DANISH Trial – ICD Subgroup Mortality Index

DANISH Trial — ICD Subgroup Mortality Index: Explanation and Clinical Context This tool is an educational, exploratory calculator that maps an individual patient’s profile onto the principal subgroup findings from the DANISH randomized trial (Køber et al., NEJM 2016) and subsequent subgroup/extended analyses. The DANISH trial randomized 1,116 patients with non-ischemic systolic heart failure to receive an ICD or usual care; overall the trial did not show a statistically significant reduction in all-cause mortality with ICD implantation (reported overall HR 0.87, 95% CI 0.68–1.12), but ICDs significantly reduced sudden cardiac death (HR 0.50). Prespecified and post-hoc subgroup analyses suggested that younger patients (commonly reported threshold ≤70 years) and patients with lower baseline NT-proBNP (trial median ≈ 1,177 pg/mL) were the groups most likely to show a mortality benefit with ICD — findings that should be considered hypothesis-generating rather than definitive.

CRT status did not show a consistent, statistically significant interaction with ICD effect on all-cause mortality in DANISH. Use this calculator only as an educational aid to highlight the subgroup signals identified in DANISH; it is not a validated risk score and should not replace clinical judgement, current guidelines, or individualized specialist assessment.