What does this research mean for the field?

Primary prevention ICD implantation reduces all-cause mortality in patients with nonischemic systolic heart failure aged ≤70 years, with the survival benefit decreasing linearly with increasing age. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate the relationship between age and mortality outcomes following ICD implantation in nonischemic systolic heart failure patients.

July 8, 2026Circulation

Primary prevention ICDs reduce mortality ~30% in nonischemic systolic heart failure patients aged ≤70 years.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Nonischemic systolic heart failure (n=1116). Intervention: Primary prevention implantable cardioverter-defibrillator (ICD) vs. No ICD. Primary outcome: All-cause mortality in patients ≤70 years of age (HR 0.70, 95% CI 0.51-0.96, p=0.03).

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Why the study?

Does primary prevention ICD implantation reduce all-cause mortality in patients with nonischemic systolic heart failure, and is this effect age-dependent?

Population

1116 patients with nonischemic systolic heart failure from the DANISH study, median age 63 years.

Comparison

Primary prevention Implantable… vs Control group (no ICD)

Design

Cohort

Key result

Primary prevention ICD implantation reduced all-cause mortality in patients with nonischemic systolic heart failure aged ≤70 years (HR 0.70; 95% CI 0.51-0.96; P=0.03).

Authors

MEMarie Bayer Elming JNJens Cosedis Nielsen JHJens Haarbo

Discussion

Member takes

Overview

May support age-stratified ICD decisions in nonischemic HF; leaves open prospective confirmation of age interaction.

Key Points

To investigate the relationship between age and mortality outcomes following ICD implantation in nonischemic systolic heart failure patients.
Included all 1116 patients from the DANISH study for subgroup analysis.
Assessed the relationship between ICD implantation and mortality by age using selection impact curves.
Compared modes of death between patients ≤70 years and >70 years using χ 2 analysis.
A linearly decreasing relationship between ICD implantation and mortality was observed (HR, 1.03; 95% CI, 1.003–1.06; P =0.03).
Patients ≤70 years had reduced all-cause mortality with ICD (HR, 0.70; 95% CI, 0.51–0.96; P =0.03), while those >70 years did not.
Significant difference in modes of death between age groups (P =0.01).

Study Design

Type

RCT (n=1,116)

Structured PICO

Does primary prevention ICD implantation reduce all-cause mortality in patients with nonischemic systolic heart failure, and is this effect age-dependent?

Population

1,116 patients with nonischemic systolic heart failure (median age 63 years) from the DANISH study, analyzed to assess age-dependent outcomes of primary prevention ICDs.

Intervention

Primary prevention Implantable Cardioverter-Defibrillator (ICD)

Comparator

Control group (no ICD)

Outcome

All-cause mortalityhard clinical

Main Result

Hazard Ratio: 0.7 (95% CI 0.51–0.96)

p-value: p=0.03

Primary prevention ICDs provide a survival benefit in patients with nonischemic systolic heart failure who are ≤70 years old, but not in older patients.

Cite This Study

Elming et al. (2017) conducted an RCT in Nonischemic systolic heart failure (n=1,116). Primary prevention implantable cardioverter-defibrillator (ICD) vs. No ICD was evaluated on All-cause mortality in patients ≤70 years of age (HR 0.70, 95% CI 0.51-0.96, p=0.03). Primary prevention ICD implantation reduced all-cause mortality in patients with nonischemic systolic heart failure aged ≤70 years (HR 0.70; 95% CI 0.51-0.96; P=0.03).

synapsesocial.com/papers/6a4ebed08d6b14ebdbbc88bc https://doi.org/10.1161/circulationaha.117.028829

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July 8, 2026Circulation

Primary prevention ICDs reduce mortality ~30% in nonischemic systolic heart failure patients aged ≤70 years.

View Full Paper

Ask AI

Bookmark

Why the study?

Does primary prevention ICD implantation reduce all-cause mortality in patients with nonischemic systolic heart failure, and is this effect age-dependent?

Population

1116 patients with nonischemic systolic heart failure from the DANISH study, median age 63 years.

Comparison

Primary prevention Implantable… vs Control group (no ICD)

Design

Cohort

Key result

Primary prevention ICD implantation reduced all-cause mortality in patients with nonischemic systolic heart failure aged ≤70 years (HR 0.70; 95% CI 0.51-0.96; P=0.03).

Authors

MEMarie Bayer Elming JNJens Cosedis Nielsen JHJens Haarbo

Discussion

Member takes

Overview

May support age-stratified ICD decisions in nonischemic HF; leaves open prospective confirmation of age interaction.

Key Points

To investigate the relationship between age and mortality outcomes following ICD implantation in nonischemic systolic heart failure patients.
Included all 1116 patients from the DANISH study for subgroup analysis.
Assessed the relationship between ICD implantation and mortality by age using selection impact curves.
Compared modes of death between patients ≤70 years and >70 years using χ 2 analysis.
A linearly decreasing relationship between ICD implantation and mortality was observed (HR, 1.03; 95% CI, 1.003–1.06; P =0.03).
Patients ≤70 years had reduced all-cause mortality with ICD (HR, 0.70; 95% CI, 0.51–0.96; P =0.03), while those >70 years did not.
Significant difference in modes of death between age groups (P =0.01).

Study Design

Type

RCT (n=1,116)

Structured PICO

Does primary prevention ICD implantation reduce all-cause mortality in patients with nonischemic systolic heart failure, and is this effect age-dependent?

Population

1,116 patients with nonischemic systolic heart failure (median age 63 years) from the DANISH study, analyzed to assess age-dependent outcomes of primary prevention ICDs.

Intervention

Primary prevention Implantable Cardioverter-Defibrillator (ICD)

Comparator

Control group (no ICD)

Outcome

All-cause mortalityhard clinical

Main Result

Hazard Ratio: 0.7 (95% CI 0.51–0.96)

p-value: p=0.03

Primary prevention ICDs provide a survival benefit in patients with nonischemic systolic heart failure who are ≤70 years old, but not in older patients.

Cite This Study

synapsesocial.com/papers/6a4ebed08d6b14ebdbbc88bc https://doi.org/10.1161/circulationaha.117.028829

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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