{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T15:34:18Z","timestamp":1782315258894,"version":"3.54.5"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Implantable cardioverter\u2013defibrillators (ICDs) reduce sudden cardiac death (SCD) in non-ischaemic cardiomyopathy (NICM), but most evidence predates comprehensive guideline-directed medical therapy (GDMT). We quantified the relative and absolute survival benefit of primary-prevention ICDs in NICM across therapeutic eras and explored how contemporary GDMT modifies absolute benefit.<\/jats:p>\n                  <jats:p>We searched MEDLINE, Embase, and CENTRAL through March 2025 and included randomized controlled trials comparing prophylactic ICD implantation vs control in NICM with left ventricular ejection fraction \u226435%. Three trials (DEFINITE, SCD-HeFT NICM subgroup, and DANISH) contributed to the quantitative synthesis. ICD therapy reduced all-cause mortality (pooled hazard ratio (HR) 0.79, 95% confidence interval (CI) 0.66\u20130.95) and SCD (HR 0.44, 95% CI 0.28\u20130.70). Five-year absolute risk reduction (ARR) was 5.9% (NNT 17) in SCD-HeFT NICM and 4.4% (NNT 23) in DANISH. Under a full-GDMT scenario parameterized from pharmacological randomized controlled trials, projected baseline risk was \u223c11%, yielding ARR 2.31% (NNT 43).<\/jats:p>\n                  <jats:p>All contemporary \u2018GDMT-era\u2019 absolute benefit estimates are scenario-based modelling outputs. No randomized trial has evaluated ICDs on top of full modern GDMT in NICM; therefore, these results represent illustrative ranges rather than empirical estimates.<\/jats:p>","DOI":"10.1093\/eschf\/xvag047","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T12:51:46Z","timestamp":1770382306000},"source":"Crossref","is-referenced-by-count":1,"title":["Time to rethink ICD indications in non-ishaemic cardiomyopathy? Evidence from a meta-analysis across therapeutic eras"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1477-2581","authenticated-orcid":false,"given":"Mislav","family":"Puljevic","sequence":"first","affiliation":[{"name":"Cardiovascular Department, University Hospital Centre Zagreb , Kispaticeva 12, Zagreb 10000 ,","place":["Croatia"]},{"name":"School of Medicine, University of Zagreb , Salata 3, Zagreb 10000 ,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedran","family":"Velagic","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, University Hospital Centre Zagreb , Kispaticeva 12, Zagreb 10000 ,","place":["Croatia"]},{"name":"School of Medicine, University of Zagreb , Salata 3, Zagreb 10000 ,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Ivandic","sequence":"additional","affiliation":[{"name":"Faculty of Electrical Engineering and 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