6/28/23, 11:16 PM MADIT-II Pathway Feedback Search Clinical Topics Home Studies MADIT II MADIT II Disease ST-elevation myocardial infarction Trial question Is implantable defibrillator superior to conventional medical therapy in patients with myocardial infarction and reduced ejection fraction? Study design Multi-center Open label RCT Population Characteristics of study participants 16.0% female N = 1232 84.0% male 1232 patients (192 female, 1040 male) Inclusion criteria: patients with myocardial infarction and reduced ejection fraction Key exclusion criteria: indication for an implantable defibrillator, NYHA functional class IV at enrollment, coronary revascularization within the preceding three months, myocardial infarction within the past month, advanced cerebrovascular disease Interventions N=742 ICD implantation (with standard techniques, plus medical therapy) N=490 conventional medical therapy ( -blockers, ACE inhibitors, and lipid lowering drugs) Primary outcome https://web.pathway.md/studies/recdICA4dZmsEIrTi 1/2 6/28/23, 11:16 PM MADIT-II Pathway Rate of death at an average follow-up of 20 months 19.8 % 19.8 14.9 % 14.2 9.9 % Significant decrease 5.0 % NNT = 18 0.0 % ICD implantation Conventional medical therapy Significant decrease in the rate of death at an average follow-up of 20 months (14.2% vs. 19.8%; HR 0.69, 95% CI 0.51 to 0.93) Secondary outcomes No significant difference in hospitalized with HF (19.9% vs. 14.9%; RR 1.36, 95% CI -0.21 to 2.93) Safety outcomes Significant difference in hospitalization with HF (19.9% vs. 14.9%). Conclusion In patients with myocardial infarction and reduced ejection fraction, ICD implantation was superior to conventional medical therapy with respect to the rate of death at an average follow-up of 20 months. Reference Moss AJ, Zareba W, Hall WJ et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002 Mar 21;346(12):877-83. Open reference URL https://web.pathway.md/studies/recdICA4dZmsEIrTi 2/2