Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation.
| Title: | Comparison of Mortality and Readmission in Non-Ischemic Versus Ischemic Cardiomyopathy After Implantable Cardioverter-Defibrillator Implantation. |
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| Authors: | Higgins AY; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.; Bjerre J; Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; Department of Health Research and Policy, Department of Medicine, Stanford University School of Medicine, Stanford, California.; Parzynski CS; Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, Connecticut.; Minges KE; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, Connecticut.; Ahmad T; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.; Desai NR; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, Connecticut.; Enriquez A; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.; Spatz ES; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, Connecticut.; Friedman DJ; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.; Curtis JP; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, Connecticut.; Hlatky MA; Department of Health Research and Policy, Department of Medicine, Stanford University School of Medicine, Stanford, California.; Freeman JV; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Center for Outcomes Research and Evaluation, Yale New Haven Health Services Corporation, New Haven, Connecticut. Electronic address: james.freeman@yale.edu. |
| Source: | The American journal of cardiology [Am J Cardiol] 2020 Oct 15; Vol. 133, pp. 116-125. Date of Electronic Publication: 2020 Jul 24. |
| Publication Type: | Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0207277 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1913 (Electronic) Linking ISSN: 00029149 NLM ISO Abbreviation: Am J Cardiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Excerpta Medica |
| MeSH Terms: | Defibrillators, Implantable* ; Patient Readmission*; Cardiomyopathies/*etiology ; Cardiomyopathies/*mortality ; Myocardial Ischemia/*complications ; Myocardial Ischemia/*mortality; Cardiomyopathies/therapy ; Myocardial Ischemia/therapy ; Aged ; Female ; Humans ; Male ; Middle Aged ; Registries ; Retrospective Studies ; Survival Rate ; United States |
| Abstract: | Data is lacking on the contemporary risk of death and readmission following implantable cardioverter-defibrillator (ICD) implantation in patients with non-ischemic cardiomyopathies (NICM) compared with ischemic cardiomyopathies (ICM) in a large nationally representative cohort. We performed a retrospective cohort study using the National Cardiovascular Data Registry ICD Registry linked with Medicare claims from April 1, 2010 to December 31, 2013. We established a cohort of NICM and ICM patients with a left ventricular ejection fraction ≤35% who received a de novo, primary prevention ICD. We compared mortality and readmission using Kaplan-Meier curves and Cox proportional hazard regressions models. We also evaluated temporal trends in mortality. In 31,044 NICM and 68,458 ICM patients with a median follow up of 2.4 years, 1-year mortality was significantly higher in ICM patients (12.3%) compared with NICM (7.9%, p < 0.001). The higher mortality in ICM patients remained significant after adjustment for covariates (hazard ratio [HR] 1.40; 95% confidence interval [CI] 1.36 to 1.45), and was consistent in subgroup analyses. These findings were consistent across the duration of the study. ICM patients were also significantly more likely to be readmitted for all causes (adjusted HR 1.15, CI 1.12 to 1.18) and for heart failure (adjusted HR 1.25, CI 1.21 to 1.31). In conclusion, the risks of mortality and hospital readmission after primary prevention ICD implantation were significantly higher in patients with ICM compared with NICM which was consistent across all patient subgroups tested and over the duration of the study.; (Copyright © 2020 Elsevier Inc. All rights reserved.) |
| Entry Date(s): | Date Created: 20200901 Date Completed: 20201112 Latest Revision: 20201112 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.amjcard.2020.07.035 |
| PMID: | 32862971 |
| Database: | MEDLINE |
Comparative Study; Journal Article; Research Support, Non-U.S. Gov't