Does advanced age increase mortality risk in patients receiving implantable cardioverter defibrillators?
Advanced age at the time of ICD implantation is strongly and independently associated with increased total, cardiac, and non-cardiac mortality, highlighting the need to consider age and comorbidities when anticipating survival.
AIMS: Given the selectivity of clinical trial patients and meager representation of elderly in the major implantable cardioverter defibrillator (ICD) randomized trials (75 years at ICD implantation. The primary outcome was time to death. Mean follow-up was 4 years. Median survival after ICD implantation was 5.3 years among subjects >75 years, less than half that of the youngest group. After adjusting for potential confounders, compared with subjects 75 years hazard ratio (HR), 4.7; 95% confidence interval (CI), 2.8-7.9; P < 0.001 and those 65-75 years (HR, 2.8; 95% CI, 1.7-4.8; P < 0.001) were at greater risk of death. Increased age was associated with higher total, cardiac, and non-cardiac mortality (all P <or= 0.001). CONCLUSION: Age at ICD implantation is strongly and independently associated with mortality. Age should be considered among potential co-morbidities in anticipating survival of the elderly patient prior to ICD implantation.
Pellegrini et al. (Fri,) studied this question.
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