Journal of Kidney Diseases  , 32-39DOI: ( /j.ajkd ) Copyright © 2014 National Kidney Foundation, Inc. Terms and Conditions

3 Figure 2 Kaplan-Meier survival curves in implantable cardioverter-defibrillator (ICD) recipients versus nonrecipients according to estimated glomerular filtration rate (eGFR). Unadjusted hazard ratios for the mortality benefit of ICDs are 0.92 and 0.53 (95% confidence intervals, and ) for eGFRs<60 and ≥60mL/min/1.73m2. American Journal of Kidney Diseases  , 32-39DOI: ( /j.ajkd ) Copyright © 2014 National Kidney Foundation, Inc. Terms and Conditions

4 Figure 3 Proportion (%) of study participants with adverse outcomes by estimated glomerular filtration rate (eGFR) group. Abbreviations: CKD, chronic kidney disease; Comp, complications; Cont, control arm; eGFR, estimated glomerular filtration rate; ICD, implantable cardioverter-defibrillator; Rehosp, rehospitalizations. American Journal of Kidney Diseases  , 32-39DOI: ( /j.ajkd ) Copyright © 2014 National Kidney Foundation, Inc. Terms and Conditions

5 Figure 4 Bayesian Weibull covariate-adjusted hazard ratio for mortality benefit of an implantable cardioverter-defibrillator (ICD) as a function of baseline estimated glomerular filtration rate (eGFR). Shaded areas reflect 95% point-wise posterior credible intervals. American Journal of Kidney Diseases  , 32-39DOI: ( /j.ajkd ) Copyright © 2014 National Kidney Foundation, Inc. Terms and Conditions

6 Figure 5 Forest plots of covariate-adjusted hazard rations (HRs) and 95% posterior credible intervals (PCIs) for (A) all-cause mortality and (B) rehospitalizations by clinical trial and estimated glomerular filtration rate (eGFR) group, with x-axis displayed in the log-scale. Abbreviations: ICD, implantable cardioverter-defibrillator; MADIT, Multicenter Automatic Defibrillator Implantation Trial; OR, odds ratio; SCD-HeFT, Sudden Cardiac Death in Heart Failure Trial. American Journal of Kidney Diseases  , 32-39DOI: ( /j.ajkd ) Copyright © 2014 National Kidney Foundation, Inc. Terms and Conditions


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