Periprocedural Risk and Survival Associated With Implantable Cardioverter-Defibrillator Placement in Older Patients With Advanced Heart Failure.
| Title: | Periprocedural Risk and Survival Associated With Implantable Cardioverter-Defibrillator Placement in Older Patients With Advanced Heart Failure. |
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| Authors: | Fudim M; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.; Duke Clinical Research Institute, Durham, North Carolina.; Ali-Ahmed F; Duke Clinical Research Institute, Durham, North Carolina.; Beaumont Health, Dearborn, Michigan.; Parzynski CS; Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut.; Ambrosy AP; Department of Cardiology, The Permanente Medical Group, San Francisco, California.; Division of Research, Kaiser Permanente Northern California, Oakland, California.; Friedman DJ; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.; Duke Clinical Research Institute, Durham, North Carolina.; Pokorney SD; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.; Duke Clinical Research Institute, Durham, North Carolina.; Curtis JP; Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut.; Fonarow GC; Division of Cardiology, David Geffen School of Medicine at UCLA (University of California, Los Angeles).; Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, University of California, Los Angeles.; Section Editor.; Masoudi FA; Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora.; Hernandez AF; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.; Duke Clinical Research Institute, Durham, North Carolina.; Associate Editor.; Al-Khatib SM; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.; Duke Clinical Research Institute, Durham, North Carolina. |
| Source: | JAMA cardiology [JAMA Cardiol] 2020 Jun 01; Vol. 5 (6), pp. 643-651. |
| Publication Type: | Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101676033 Publication Model: Print Cited Medium: Internet ISSN: 2380-6591 (Electronic) NLM ISO Abbreviation: JAMA Cardiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Chicago, Illinois] : American Medical Association, [2016]- |
| MeSH Terms: | Defibrillators, Implantable* ; Registries*; Death, Sudden, Cardiac/*prevention & control ; Heart Failure/*therapy ; Primary Prevention/*methods ; Stroke Volume/*physiology ; Ventricular Function, Left/*physiology; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/etiology ; Heart Failure/complications ; Heart Failure/physiopathology ; Survival Rate/trends ; United States/epidemiology ; Aged ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Retrospective Studies ; Time Factors |
| Abstract: | Importance: Little is known about the utilization rates and outcomes of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) placement among patients with advanced heart failure (HF).; Objective: To examine utilization rates, patient characteristics, and outcomes of ICD and CRT-D placements among patients with advanced HF.; Design, Setting, and Participants: This cohort study was a post hoc analysis of 81 492 Medicare fee-for-service beneficiaries enrolled in the National Cardiovascular Data Registry ICD Registry between January 2010 and December 2014. Inclusion criteria were patients who had received an HF diagnosis, had a left ventricular ejection fraction of 35% or lower, and showed evidence of advanced HF, which was defined as New York Heart Association (NYHA) class IV symptoms, inotrope use within the last 60 days, left ventricular assist device in situ, or orthotopic heart transplant listing. The comparator group included patients with NYHA class II and no HF hospitalization within the last 12 months, no left ventricular assist device, no orthotopic heart transplant listing, and no current or recent inotrope use. All eligible patients underwent first-time ICD or CRT-D placement for primary prevention of sudden cardiac death. Data were analyzed from January 2010 to December 2014.; Main Outcomes and Measures: All-cause mortality and periprocedural complications.; Results: Of 81 492 Medicare patients, 3343 had advanced HF (4.1%) and 19 424 were in the comparator group (23.8%). Among the advanced HF population, the mean (SD) age of patients was 74 (9) years, and patients were predominantly white individuals (81.5%) and men (71.1%). The all-cause mortality rate at 30 days was 3.1% (95% CI, 2.6%-3.8%) in the advanced HF group vs 0.5% (0.4%-0.6%) in the comparator group (P |
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| Grant Information: | UL1 TR001863 United States TR NCATS NIH HHS |
| Entry Date(s): | Date Created: 20200327 Date Completed: 20210128 Latest Revision: 20210919 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC7097837 |
| DOI: | 10.1001/jamacardio.2020.0391 |
| PMID: | 32211811 |
| Database: | MEDLINE |
Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't