1. Is Time From Last Hospitalization for Heart Failure to Placement of a Primary Prevention Implantable Cardioverter-Defibrillator Associated With Patient Outcomes?
- Author
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Ambrosy, Andrew P, Parzynski, Craig S, Friedman, Daniel J, Fudim, Marat, Hernandez, Adrian F, Fonarow, Gregg C, Masoudi, Frederick A, and Al-Khatib, Sana M
- Subjects
Cardiovascular ,Prevention ,Heart Disease ,Clinical Research ,Aged ,Aged ,80 and over ,Anti-Arrhythmia Agents ,Defibrillators ,Implantable ,Female ,Heart Failure ,Hospital Mortality ,Hospitalization ,Humans ,Male ,Odds Ratio ,Patient Readmission ,Primary Prevention ,Registries ,Time Factors ,Treatment Outcome ,heart failure ,hospitalization ,defibrillators ,implantable ,treatment outcome ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Public Health and Health Services ,Cardiovascular System & Hematology - Abstract
BACKGROUND:Landmark studies have demonstrated the safety and efficacy of implantable cardioverter-defibrillators (ICDs) in selected stable ambulatory patients with heart failure (HF) with a reduced ejection fraction receiving optimal medical therapy. It is not known whether a recent hospitalization for HF before ICD placement is associated with subsequent outcomes. METHODS:A post hoc analysis was performed of Medicare beneficiaries enrolled in the National Cardiovascular Data Registry's ICD Registry with a known diagnosis of HF and an ejection fraction ≤35% underdoing a new ICD placement for primary prevention. Patients were grouped based on the timing of ICD placement from the last hospitalization for HF. The association between timing of ICD placement and outcomes was assessed by using multivariable logistic regression models. RESULTS:The final analytic cohort included 81 180 patients undergoing initial ICD placement for primary prevention who were currently hospitalized for HF (n=11 563, 14%), hospitalized for HF within 3 months (n=6252, 8%), or hospitalized for HF >3 months previously or had no previous hospitalizations for HF (n=63 365, 78%). Patients currently or recently hospitalized for HF had a higher unadjusted composite periprocedural complication rate (2.60% versus 1.71% versus 1.25%, P
- Published
- 2018