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Abstract：
UNASSIGNED: Implantable cardioverter-defibrillator (ICD) implantation to prevent sudden cardiac death (SCD) in post-myocardial infarction (MI) patients varies by geography but remains low in many regions despite guideline recommendations.
UNASSIGNED: This study aimed to characterize the care pathway of post-MI patients and understand barriers to referral for further SCD risk stratification and management in patients meeting referral criteria.
UNASSIGNED: This prospective, nonrandomized, multi-nation study included patients ≥18 years of age, with an acute MI ≤30 days and left ventricular ejection fraction <50% ≤14 days post-MI. The primary endpoint was defined as the physician\'s decision to refer a patient for SCD stratification and management.
UNASSIGNED: In total, 1,491 post-MI patients were enrolled (60.2 ± 12.0 years of age, 82.4% male). During the study, 26.7% (n = 398) of patients met criteria for further SCD risk stratification; however, only 59.3% of those meeting criteria (n = 236; 95% CI: 54.4%-64.0%) were referred for a visit. Of patients referred for SCD risk stratification and management, 94.9% (n = 224) attended the visit of which 56.7% (n =127; 95% CI: 50.1%-63.0%) met ICD indication criteria. Of patients who met ICD indication criteria, 14.2% (n = 18) were implanted.
UNASSIGNED: We found that ∼40% of patients meeting criteria were not referred for further SCD risk stratification and management and ∼85% of patients who met ICD indications did not receive a guideline-directed ICD. Physician and patient reasons for refusing referral to SCD risk stratification and management or ICD implant varied by geography suggesting that improvement will require both physician- and patient-focused approaches. (Improve Sudden Cardiac Arrest [SCA] Bridge Study; NCT03715790).
UNASSIGNED: This study aimed to characterize the care pathway of post-MI patients and understand barriers to referral for further SCD risk stratification and management in patients meeting referral criteria.
UNASSIGNED: This prospective, nonrandomized, multi-nation study included patients ≥18 years of age, with an acute MI ≤30 days and left ventricular ejection fraction <50% ≤14 days post-MI. The primary endpoint was defined as the physician\'s decision to refer a patient for SCD stratification and management.
UNASSIGNED: In total, 1,491 post-MI patients were enrolled (60.2 ± 12.0 years of age, 82.4% male). During the study, 26.7% (n = 398) of patients met criteria for further SCD risk stratification; however, only 59.3% of those meeting criteria (n = 236; 95% CI: 54.4%-64.0%) were referred for a visit. Of patients referred for SCD risk stratification and management, 94.9% (n = 224) attended the visit of which 56.7% (n =127; 95% CI: 50.1%-63.0%) met ICD indication criteria. Of patients who met ICD indication criteria, 14.2% (n = 18) were implanted.
UNASSIGNED: We found that ∼40% of patients meeting criteria were not referred for further SCD risk stratification and management and ∼85% of patients who met ICD indications did not receive a guideline-directed ICD. Physician and patient reasons for refusing referral to SCD risk stratification and management or ICD implant varied by geography suggesting that improvement will require both physician- and patient-focused approaches. (Improve Sudden Cardiac Arrest [SCA] Bridge Study; NCT03715790).
摘要：
UNASSIGNED：植入心脏复律除颤器（ICD）以预防心肌梗死（MI）后患者的心源性猝死（SCD）因地域而异，但尽管有指南建议，但在许多地区仍然很低。
UNASSIGNED：本研究旨在表征MI后患者的护理途径，并了解符合转诊标准的患者为进一步SCD风险分层和管理进行转诊的障碍。
未经批准：此预期，非随机化，多国研究包括年龄≥18岁的患者，急性MI≤30天，MI后左心室射血分数<50%≤14天。主要终点定义为医师决定转介患者进行SCD分层和管理。
未经批准：总共，纳入1,491例MI后患者(60.2±12.0岁，82.4%男性）。在研究期间,26.7%(n=398)的患者符合进一步SCD风险分层的标准;然而,只有59.3%的符合标准的患者(n=236;95%CI:54.4%-64.0%)被转诊.在接受SCD风险分层和管理的患者中，94.9％（n=224）参加了访问，其中56.7％（n=127；95％CI：50.1％-63.0％）符合ICD适应症标准。在符合ICD适应症标准的患者中，14.2%(n=18)被植入。
UNASSIGNED：我们发现40%符合标准的患者没有被转诊进行进一步的SCD风险分层和管理，85%符合ICD适应症的患者没有接受指南指导的ICD。医生和患者拒绝转诊SCD风险分层和管理或ICD植入的原因因地理位置而异，这表明改善需要以医生和患者为中心的方法。（改善心脏骤停[SCA]桥研究；NCT03715790）。
UNASSIGNED：本研究旨在表征MI后患者的护理途径，并了解符合转诊标准的患者为进一步SCD风险分层和管理进行转诊的障碍。
未经批准：此预期，非随机化，多国研究包括年龄≥18岁的患者，急性MI≤30天，MI后左心室射血分数<50%≤14天。主要终点定义为医师决定转介患者进行SCD分层和管理。
未经批准：总共，纳入1,491例MI后患者(60.2±12.0岁，82.4%男性）。在研究期间,26.7%(n=398)的患者符合进一步SCD风险分层的标准;然而,只有59.3%的符合标准的患者(n=236;95%CI:54.4%-64.0%)被转诊.在接受SCD风险分层和管理的患者中，94.9％（n=224）参加了访问，其中56.7％（n=127；95％CI：50.1％-63.0％）符合ICD适应症标准。在符合ICD适应症标准的患者中，14.2%(n=18)被植入。
UNASSIGNED：我们发现40%符合标准的患者没有被转诊进行进一步的SCD风险分层和管理，85%符合ICD适应症的患者没有接受指南指导的ICD。医生和患者拒绝转诊SCD风险分层和管理或ICD植入的原因因地理位置而异，这表明改善需要以医生和患者为中心的方法。（改善心脏骤停[SCA]桥研究；NCT03715790）。
