{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:20:22Z","timestamp":1791832822602,"version":"4.3.4"},"reference-count":28,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,5,3]]},"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The objective of this meta-analysis of randomised controlled trials (RCTs) is to evaluate the role of primary prevention implantable cardioverter defibrillator (ICD) in patients with non-ischaemic cardiomyopathy (NICM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>A meta-analysis of RCTs performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data sources<\/jats:title>\n                  <jats:p>The PubMed, MEDLINE, Embase and Cochrane Central Register of Controlled Trials databases were searched for relevant articles.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>A total of 5 RCTs with 2573 patients with NICM were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention<\/jats:title>\n                  <jats:p>Primary prevention ICD, compared with medical therapy alone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>All-cause mortality (primary outcome) and sudden cardiac death (SCD, secondary outcome).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data analysis<\/jats:title>\n                  <jats:p>Summary estimate HR were constructed using the random-effect DerSimonian and Laird\u2019s model. Multiple study-level subgroup analyses were performed, and interaction was tested using random-effect analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with medical therapy alone, ICD placement was associated with lower risk of all-cause mortality (HR 0.79; 95%\u2009CI 0.64 to 0.93; p&lt;0.001; I<jats:sup>2<\/jats:sup>=0%) at a mean follow-up of 4.2 years. The risk of SCD was also lower with ICD placement (RR 0.47; 95%\u2009CI 0.30 to 0.73; p=0.001; I<jats:sup>2<\/jats:sup>=0%) compared with control. On subgroup analyses, there was a suggestion of possible effect modification by age, in which benefit was observed in age group &lt;60 years (HR 0.64; 95%\u2009CI 0.47 to 0.89), but not with age \u226560 years (HR 0.82; 95%\u2009CI 0.65 to 1.03) (P<jats:sub>interaction<\/jats:sub>=0.058), but not with other study-level variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Compared with medical therapy alone, primary prevention ICD therapy in patients with NICM is associated with a significant reduction in all-cause mortality, especially in younger patients. Future dedicated studies are needed to investigate the role of primary prevention ICD in the elderly population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPEROregistrationnumber<\/jats:title>\n                  <jats:p>PROSPERO CRD42016052010.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016352","type":"journal-article","created":{"date-parts":[[2017,6,21]],"date-time":"2017-06-21T20:10:16Z","timestamp":1498075816000},"page":"e016352","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Primary prevention implantable cardioverter defibrillator in patients with non-ischaemic cardiomyopathy: a meta-analysis of randomised controlled trials"],"prefix":"10.1136","volume":"7","clinical-trial-number":[{"clinical-trial-number":"nct02121158","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Amr F","family":"Barakat","sequence":"first","affiliation":[{"name":"Department of Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akram Y","family":"Elgendy","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amgad","family":"Mentias","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Abuzaid","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine, Sidney Kimmel Medical College at Thomas Jefferson University\/Christiana Care Health System, Newark, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed N","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islam Y","family":"Elgendy","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,6,21]]},"reference":[{"key":"2025101814012901000_7.6.e016352.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"2025101814012901000_7.6.e016352.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.019"},{"key":"2025101814012901000_7.6.e016352.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612263352601"},{"key":"2025101814012901000_7.6.e016352.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912163412503"},{"key":"2025101814012901000_7.6.e016352.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"2025101814012901000_7.6.e016352.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"2025101814012901000_7.6.e016352.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.23.2874"},{"key":"2025101814012901000_7.6.e016352.8","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1056\/NEJMoa1608029","article-title":"Defibrillator Implantation in patients with nonischemic systolic Heart failure","volume":"375","author":"K\u00f8ber","year":"2016","journal-title":"N Engl J Med"},{"key":"2025101814012901000_7.6.e016352.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"2025101814012901000_7.6.e016352.10","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-1-2"},{"key":"2025101814012901000_7.6.e016352.11","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.11.1297"},{"key":"2025101814012901000_7.6.e016352.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199711273372202"},{"key":"2025101814012901000_7.6.e016352.13","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.7.748"},{"key":"2025101814012901000_7.6.e016352.14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"2025101814012901000_7.6.e016352.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"2025101814012901000_7.6.e016352.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"2025101814012901000_7.6.e016352.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"2025101814012901000_7.6.e016352.18","doi-asserted-by":"crossref","unstructured":"Higgins J , Green S . 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