Nocturnal respiratory rate predicts ICD benefit: A prospective,
controlled, multicentre cohort study

J 2021

Nocturnal respiratory rate predicts ICD benefit: A prospective, controlled, multicentre cohort study

DOMMASCH, M., A. STEGER, P. BARTHEL, KM HUSTER, A. MULLER et. al.

Basic information

Original name

Nocturnal respiratory rate predicts ICD benefit: A prospective, controlled, multicentre cohort study

Authors

Edition

EClinicalMedicine, AMSTERDAM, ELSEVIER, 2021, 2589-5370

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30218 General and internal medicine

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 17.033

RIV identification code

RIV/00216224:14110/21:00121727

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.eclinm.2020.100695

UT WoS

000645898300034

Keywords in English

Nocturnal respiratory rate; Primary prophylactic ICD; Benefit prediction

Abstract

V originále

Background: Implantable cardioverter defibrillators (ICDs) prevent sudden cardiac death. ICD implantation decisions are currently based on reduced left ventricular ejection fraction (LVEF <= 35%). However, in some patients, the non-arrhythmic death risk predominates thus diminishing ICD-therapy benefits. Based on previous observations, we tested the hypothesis that compared to the others, patients with nocturnal respiratory rate (NRR) >= 18 breaths per minute (brpm) benefit less from prophylactic ICD implantations. Methods: This prospective cohort study was a pre-defined sub-study of EU-CERT-ICD trial conducted at 44 centers in 15 EU countries between May 12, 2014, and September 6, 2018. Patients with ischaemic or non-ischaemic cardiomyopathy were included if meeting primary prophylactic ICD implantation criteria. The primary endpoint was all-cause mortality. NRR was assessed blindly from pre-implantation 24-hour Holters. Multivariable models and propensity stratification evaluated the interaction between NRR and the ICD mortality effect. This study is registered with ClinicalTrials.gov (NCT0206419). Findings: Of the 2,247 EU-CERT-ICD patients, this sub-study included 1,971 with complete records. In 1,363 patients (61.7 (12) years; 244 women) an ICD was implanted; 608 patients (63.2 (12) years; 108 women) were treated conservatively. During a median 2.5-year follow-up, 202 (14.8%) and 95 (15.6%) patients died in the ICD and control groups, respectively. NRR statistically significantly interacted with the ICD mortality effect (p = 0.0070). While the 1,316 patients with NRR<18 brpm showed a marked ICD benefit on mortality (adjusted HR 0.529 (95% CI 0.376-0.746); p = 0.0003), no treatment effect was demonstrated in 655 patients with NRR >= 18 brpm (adjusted HR 0.981 (95% CI 0.669-1.438); p = 0.9202). Interpretation: In the EU-CERT-ICD trial, patients with NRR >= 18 brpm showed limited benefit from primary prophylactic ICD implantation. Those with NRR<18 brpm benefitted substantially. (c) 2020 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Citovat

DOMMASCH, M., A. STEGER, P. BARTHEL, KM HUSTER, A. MULLER, D. SINNECKER, K. L. LAUGWITZ, T. PENZEL, A. LUBINSKI, P. FLEVARI, M. HARDEN, T. FRIEDE, S. KAAB, B. MERKELY, C. STICHERLING, R. WILLEMS, H. V. HUIKURI, A. BAUER, Marek MALÍK, M. ZABEL and G. SCHMIDT. Nocturnal respiratory rate predicts ICD benefit: A prospective, controlled, multicentre cohort study. EClinicalMedicine. AMSTERDAM: ELSEVIER, 2021, vol. 31, JAN 2021, p. 1-6. ISSN 2589-5370. Available from: https://dx.doi.org/10.1016/j.eclinm.2020.100695.

@article{1774645,
   author = {Dommasch, M. and Steger, A. and Barthel, P. and Huster, KM and Muller, A. and Sinnecker, D. and Laugwitz, K. L. and Penzel, T. and Lubinski, A. and Flevari, P. and Harden, M. and Friede, T. and Kaab, S. and Merkely, B. and Sticherling, C. and Willems, R. and Huikuri, H. V. and Bauer, A. and Malík, Marek and Zabel, M. and Schmidt, G.},
   article_location = {AMSTERDAM},
   article_number = {JAN 2021},
   doi = {http://dx.doi.org/10.1016/j.eclinm.2020.100695},
   keywords = {Nocturnal respiratory rate; Primary prophylactic ICD; Benefit prediction},
   language = {eng},
   issn = {2589-5370},
   journal = {EClinicalMedicine},
   title = {Nocturnal respiratory rate predicts ICD benefit: A prospective, controlled, multicentre cohort study},
   url = {https://www.thelancet.com/pdfs/journals/eclinm/PIIS2589-5370(20)30439-9.pdf},
   volume = {31},
   year = {2021}
}

TY  - JOUR
ID  - 1774645
AU  - Dommasch, M. - Steger, A. - Barthel, P. - Huster, KM - Muller, A. - Sinnecker, D. - Laugwitz, K. L. - Penzel, T. - Lubinski, A. - Flevari, P. - Harden, M. - Friede, T. - Kaab, S. - Merkely, B. - Sticherling, C. - Willems, R. - Huikuri, H. V. - Bauer, A. - Malík, Marek - Zabel, M. - Schmidt, G.
PY  - 2021
TI  - Nocturnal respiratory rate predicts ICD benefit: A prospective, controlled, multicentre cohort study
JF  - EClinicalMedicine
VL  - 31
IS  - JAN 2021
SP  - 1-6
EP  - 1-6
PB  - ELSEVIER
SN  - 25895370
KW  - Nocturnal respiratory rate
KW  - Primary prophylactic ICD
KW  - Benefit prediction
UR  - https://www.thelancet.com/pdfs/journals/eclinm/PIIS2589-5370(20)30439-9.pdf
N2  - Background: Implantable cardioverter defibrillators (ICDs) prevent sudden cardiac death. ICD implantation decisions are currently based on reduced left ventricular ejection fraction (LVEF <= 35%). However, in some patients, the non-arrhythmic death risk predominates thus diminishing ICD-therapy benefits. Based on previous observations, we tested the hypothesis that compared to the others, patients with nocturnal respiratory rate (NRR) >= 18 breaths per minute (brpm) benefit less from prophylactic ICD implantations. Methods: This prospective cohort study was a pre-defined sub-study of EU-CERT-ICD trial conducted at 44 centers in 15 EU countries between May 12, 2014, and September 6, 2018. Patients with ischaemic or non-ischaemic cardiomyopathy were included if meeting primary prophylactic ICD implantation criteria. The primary endpoint was all-cause mortality. NRR was assessed blindly from pre-implantation 24-hour Holters. Multivariable models and propensity stratification evaluated the interaction between NRR and the ICD mortality effect. This study is registered with ClinicalTrials.gov (NCT0206419). Findings: Of the 2,247 EU-CERT-ICD patients, this sub-study included 1,971 with complete records. In 1,363 patients (61.7 (12) years; 244 women) an ICD was implanted; 608 patients (63.2 (12) years; 108 women) were treated conservatively. During a median 2.5-year follow-up, 202 (14.8%) and 95 (15.6%) patients died in the ICD and control groups, respectively. NRR statistically significantly interacted with the ICD mortality effect (p = 0.0070). While the 1,316 patients with NRR<18 brpm showed a marked ICD benefit on mortality (adjusted HR 0.529 (95% CI 0.376-0.746); p = 0.0003), no treatment effect was demonstrated in 655 patients with NRR >= 18 brpm (adjusted HR 0.981 (95% CI 0.669-1.438); p = 0.9202). Interpretation: In the EU-CERT-ICD trial, patients with NRR >= 18 brpm showed limited benefit from primary prophylactic ICD implantation. Those with NRR<18 brpm benefitted substantially. (c) 2020 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ER  -

DOMMASCH, M., A. STEGER, P. BARTHEL, KM HUSTER, A. MULLER, D. SINNECKER, K. L. LAUGWITZ, T. PENZEL, A. LUBINSKI, P. FLEVARI, M. HARDEN, T. FRIEDE, S. KAAB, B. MERKELY, C. STICHERLING, R. WILLEMS, H. V. HUIKURI, A. BAUER, Marek MALÍK, M. ZABEL and G. SCHMIDT. Nocturnal respiratory rate predicts ICD benefit: A prospective, controlled, multicentre cohort study. \textit{EClinicalMedicine}. AMSTERDAM: ELSEVIER, 2021, vol.~31, JAN 2021, p.~1-6. ISSN~2589-5370. Available from: https://dx.doi.org/10.1016/j.eclinm.2020.100695.

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