NIDCM studies 5.76) an ICD implanted and to ⊕⊕⊕⨀ have an appropriate ICD Any cardiac event RR shock. = 3.71 (95%CI 2.29, 6.04) B5.1. Effect of N=488 In those patients CMR is effective at Moderate Therapeutic CMR on scheduled for devices, reducing the proportion efficacy device 21/72 (29.2%) avoided of patients who receive K=1 cohort ⊕⊕⊕⨀ implantation following devices or surgery for study and CMR imaging. treatment of CM, surgery for compared with what is NIDCM In those not scheduled done currently in for devices, 20/375 Australia. Only a small proportion of patients (5.3%) had one who would otherwise not implanted after CMR imaging. receive devices or surgery had their treatment plan amended In those scheduled for following investigation surgery, 13/20 (65%) with CMR. avoided surgery after CMR. Appropriate avoidance of invasive therapies would In those not scheduled result in superior safety for surgery, 7/427 outcomes. (1.6%) underwent surgery after CMR. B5.2. N=719 Mean LVEF difference Treatment specific for Moderate Therapeutic of = 7.36% (95%CI 4.94, myocarditis may improve effectiveness K=8 RCTs 9.79), favouring cardiovascular ⊕⊕⊕⨀ for corticosteroids over no functioning, compared myocarditis corticosteroids after with general treatment 3 months for HF symptoms. No significant difference in mortality N=93,553 CABG reduces the risk Correct identification of Low of of death, myocardial ICM is likely to reduce ⊕⊕⨀⨀ infarction and patient cardiac deaths K=100 RCTs for subsequent and other outcomes. revascularisation, However, the impact of ICM compared with an incorrect diagnosis of medical treatment NIDCM in those who are alone. LGE– is unknown. There were no data specific to patients who were negative for scarring or inflammation using LGE-CMR. CABG = coronary artery bypass grafting; CI = confidence interval; CM = cardiomyopathy; CMR = cardiac magnetic resonance (imaging); DCM = dilated cardiomyopathy; CTCA = computed tomography coronary
NIDCM studies 5.76) Any cardiac event RR = 3.71 (95%CI 2.29, 6.04) an ICD implanted and to have an appropriate ICD shock. ⊕⊕⊕⨀ B5.1. Therapeutic efficacy Effect of CMR on device and surgery for NIDCM N=488 K=1 cohort study In those patients scheduled for devices, 21/72 (29.2%) avoided implantation following CMR imaging. In those not scheduled for devices, 20/375 (5.3%) had one implanted after CMR imaging. In those scheduled for surgery, 13/20 (65%) avoided surgery after CMR. In those not scheduled for surgery, 7/427 (1.6%) underwent surgery after CMR. CMR is effective at reducing the proportion of patients who receive devices or surgery for treatment of CM, compared with what is done currently in Australia. Only a small proportion of patients who would otherwise not receive devices or surgery had their treatment plan amended following investigation with CMR. Appropriate avoidance of invasive therapies would result in superior safety outcomes. Moderate ⊕⊕⊕⨀ B5.2. Therapeutic effectiveness of for myocarditis N=719 K=8 RCTs Mean LVEF difference = 7.36% (95%CI 4.94, 9.79), favouring corticosteroids over no corticosteroids after months No significant difference in mortality Treatment specific for myocarditis may improve cardiovascular functioning, compared with general treatment for HF symptoms. Moderate ⊕⊕⊕⨀ of for ICM N=93,553 K=100 RCTs CABG reduces the risk of death, myocardial infarction and subsequent revascularisation, compared with medical treatment alone. There were no data specific to patients who were negative for scarring or inflammation using LGE-CMR. Correct identification of ICM is likely to reduce patient cardiac deaths and other outcomes. However, the impact of an incorrect diagnosis of NIDCM in those who are LGE– is unknown. Low ⊕⊕⨀⨀ CABG = coronary artery bypass grafting; CI = confidence interval; CM = cardiomyopathy; CMR = cardiac magnetic resonance (imaging); DCM = dilated cardiomyopathy; CTCA = computed tomography coronary 3
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