Dr. Molly Kelly is a senior resident in Internal Medicine who is doing research with Dr. Wayne Levy, who was an original investigator involved in the creation of the Seattle Proportional Risk Model, used to estimate the risk of all-cause mortality from sudden cardiac death.
The Seattle Proportional Risk Model is used to identify people who are more likely to benefit from the potential life-saving benefit of an implantable cardioverter-defibrillator device, commonly referred to as an “ICD”.
Dr. Kelly is now examining whether that same risk model is particularly useful in a high risk group: a group who experienced a prior event with ventricular fibrillation or sustained ventricular tachycardia.
Dr. Kelly and colleagues performed a secondary analysis of a multicenter randomized controlled trial that compared outcomes between systemic antiarrhythmic therapy versus ICD placement.
They found that the benefit of ICDs varied between groups that scored differently on the risk model (interaction term p=.01). In the group with risk scores below the median who lacked heart failure, there was no evidence that implantable defibrillators offered greater mortality benefit than systemic antiarrhythmic therapy. In contrast, ICDs reduced the risk of all-cause mortality in subjects with higher risk scores. The benefit was greatest in the group with high risk scores and heart failure.
“Through this research, I developed many foundational research skills that I’m grateful to carry forward as I continue exploring my career interests. I found each step in the process – from writing an IRB protocol to applying to the NIH for data access – has presented challenges that were rewarding to overcome.”