{ "abstract": "Background\n\nPrimary prevention with an implantable cardioverter-defibrillator (ICD) has become an increasingly debated strategy, with its role in patients with nonischemic heart failure with reduced ejection fraction (HFrEF) undergoing continued reassessment.Objective\n\nTo summarize the available scientific evidence on the effectiveness of ICD therapy for primary prevention in patients with nonischemic HFrEF.Methods\n\nA rapid systematic review and meta-analysis was conducted in accordance with the recommendations of the Cochrane Rapid Reviews Methods Group and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Statistical significance was defined as a two-sided p-value < 0.05. Searches were performed in the MEDLINE, Embase, and CENTRAL databases. Randomized controlled trials (RCTs) evaluating ICD implantation for primary prevention were included, with sudden cardiac death (SCD), cardiovascular mortality, and all-cause mortality as the primary outcomes.Results\n\nA total of 18 publications reporting daata from six pivotal RCTs were included. ICD therapy was associated with a statistically significant reduction in SCD (relative risk [RR] 0.41; 95%CI 0.26-0.65; high-certainty evidence) and cardiovascular mortality (RR 0.75; 95%CI 0.59-0.95; high-certainty evidence). For all-cause mortality, the primary analysis showed no statistically significant difference between groups (RR 0.88; 95%CI 0.72-1.07; moderate-certainty evidence). In the subgroup analysis, studies with shorter follow-up (< 6.8 years) demonstrated a significant reduction in all-cause mortality (RR 0.69; 95%CI 0.52-0.92).Conclusion\n\nIn patients with nonischemic HFrEF, ICD therapy reduced SCD and cardiovascular mortality but did not significantly reduce all-cause mortality in the primary analysis. These findings support the use of ICD therapy when guided by individualized clinical assessment.", "abstract_shown": true, "affiliations": [ "Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brasil.", "Hospital Moinhos de Vento, Porto Alegre, RS - Brasil.", "Hospital Universitário do Cajuru, Pontifícia Universidade Católica Paraná (PUCPR), Curitiba, PR - Brasil.", "Santa Casa de Porto Alegre, Porto Alegre, RS - Brasil.", "Universidade Luterana do Brasil, Canoas, RS - Brasil.", "PROCAPE- Universidade de Pernambuco, Recife, PE - Brasil.", "Hospital Sírio-Libanes, São Paulo, SP - Brasil.", "Instituto de Cardiologia/ Fundação Universitária de Cardiologia, Porto Alegre, RS - Brasil.", "Hospital Universitário da Universidade Federal do Maranhão, São Luiz, MA - Brasil.", "Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.", "Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ - Brasil.", "Complexo Hospitalar Américas - Vitória e Samaritano Barra, Rio de Janeiro, RJ - Brasil.", "Instituto D'Or de Pesquisa e Ensino-IDOR, Rio de Janeiro, RJ - Brasil.", "Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP - Brasil." ], "article_type": "research article", "arxiv": null, "author_total": 13, "authors": [ { "affs": [ 0, 1 ], "name": "Luis E Rohde", "orcid": "0000-0002-6557-393X" }, { "affs": [ 0, 1 ], "name": "Leandro I Zimerman", "orcid": "0000-0001-9980-9114" }, { "affs": [ 2 ], "name": "Lídia Z Moura", "orcid": "0000-0002-4741-322X" }, { "affs": [ 3, 4 ], "name": "Luis C Danzmann", "orcid": "0000-0002-5774-2780" }, { "affs": [ 5 ], "name": "Silvia M Martins", "orcid": "0000-0002-3093-9743" }, { "affs": [ 0, 6 ], "name": "Verônica Colpani", "orcid": "0000-0002-7908-4213" }, { "affs": [ 7 ], "name": "Kelly Zucatti", "orcid": "0000-0003-1190-0760" }, { "affs": [ 8 ], "name": "José Albuquerque de Figueiredo-Neto", "orcid": "0000-0003-3739-7702" }, { "affs": [ 9 ], "name": "Fabiana G Marcondes-Braga", "orcid": "0000-0002-2533-5638" }, { "affs": [ 10, 11 ], "name": "Ricardo Mourilhe-Rocha", "orcid": "0000-0003-2501-302X" }, { "affs": [ 10, 12 ], "name": "Denilson Campos de Albuquerque", "orcid": "0000-0003-1883-6546" }, { "affs": [ 9 ], "name": "Mucio T de Oliveira-Júnior", "orcid": "0000-0001-9413-3792" }, { "affs": [ 13 ], "name": "Marcus V Simões", "orcid": "0000-0001-6553-8387" } ], "bibtex": "https://research.draconitic.com/paper/78y2qrrc83v5v.bib", "cited_by": 0, "doi": "10.36660/abc.20250675", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668461/?tool=EBI", "id": "78y2qrrc83v5v", "issns": [ "0066-782X", "1678-4170" ], "landing_url": "https://europepmc.org/article/PMC/PMC13668461", "language": "por", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2705|Cardiac pacing and defibrillation studies" ] ], "openalex": "W7222873724", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13668461/pdf/?tool=EBI", "pmcid": "PMC13668461", "pmid": "42961239", "published": "2026-10-19", "publisher": null, "ris": "https://research.draconitic.com/paper/78y2qrrc83v5v.ris", "sources": [ { "first_seen": "2026-10-30T12:18:25Z", "native_id": "PMC:PMC13668461", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13668461" }, { "first_seen": "2026-11-01T00:20:50Z", "native_id": "MED:42961239", "source": "europepmc", "url": "https://europepmc.org/article/MED/42961239" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2705|Cardiac pacing and defibrillation studies", "subfield": "cardiovascular" } ], "title": "Eficácia de Cardiodesfibrilador Implantável na Prevenção Primária em Pacientes com Insuficiência Cardíaca com Fração de Ejeção Reduzida não Isquêmica", "title_text": "Eficácia de Cardiodesfibrilador Implantável na Prevenção Primária em Pacientes com Insuficiência Cardíaca com Fração de Ejeção Reduzida não Isquêmica", "type": "peer-reviewed", "updated_at": "2026-11-02T03:21:21Z", "url": "https://research.draconitic.com/paper/78y2qrrc83v5v", "venue": "Arquivos brasileiros de cardiologia", "versions": [] }