Observational studyESC heart failure2020
Prognostic role of NYHA class in heart failure patients undergoing primary prevention ICD therapy.
Observational study in ESC heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Influence of diabetes on mortality and ICD therapies in ICD recipients: a systematic review and meta-analysis of 162,780 patients.Cardiovascular diabetology · 2022Pooled it
- A Cumulative Electrical Risk Score Is Associated with Appropriate ICD Therapy in Primary-Prevention Patients with Reduced Ejection Fraction: A Single-Center Retrospective Study.Journal of clinical medicine · 2026Article
- The adjusted ferritin inflammation index: a novel metric for predicting mortality in heart failure with reduced and mildly reduced ejection fraction.ESC heart failure · 2026Article
- Eight-Year Survival Analysis of Patients With Dilated Cardiomyopathy: Does Treatment Era Affect Prognosis?Cureus · 2025Article
- Nutritional Status Is Associated with Mortality but Not Appropriate Discharge of Implantable Cardioverter Defibrillators in Patients with Heart Failure.Diagnostics (Basel, Switzerland) · 2025Article
- Observational
- Prediction of prognosis in elderly patients with chronic heart failure based on random survival forest.Frontiers in cardiovascular medicine · 2025Article
- Serum Periostin as a Novel Biomarker for Predicting 30-Day Major Adverse Cardiac Events After Off-Pump Coronary Artery Bypass Grafting.Therapeutics and clinical risk management · 2025Article
- Prognostic value of quality of life and functional status in patients with heart failure: a systematic review and meta-analysis.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2024Review
- Real-life effectiveness of sacubitril/valsartan in older Belgians with heart failure, reduced ejection fraction and most severe symptoms.Scientific reports · 2024Article
- Usefulness of Clinical Frailty Scale for Comprehensive Geriatric Assessment of Older Heart Failure Patients.Circulation reports · 2024Article
- Predictive Value of the Prognostic Nutritional Index for Long-Term Mortality in Patients with Advanced Heart Failure.Acta Cardiologica Sinica · 2023Article
- Heart function grading evaluation based on heart sounds and convolutional neural networks.Physical and engineering sciences in medicine · 2023Article
- Primary prevention implantable cardioverter-defibrillator use in non-ischemic dilated cardiomyopathy based on arrhythmic risk stratification and left ventricular reverse remodeling prediction.Heart failure reviews · 2023Review
- The Impact of Complete Revascularization in Symptomatic Severe Left Ventricular Dysfunction between Coronary Artery Bypass Graft and Percutaneous Coronary Intervention.Cardiology research and practice · 2023Article
- An Artificial Intelligence Approach to Guiding the Management of Heart Failure Patients Using Predictive Models: A Systematic Review.Biomedicines · 2022Review
- The Cost Effectiveness of Patiromer for the Treatment of Hyperkalaemia in Patients with Chronic Kidney Disease with and without Heart Failure in Ireland.PharmacoEconomics - open · 2022Article
- Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up - subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trial.Archives of medical science : AMS · 2022Article
- Oral procainamide as pharmacological treatment of recurrent and refractory ventricular tachyarrhythmias: A single-center experience.Heart rhythm O2 · 2021Article
- Clinical Value of Circulating ZFAS1 and miR-590-3p in the Diagnosis and Prognosis of Chronic Heart Failure.Cardiovascular toxicology · 2021Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsConcerns about the prognostic value of NYHA functional class (FC) in heart failure (HF) patients carrying a prophylactic implantable cardioverter defibrillator (ICD) are still present. We aimed to compare whether mortality and arrhythmic risk were different, in a cohort of HF patients undergoing ICD-only implant, according to their FC. METHODS AND
resultsHF patients with left ventricle ejection fraction (LVEF) ≤35%, undergoing first prophylactic ICD-only implant were collected from a multicentre nationwide registry (2006-2015). Six hundred and twenty-one patients were identified (101 patients in NYHA I; 411 in NYHA II; 109 in NYHA III). After a mean follow-up of 4.4 years (±2.1), 126 patients died (20.3%). All-cause mortality risk was higher in symptomatic patients: 13.9% in NYHA I patients, 18.3% in NYHA II patients (HR: 1.8, 95% CI 1.1-3.2), and 32.9% in NYHA III patients (HR: 3.9, 95% CI 2.1-7.3). Seventy-eight out of all deaths were due to cardiovascular causes (12.6%). Cardiovascular mortality risk was also higher in symptomatic patients: 6.9% in NYHA I patients, 11% in NYHA II patients (HR: 2.2, 95% CI 1.1-4.9), and 23.9% in NYHA III (HR: 5.5, 95% CI 2.4-12.7). One hundred and seventeen patients received a first appropriate ICD therapy (19.4%). Arrhythmia free survival did not differ among study groups [20.8% in NYHA I patients, 18.7% in NYHA II (HR: 1.1, 95% CI 0.6-1.7) and 20.8% in NYHA III patients (HR: 1.3, 95% CI 0.7-2.5)]. NYHA class independently predicted cardiovascular mortality (NYHA III vs. NYHA I: HR, 4.7; 95% CI, 1.7-12.8, P = 0.002; NYHA II vs. NYHA I: HR, 2.1, 95% CI, 1.0-5.6, P = 0.05) but not all-cause death (NYHA III vs. NYHA I: HR: 1.8, 95% CI 0.8-3.9, P = 0.11; NYHA II vs. NYHA I: HR, 1.1, 95% CI 0.6-2.2, P = 0.71;). Atrial fibrillation, chronic kidney disease, and diabetes emerged as predictors of both all-cause death [(HR: 1.8, 95% CI 1.2-2.8, P = 0.005), (HR: 2.2, 95% CI 1.4-3.4, P < 0.001), (HR: 2.0, 95% CI 1.3-3.1, P = 0.001), respectively] and cardiovascular mortality [(HR: 1.8, 95% CI 1.1-3.1, P = 0.02), (HR: 3.1, 95% CI 1.8-5.4, P < 0.001), (HR: 1.7, 95% CI 1.1-3, P = 0.032), respectively].
conclusionsMortality in HF patients undergoing prophylactic ICD implantation was higher in symptomatic patients. NYHA functional class along with other comorbidities might be helpful to identify a subgroup of ICD carriers with poorer prognosis and higher risk of cardiovascular death.
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