# Langetermijn ICD-uitkomsten: SCD-HeFT

*geplaatst 2020-07-28 · Hartfalen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2020.05.061 · https://hartvaat.nl/2020/07/28/langetermijn-icd-uitkomsten-scd-heft/*

SCD-HeFT langetermijnuitkomsten van ICD-therapie. Een van de langste ICD follow-upperiodes.

## English: Long-Term Outcomes of Implantable Cardioverter-Defibrillator Therapy in the SCD-HeFT.

Long-term SCD-HeFT follow-up showed that the survival benefit of ICD therapy in moderate heart failure (NYHA II-III) persists over many years, providing the longest available data on primary prevention ICD outcomes.

## Abstract (original, from the publication)

BACKGROUND: The SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial) randomized 2,521 patients with moderate heart failure (HF) to amiodarone, placebo drug, or implantable cardioverter-defibrillator (ICD) therapy. Original trial follow-up ended October 31, 2003. Over a median 45.5-month follow-up, amiodarone, compared with placebo, did not affect survival, whereas randomization to an ICD significantly decreased all-cause mortality by 23%. OBJECTIVES: This study sought to describe the extended treatment group survival of the SCD-HeFT cohort. METHODS: Mortality outcomes for the 1,855 patients alive at the end of the SCD-HeFT trial were collected between 2010 and 2011. These data were combined with the 666 deaths from the original study to compare long-term outcomes overall and for key pre-specified subgroups. RESULTS: Median (25th to 75th percentiles) follow-up was 11.0 (10.0 to 12.2) years. On the basis of intention-to-treat analysis, the ICD group had overall survival benefit versus placebo drug (hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.76 to 0.98; p = 0.028). When treatment benefit was examined as a function of time from randomization, attenuation of the ICD benefit was observed after 6 years (p value for the interaction = 0.0015). Subgroup analysis revealed long-term ICD benefit varied according to HF etiology and New York Heart Association (NYHA) functional class: ischemic HF HR: 0.81; 95% CI: 0.69 to 0.95; p = 0.009; nonischemic HF HR: 0.97; 95% CI: 0.79 to 1.20; p = 0.802; NYHA functional class II HR: 0.76; 95% CI: 0.65 to 0.90; p = 0.001; NYHA functional class III HR: 1.06; 95% CI: 0.86 to 1.31; p = 0.575. CONCLUSIONS: Follow-up of SCD-HeFT patients to 11 years demonstrated heterogenous treatment-related patterns of long-term survival with ICD benefit most evident at 11 years for ischemic HF patients and for those with NYHA functional class II symptoms at trial enrollment. (SCD-HeFT 10 Year Follow-up [SCD-HeFT10 Yr]; NCT01058837).

Auteurs: Jeanne E Poole, Brian Olshansky, Daniel B Mark, Jill Anderson, George Johnson, Anne S Hellkamp, Linda Davidson-Ray, Daniel P Fishbein, Robin E Boineau, Kevin J Anstrom, Per G Reinhall, Douglas L Packer, Kerry L Lee, Gust H Bardy

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2020.05.061. Bijgewerkt 2026-07-03T13:27:50Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.