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Predicting Persistent Left Ventricular Dysfunction Following Myocardial Infarction: The PREDICTS Study

Wednesday, March 23, 2016

Submitted by

Arie Blitz

Source

Source Name: Journal of the American College of Cardiology

Source URL: http://content.onlinejacc.org/article.aspx?articleid=2499915&resultClick=3

Author(s)

Gabriel C. Brooks, MD,a Byron K. Lee, MD, MAS,a Rajni Rao, MD,a Feng Lin, MS,b Daniel P. Morin, MD, MPH,c,d Steven L. Zweibel, MD,e Alfred E. Buxton, MD,f Mark J. Pletcher, MD, MPH,b Eric Vittinghoff, PHD,b Jeffrey E. Olgin, MD,a on behalf of the PREDICTS Investigators

Guidelines recommend that ICDs should not be implanted until after 90 days following revascularization in patients with an EF<35% and an MI. Studies have shown that no clinical benefit or detriment was derived by implantation prior to 90 days. In the PREDICTS study, the results of which are reported in this publication, patients who had sustained an AMI and had an EF<35% around the time of the MI were evaluated for ICD implantation after the 90-day mark. Of 231 enrolled patients, 84% of patients underwent PCI and 16% underwent medical management. In the PCI cohort, 94/166 (57%) patients had an EF>35% at follow-up.

Although revascularization in this trial was accomplished by PCI, at least under these circumstances, more than half of patients who initially would have qualified for an ICD by EF criteria alone no longer qualified after 90 days.