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Record W3022909442 · doi:10.1093/eurheartj/ehaa226

Clinical effectiveness of primary prevention implantable cardioverter-defibrillators: results of the EU-CERT-ICD controlled multicentre cohort study

2020· article· en· W3022909442 on OpenAlex
Markus Zabel, Rik Willems, Andrzej Lubiński, Axel Bauer, Josép Brugada, David Conen, Panagiota Flevari, Gerd Hasenfuß, Martin Svetlošák, Heikki V. Huikuri, Marek Malík, Nikola Pavlović, Georg Schmidt, R. Sritharan, Simon Schlögl, Janko Szavits-Nossan, Vassil Traykov, Anton E. Tuinenburg, Stefan N. Willich, Markus Harden, Tim Friede, Jesper Hastrup Svendsen, Christian Sticherling, Béla Merkely, Péter Perge, Zoltán Salló, Gábor Széplaki, Nándor Szegedi, Klaudia Vivien Nagy, Lars Lüthje, Helge Haarmann, Leonard Bergau, Joachim Seegers, Pascal Muñoz-Exposito, Tobias Tichelbäcker, Aleksandra Kirova, Katerina Hnatkova, Marc A. Vos, Thomas Reinhold, Bert Vandenberk, Magdalena Klinika, Luka Rotkvić, Panayota Flevari, Ανδρέας Κατσιμάρδος, Dimitrios Katsaras, Róbert Hatala, Tomasz Kuczejko, Jim Hansen, Šime Manola, Ozren Vinter, Ivica Benko, David J. Sprenkeler, Agnieszka Smoczyńska, Christine Meyer‐Zürn, Christian Eick, Elena Arbelo, Gabriela Kaliská, Jozef Martinek, Michael Dommasch, Alexander Steger, Stefan Kääb, Moritz F. Sinner, Konstantinos D. Rizas, Wolfgang Hamm, Iwona Cygankiewicz, Paweł Ptaszyński, Krzysztof Kaczmarek, Izabela Poddębska, Svetoslav Iovev, Tomáš Novotný, Milan Kozák, Tuomas Kenttä, Ari Pelli, Jarosław D. Kasprzak, Dariusz Qavoq, Sandro Brusich, Ervin Avdović, Marina Klasan, Jan Gałuszka, Miloš Táborský, Vasil Velchev, Rüdiger Dißmann, Tchavdar Shalganov, Przemysław Guzik, Tomasz Krauze, Dieter Bimmel, Christiane Lieberz, Stefan Stefanow, Norman Rüb, Christian Wolpert, Lars S Meier, Steffen Behrens, Zrinka Jurišić, Frieder Braunschweig, Florian Blaschke, Burkert Pieske, Zoran Bakotić, Ante Anić, Robert H. G. Schwinger, Pyotr G. Platonov, Gerian Grönefeld, Thomas Klingenheben

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueEuropean Heart Journal · 2020
Typearticle
Languageen
FieldMedicine
TopicCardiac pacing and defibrillation studies
Canadian institutionsMcMaster UniversityPopulation Health Research Institute
FundersSemmelweis EgyetemDeutsches Zentrum für Herz-Kreislaufforschung
KeywordsMedicinePrimary preventionImplantable cardioverter-defibrillatorCohortEmergency medicineSecondary preventionMedical emergencyIntensive care medicineInternal medicineDisease

Abstract

fetched live from OpenAlex

AIMS: The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter-Defibrillators (EU-CERT-ICD), a prospective investigator-initiated, controlled cohort study, was conducted in 44 centres and 15 European countries. It aimed to assess current clinical effectiveness of primary prevention ICD therapy. METHODS AND RESULTS: We recruited 2327 patients with ischaemic cardiomyopathy (ICM) or dilated cardiomyopathy (DCM) and guideline indications for prophylactic ICD implantation. Primary endpoint was all-cause mortality. Clinical characteristics, medications, resting, and 12-lead Holter electrocardiograms (ECGs) were documented at enrolment baseline. Baseline and follow-up (FU) data from 2247 patients were analysable, 1516 patients before first ICD implantation (ICD group) and 731 patients without ICD serving as controls. Multivariable models and propensity scoring for adjustment were used to compare the two groups for mortality. During mean FU of 2.4 ± 1.1 years, 342 deaths occurred (6.3%/years annualized mortality, 5.6%/years in the ICD group vs. 9.2%/years in controls), favouring ICD treatment [unadjusted hazard ratio (HR) 0.682, 95% confidence interval (CI) 0.537-0.865, P = 0.0016]. Multivariable mortality predictors included age, left ventricular ejection fraction (LVEF), New York Heart Association class <III, and chronic obstructive pulmonary disease. Adjusted mortality associated with ICD vs. control was 27% lower (HR 0.731, 95% CI 0.569-0.938, P = 0.0140). Subgroup analyses indicated no ICD benefit in diabetics (adjusted HR = 0.945, P = 0.7797, P for interaction = 0.0887) or those aged ≥75 years (adjusted HR 1.063, P = 0.8206, P for interaction = 0.0902). CONCLUSION: In contemporary ICM/DCM patients (LVEF ≤35%, narrow QRS), primary prophylactic ICD treatment was associated with a 27% lower mortality after adjustment. There appear to be patients with less survival advantage, such as older patients or diabetics.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Direct model labels (unvalidated)

Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.

Model armCategoriesStudy designConfidence
gemmano category
Domain: not available · Genre: Empirical
About the Canadian research system: no · About a Canadian topic: no
Observationallow
gptno category
Domain: not available · Genre: Empirical
About the Canadian research system: no · About a Canadian topic: no
Observationalhigh
models agreeAgreement compares identical category sets and study designs across arms.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.079
Threshold uncertainty score0.420

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0040.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.001
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.057
GPT teacher head0.346
Teacher spread0.289 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it