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dc.contributor.authorZhao S
dc.contributor.authorChing C.-K
dc.contributor.authorHuang D
dc.contributor.authorLiu Y.-B
dc.contributor.authorRodriguez-Guerrero D.A
dc.contributor.authorHussin A
dc.contributor.authorKim Y.-H
dc.contributor.authorVan Dorn B
dc.contributor.authorZhou X
dc.contributor.authorSingh B
dc.contributor.authorZhang S
dc.contributor.authorthe Improve SCA Investigators
dc.date.accessioned2024-10-07T21:38:53Z
dc.date.available2024-10-07T21:38:53Z
dc.date.issued2024
dc.identifier.issn17417015
dc.identifier.otherhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85188472332&doi=10.1186%2fs12916-024-03310-5&partnerID=40&md5=a986d9b853356a3a38144f7425811b2a
dc.identifier.urihttp://hdl.handle.net/10818/61873
dc.description.abstractBackground: Comprehensive data on patients at high risk of sudden cardiac death (SCD) in emerging countries are lacking. The aim was to deepen our understanding of the SCD phenotype and identify risk factors for death among patients at high risk of SCD in emerging countries. Methods: Patients who met the class I indication for implantable cardioverter-defibrillator (ICD) implantation according to guideline recommendations in 17 countries and regions underrepresented in previous trials were enrolled. Countries were stratified by the WHO regional classification. Patients were or were not implanted with an ICD at their discretion. The outcomes were all-cause mortality and SCD. Results: We enrolled 4222 patients, and 3889 patients were included in the analysis. The mean follow-up period was 21.6 ± 10.2 months. There were 433 (11.1%) instances of all-cause mortality and 117 (3.0%) cases of SCD. All-cause mortality was highest in primary prevention (PP) patients from Southeast Asia and secondary prevention (SP) patients from the Middle East and Africa. The SCD rates among PP and SP patients were both highest in South Asia. Multivariate Cox regression modelling demonstrated that in addition to the independent predictors identified in previous studies, both geographic region and ICD use were associated with all-cause mortality in patients with high SCD risk. Primary prophylactic ICD implantation was associated with a 36% (HR = 0.64, 95% CI 0.531–0.802, p < 0.0001) lower all-cause mortality risk and an 80% (HR = 0.20, 95% CI = 0.116–0.343, p < 0.0001) lower SCD risk. Conclusions: There was significant heterogeneity among patients with high SCD risk in emerging countries. The influences of geographic regions on patient characteristics and outcomes were significant. Improvement in increasing ICD utilization and uptake of guideline-directed medical therapy in emerging countries is urgent. Trial registration: ClinicalTrials.gov, NCT02099721. © The Author(s) 2024.en
dc.formatapplication/pdfes_CO
dc.language.isoenges_CO
dc.publisherBMC Medicinees_CO
dc.relation.ispartofseriesBMC Medicine Vol. 22 N° 1 art. 130
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.sourceUniversidad de La Sabanaes_CO
dc.sourceIntellectum Repositorio Universidad de La Sabanaes_CO
dc.subject.otherAsianen
dc.subject.otherEmerging countriesen
dc.subject.otherImplantable cardioverter-defibrillatoren
dc.subject.otherMortalityen
dc.subject.otherRisk factoren
dc.subject.otherSudden cardiac deathen
dc.titleRegional disparities and risk factors of mortality among patients at high risk of sudden cardiac death in emerging countries: a nonrandomized controlled trialen
dc.typejournal articlees_CO
dc.type.hasVersionpublishedVersiones_CO
dc.rights.accessRightsopenAccesses_CO
dc.identifier.doi10.1186/s12916-024-03310-5


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