| Title: |
Patients with improved left ventricular ejection fraction without implantable cardioverter defibrillator may continue to be at high mortality risk despite optimal medical management |
| Authors: |
Singh, Kanwar Yugraj; Zahwe, Firas; Mengesha, Tadele W.; Shearer, Robyn; Platz, Crystal; Omery, Bilal; Jahangir, Arshad; Ballany, Wassim; Akhtar, Masood; Mortada, M. Eyman; Sra, Jasbir; Choudhuri, Indrajit |
| Source: |
Aurora UW Electrophysiology Faculty |
| Publisher Information: |
SHARE @ Advocate Health - Midwest |
| Publication Year: |
2017 |
| Collection: |
Aurora Health Care Digital Repository |
| Subject Terms: |
Aurora Electrophysiology Fellows; Aurora Cardiology Fellows |
| Description: |
BACKGROUND: With advances in medical and interventional management, the risk of sudden cardiac death (SCD) has decreased in the high-risk patients identified by left ventricular ejection fraction (LVEF) OBJECTIVE: To evaluate benefit of ICD in addition to optimal medical management (OMT) in patients with improved LVEF. METHODS: Aurora Healthcare patient records from 1/2010 to 10/2014 were screened to identify patients with LVEF≤35% and subsequent improvement to EF≥40%, in whom ICD implant was deferred vs. patients who received ICD. Propensity score matching was applied to match the medications and other clinical confounders. The primary outcome was all-cause mortality. RESULTS: One thousand three hundred sixty-four patients were identified with improved LVEF during the study period. We further propensity matched both groups for clinical characteristics and medications at improved LVEF (40-49%) to evaluate additional benefit of ICD in this cohort of patients. A total of 540 patients were included in the mortality analysis. Sixty-eight patients (15%) in non-ICD group died (majority as SCD) as compared to 10 (9%) in the ICD group (majority non-SCD), p=0.0108 . This effect was not statistically significant in patients with completely recovered LVEF >50%. CONCLUSIONS: Our findings suggest that the ICD may continue to provide survival benefit over and above OMT in patients with improved LVEF. |
| Document Type: |
text |
| Language: |
unknown |
| Relation: |
https://institutionalrepository.aah.org/cardiacelectrofaculty/26 |
| Availability: |
https://institutionalrepository.aah.org/cardiacelectrofaculty/26 |
| Accession Number: |
edsbas.61B6D726 |
| Database: |
BASE |