6/28/23, 1:16 AM DINAMIT Pathway Feedback Search Clinical Topics Home Studies DINAMIT DINAMIT Disease Disease Disease Non-ST-elevation myocardial inf ST-elevation myocardial infarction Ventricula Trial question What is the role of ICD therapy in patients with acute myocardial infarction who had reduced LV function and impaired cardiac autonomic function? Study design Multi-center Open label RCT Population Characteristics of study participants 24.0% female N = 674 76.0% male 674 patients (160 female, 514 male) Inclusion criteria: patients with acute myocardial infarction who had reduced LV function and impaired cardiac autonomic function Key exclusion criteria: congestive HF; noncardiac disease that limited life expectancy; name on a waiting list for a heart transplant; current, ongoing ICD therapy; prior implantation of a permanent pacemaker; requirement for an ICD Interventions N=332 implantation of a cardioverter-defibrillator (plus standard medical therapy) N=342 standard medical therapy alone (no ICD) https://web.pathway.md/studies/recJR0dgj6DtshZOz 1/2 6/28/23, 1:16 AM DINAMIT Pathway Primary outcome Incidence of death from any cause 7.5 % / y 7.5 6.9 5.6 % / y 3.8 % / y 1.9 % / y No significant difference 0.0 % / y Implantation of a cardioverter-defibrillator Standard medical therapy alone No significant difference in the incidence of death from any cause (7.5% / y vs. 6.9% / y; HR 1.08, 95% CI 0.76 to 1.55) Secondary outcomes Significant decrease in the incidence of death due to arrhythmia (1.5% / y vs. 3.5% / y; HR 0.42, 95% CI 0.22 to 0.83) Significant increase in the incidence of death from nonarrhythmic causes (6.1% / y vs. 3.5% / y; HR 1.75, 95% CI 1.11 to 2.76) Conclusion In patients with acute myocardial infarction who had reduced LV function and impaired cardiac autonomic function, implantation of a cardioverter-defibrillator was not superior to standard medical therapy alone with respect to the incidence of death from any cause. Reference Hohnloser SH, Kuck KH, Dorian P et al. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med. 2004 Dec 9;351(24):2481-8. Open reference URL https://web.pathway.md/studies/recJR0dgj6DtshZOz 2/2