Search-MI: Survey to Evaluate Arrhythmia Rate in so-Called High Risk MI Patient
Immediately after the publication of the MADIT-II study results, a debate thus emerged on the possibility to translate the benefits observed in strictly controlled trial-selected patients to "real world" practice. SEARCH-MI was thus created in 2002 to prospectively evaluate the arrhythmic rate, ICD interventions and adherence to trial-based recommendations on post-MI patients in regular clinical practice. The study was carried out in 69 centers across Italy, Germany, Austria, Israel and Saudi-Arabia. 788 patients were admitted for ICD indication as primary prevention after myocardial infarction, enrolled and followed for an average of 2 years. SEARCH-MI thus represents the current clinical management of post-MI patients with left ventricular dysfunction with a primary indication for defibrillator implant. These implantations have also been influenced by other heart failure landmark trials and guidelines which appeared in the last 5 years.
All episodes collected in the SEARCH-MI registry were reviewed independently. The final results, with a mean follow-up close to 2 years, demonstrate that one patient in five (1/5) will benefit from successfully treated ventricular arrhythmic events by their implanted ICD. This event rate is similar to that reported for the ICD arm of the MADIT-II trial. A relevant proportion of patients (1/4) enrolled in the SEARCH-MI registry received a device for cardiac resynchronization therapy, also illustrating the evolving trends towards device-based therapy in heart-failure patients.
This registry, designed to enroll MADIT-II like patients, results in outcomes for appropriate ventricular therapy that are comparable to strictly controlled randomized clinical trial conditions. The SEARCH-MI registry supports the benefits of ICD therapy in primary prevention patients in reducing all cause mortality and confirms the extended role of these devices for heart failure patients in routine clinical practice.
Notes to editors:
This study was presented at the ESC Congress 2007 in Vienna.
The European Society of Cardiology (ESC):
The ESC represents nearly 53,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
The ESC achieves this through a variety of scientific and educational activities including the coordination of: clinical practice guidelines, education courses and initiatives, pan-European surveys on specific disease areas and the ESC Annual Congress, the largest medical meeting in Europe. The ESC also works closely with the European Commission and WHO to improve health policy in the EU.
The ESC comprises 3 Councils, 5 Associations, 19 Working Groups, 50 National Cardiac Societies and an ESC Fellowship Community (Fellow, FESC; Nurse Fellow, NFESC). For more information on ESC Initiatives, Congresses and Constituent Bodies see www.escardio.org.
European Society of Cardiology, The European Heart House 2035 Route des Colles, B.P. 179 - Les Templiers, Sophia Antipolis F-06903 France
About the Author(s)
Professor Guiseppe Boriani
Institute of Cardiology, University of Bologna, Italy
Be the first to comment on this!
Personal Subscriber? Sign In
Note: Please enter a display name. Your email address will not be publically displayed