Predictors of appropriate interventions and mortality in patients with implantable cardioverter-defibrillators.
Pol Arch Intern Med
; 129(10): 667-672, 2019 10 30.
Article
en En
| MEDLINE
| ID: mdl-31498300
ABSTRACT
INTRODUCTION:
Additional risk assessment in patients with heart failure referred for implantable cardioverterdefibrillator (ICD) implantation as primary prevention is needed. A reduction in left ventricular ejection fraction (LVEF) seems to lack sufficient sensitivity and specificity to be used for identification of patients at the highest risk of sudden cardiac death.OBJECTIVES:
The aim of this study was to identify short- and longterm predictors of appropriate implantable cardioverterdefibrillator therapy as well as predictors of longterm mortality in patients with an ICD or cardiac resynchronization therapy defibrillator (CRTD). PATIENTS ANDMETHODS:
In this retrospective study, data from 457 patients who had an ICD or CRTD implanted between 2011 and 2017 were analyzed.RESULTS:
During the median followup of 31 months (interquartile range, 17-52 months), 153 patients died (33.9%) and 140 had appropriate interventions (31%). In a multivariate Cox regression analysis, implantation for secondary prevention (hazard ratio [HR], 2.49; P <0.001), severe mitral valve disease (HR, 2.17; P <0.001), and previous myocardial infarction (HR, 1.68; P = 0.009) were predictors of appropriate intervention. Resynchronization therapy (HR, 0.59; P = 0.025) and severe mitral valve disease (HR, 2.42; P <0.001) were predictors of appropriate intervention in primary prevention. Body mass index, hemoglobin concentrations, LVEF, diabetes, and left atrial diameter were significant predictors of death.CONCLUSIONS:
Implantation of ICD or CRTD as secondary prevention was a potent predictor of appropriate intervention, while resynchronization therapy and severe mitral regurgitation predicted ICD therapy in primary prevention. In patients with ICD or CRT-D, independent predictors of mortality included body mass index, hemoglobin concentrations, LVEF, diabetes, and left atrial diameter.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Arritmias Cardíacas
/
Muerte Súbita Cardíaca
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Desfibriladores Implantables
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Terapia de Resincronización Cardíaca
Tipo de estudio:
Etiology_studies
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Pol Arch Intern Med
Año:
2019
Tipo del documento:
Article
País de afiliación:
Polonia