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Longitudinal Outcomes Associated With Non-Evidence-Based Implantable Cardioverter-Defibrillators Among Medicare Beneficiaries (From the National Cardiovascular Data Registry).

Title: Longitudinal Outcomes Associated With Non-Evidence-Based Implantable Cardioverter-Defibrillators Among Medicare Beneficiaries (From the National Cardiovascular Data Registry).
Authors: Daimee UA; Johns Hopkins University School of Medicine, Baltimore, Maryland.; Aslam F; Yale School of Medicine, New Haven, Connecticut.; Parzynski CS; Yale School of Medicine, New Haven, Connecticut.; Desai NR; Yale School of Medicine, New Haven, Connecticut.; Curtis JP; Yale School of Medicine, New Haven, Connecticut. Electronic address: jeptha.curtis@yale.edu.
Source: The American journal of cardiology [Am J Cardiol] 2021 Sep 15; Vol. 155, pp. 64-71. Date of Electronic Publication: 2021 Jul 25.
Publication Type: Journal Article; Multicenter Study; 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* ; Registries*; Death, Sudden, Cardiac/*prevention & control ; Heart Failure/*therapy ; Insurance Benefits/*economics ; Primary Prevention/*methods; Heart Failure/economics ; Heart Failure/mortality ; Survival Rate/trends ; United States/epidemiology ; Aged ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Male ; Retrospective Studies ; Time Factors
Abstract: Primary prevention implantable cardioverter-defibrillators (ICDs) in patients with recent myocardial infarction or coronary revascularization and those with newly diagnosed or severe heart failure (HF) are considered non-evidence-based, as defined by pivotal randomized clinical trials. Although non-evidence-based ICDs have been associated previously with greater risk of in-hospital adverse events, longitudinal outcomes are not known. We used Medicare-linked data from the National Cardiovascular Data Registry's ICD Registry to identify patients discharged alive following first-time primary prevention ICD implantations performed between 2010 and 2013. We compared longitudinal outcomes, including all-cause mortality and all-cause hospital readmission among patients receiving non-evidence-based versus evidence-based ICDs, up to 4.75 years after implantation, using multivariable time-to-event analyses. Of 71,666 ICD implantations, 9,609 (13.4%) were classified as non-evidence-based. Compared to patients receiving evidence-based ICDs, non-evidence-based ICD recipients had greater mortality risk at 90 days (HR = 1.44, CI: 1.37 - 1.52, p
Entry Date(s): Date Created: 20210728 Date Completed: 20210921 Latest Revision: 20210921
Update Code: 20260130
DOI: 10.1016/j.amjcard.2021.06.020
PMID: 34315569
Database: MEDLINE

Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't