Journal Club - PROFID tool effective in screening sudden cardiac death

Profid is a consortium comprising a wide variety of European cardiology key opinion leaders, large hospital chains, patient organizations, health industry, insurance, and government stakeholders, as well as bioinformatics, epidemiology, and health economics experts across Europe. With the development of an online software risk-prediction tool to be hosted on the website of the European Society of Cardiology, the broad make-up of the consortium will facilitate the goal of adopting the tool for use in routine clinical practice.

how cardiac MRI helps in improving in predicting sudden cardiac death after myocardial infarction. Using cardiac magnetic resonance imaging (CMR), investigators have improved upon earlier results of the PROFID clinical prediction model for risk for sudden cardiac death (SCD) after myocardial infarction (MI) by considering core scar and gray zone quantification.

The first step in PROFID was to develop an individualized sudden cardiac death risk-prediction model using machine learning to analyze existing data of several clinical characteristics, biomarkers, and imaging in 224,898 postinfarction patients.

The investigators analyzed all the data by five different methods but excluded cardiac magnetic resonance, they found that the predictive value of Left ventricular Ejection Fraction LVEF yielded a moderate C-statistic area under the curve value slightly above 0.6 (range, 0.618 - 0.690),and importantly, none of the other baseline characteristics, demographics, ECG characteristics, biomarkers, etc of the traditional potential predictors could increase this predictive performance.

Researchers concluded that Patients with reduced ejection fraction below 35% are going to significant over-treatment because only a minority will, at the end, use the device, and patients with Left ventricular Ejection Fraction greater than 35% may experience undertreatment because the majority of sudden cardiac death occurs in this population.