1. The mortality analysis of primary prevention patients receiving a cardiac resynchronization defibrillator (CRT‐D) or implantable cardioverter‐defibrillator (ICD) according to guideline indications in the improve SCA study
- Author
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Yen-Bing Liu, Jeffrey Cerkvenik, Yu-Cheng Hsieh, Boyoung Joung, A. Chasnoits, Brian Van Dorn, Janet E. O'Brien, Diego A. Rodriguez, Chi Keong Ching, Daniel R. Lexcen, Azlan Hussin, Balbir Singh, Shu Zhang, Younghoon Kim, and Dejia Huang
- Subjects
medicine.medical_specialty ,Defibrillation ,medicine.medical_treatment ,Sudden cardiac death ,Cardiac Resynchronization Therapy ,Risk Factors ,Physiology (medical) ,Internal medicine ,Multicenter trial ,medicine ,Humans ,Cardiac Resynchronization Therapy Devices ,Prospective Studies ,Heart Failure ,Proportional hazards model ,business.industry ,Hazard ratio ,Sudden cardiac arrest ,Guideline ,Implantable cardioverter-defibrillator ,medicine.disease ,Defibrillators, Implantable ,Primary Prevention ,Treatment Outcome ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
BACKGROUND In primary prevention (PP) patients the utilization of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy-defibrillators (CRT-D) remains low in many geographies, despite the proven mortality benefit. PURPOSE The objective of this analysis was to examine the mortality benefit in PP patients by guideline-indicated device type: ICD and CRT-D. METHODS Improve sudden cardiac arrest was a prospective, nonrandomized, nonblinded multicenter trial that enrolled patients from regions where ICD utilization is low. PP patient's CRT-D or ICD eligibility was based upon the 2008 ACC/AHA/HRS and 2006 ESC guidelines. Mortality was assessed according to guideline-indicated device type comparing implanted and nonimplanted patients. Cox proportional hazards methods were used, adjusting for known factors affecting mortality risk. RESULTS Among 2618 PP patients followed for a mean of 20.8 ± 10.8 months, 1073 were indicated for a CRT-D, and 1545 were indicated for an ICD. PP CRT-D-indicated patients who received CRT-D therapy had a 58% risk reduction in mortality compared with those without implant (adjusted hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.28-0.61, p
- Published
- 2021
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