肥厚型心肌病一级预防 ICD 推荐指南之间的一致性较低:简短标题:针对肥厚型心肌病的不同 ICD 建议。

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Fernando Luís Scolari, Henrique Iahnke Garbin, Guilherme Dagostin de Carvalho, Fernanda Thomaz Rodrigues, Rodrigo Araujo de Menezes, Edileide de Barros Correia, Marcelo Imbroinise Bittencourt
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引用次数: 0

摘要

背景:肥厚型心肌病(HCM)的心脏性猝死(SCD)风险分层和一级预防植入式心律转复除颤器(ICD)建议基于不同的策略:研究旨在评估2023年欧洲心脏病学会(ESC)指南对2014年ESC和2024年美国心脏协会(AHA)/美国心脏病学会(ACC)关于HCM一级预防ICD系统的影响:方法:根据现行指南,对巴西 200 名 HCM 患者进行了 SCD 风险概况评估。评估了不同策略对一级预防 ICD 建议的一致性。SCD和适当休克被定义为终点:在 200 名患者中,63 人(31%)接受了一级预防 ICD,10 人(15.8%)接受了适当电击。指南之间的一致性较低,Fleiss' Kappa为0.340(95% CI为0.286-0.395),PC结论:指南之间的一致性较低,Fleiss' Kappa为0.340(95% CI为0.286-0.395):发现各指南对 HCM 一级预防 ICD 建议的一致性较低,尤其是在 2023 ESC 和 2024 AHA/ACC 系统之间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Low Agreement Among Guidelines for Primary Prevention Implantable Cardioverter-Defibrillator Recommendations in Hypertrophic Cardiomyopathy.

Sudden cardiac death (SCD) risk stratification and primary prevention implantable cardioverter-defibrillator (ICD) recommendations are based on differing strategies for hypertrophic cardiomyopathy (HCM). This study aimed to evaluate the impact of the 2023 European Society of Cardiology (ESC) guidelines on the 2014 ESC and the 2024 American Heart Association (AHA)/American College of Cardiology (ACC) systems in terms of primary prevention ICD recommendations for HCM. A cohort of 200 patients with HCM in Brazil was assessed for SCD risk profile according to current guidelines. The agreement for primary prevention ICD recommendations was evaluated among different strategies. SCD and appropriate shock were defined as the end points. Among the 200 patients, 63 (31%) received a primary prevention ICD, with 10 (15.8%) receiving appropriate shocks. Low agreement was found among the guidelines (Fleiss' kappa 0.340, 95% confidence interval [CI] 0.286 to 0.395, p <0.001). The European systems showed moderate agreement. The 2024 AHA/ACC algorithm placed 58% of patients in class IIa, whereas only 29% achieved this recommendation with the 2023 ESC model. The end points occurred in 8% of patients over 9.4 ± 6.5 years. The 2014 ESC guidelines had the highest accuracy (77%, 95% CI 71 to 83) and negative predictive value (96%, 95% CI 90 to 98) in detecting patients in class IIa with primary end points. However, all guidelines showed a low positive predictive value. The 2024 AHA/ACC guidelines classified the largest proportion of patients (81%) with the primary end point as class IIa. Low agreement was found among guidelines regarding primary prevention ICD recommendations in HCM, particularly between the 2023 ESC and 2024 AHA/ACC systems.

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来源期刊
American Journal of Cardiology
American Journal of Cardiology 医学-心血管系统
CiteScore
4.00
自引率
3.60%
发文量
698
审稿时长
33 days
期刊介绍: Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.
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