Evaluation of MADIT II risk stratification score among registry of heart failure patients with primary prevention ICD/CRTD device

Abstract Funding Acknowledgements Type of funding sources: None. Background Current guidelines advocate primary prevention ICD implantation for all symptomatic heart failure (HF) patients with low LVEF. As most will not use their device during lifetime, a score delineating subgroups differential benefit is crucial. The MADIT Risk Stratification Score (MRSS) based on 5 parameters including: age>70, Creatinine >1.4 mg/dl, QRS width >120ms, presence AF, and NYHA >2, was developed this purpose. Objective Evaluate MRSS among Israeli nationwide registry HF implanted prophylactic ICD/CRTD. Endpoints included overall mortality, sustained ventricular arrhythmia (VA), competing risk arrhythmic (VA-related) versus non-arrhythmic death, surrogate potential survival benefit. Methods Study comprehensive ICD/CRTDs in Israel between 2011-2018. All were categorized into MRSS-based risk-groups (low-risk- 0, intermediate-risk- 1-5, very high-risk (VHR) group defined by >2.5mg/dL). Univariate Kaplan Meier analysis used to evaluate the association groups study endpoints. Results 2177 patients, (1255, 58%) or CRTD (922, 42%) included. There 189 (8.7%) VA 316 (14.5%) deaths median follow-up (F/U) period 2.5 years. A significant correlation found mortality (p 0.001). However, weak 0.2). Notably, subgroup had an exceptionally high but incidence. Competing death revealed large intermediate subgroups, 10.2 12.3 months gained over 3-year F/U these respectively VHR contrast, showed minimal non-significant Conclusions Use contemporary real-world differing benefit, suggesting it as universal tool predict may gain from implant.