July 1, 2010American Journal of Therapeutics
Implantable Cardioverter-Defibrillators in Patients Hospitalized for Heart Failure With Chronically Reduced Left Ventricular Ejection Fraction
Key result
In patients hospitalized for worsening heart failure with LVEF ≤40%, baseline ICD presence was associated with similar adjusted all-cause mortality (HR 1.01; 95% CI 0.83-1.22) but higher HF rehospitalization.
Why the study?
Does the presence of an ICD at the time of hospitalization for worsening heart failure affect postdischarge mortality and heart failure rehospitalization in patients with LVEF ≤40%?
Population
3,702 patients hospitalized for worsening heart failure with left ventricular ejection fraction ≤40%…
Comparison
Implantable cardioverter-defibrillator present… vs No electrophysiological device at the time of…
Design
Cohort
Follow-up
median 300 days
Authors
Discussion
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Member takes
Implication
ICD not associated with lower mortality but higher HF rehospitalization after adjustment; challenges unadjusted benefits and leaves open optimization strategies.
Study Design
Type
Cohort (n=3,702)
Structured PICO
Does the presence of an ICD at the time of hospitalization for worsening heart failure affect postdischarge mortality and heart failure rehospitalization in patients with LVEF ≤40%?
P
Population
3,702 patients hospitalized for worsening heart failure with left ventricular ejection fraction ≤40%, followed for a median of 300 days.
E
Exposure
Implantable cardioverter-defibrillator (ICD) present at the time of hospitalization for worsening heart failure
C
Comparator
No electrophysiological device at the time of enrollment
O
Outcome
All-cause mortality and rehospitalization for heart failurehard clinical
Main Result
Hazard Ratio: 1.01 (95% CI 0.83–1.22)
Absolute Event Rate: 35.2% vs 22.9%
In patients hospitalized for worsening HFrEF, having an ICD at presentation is associated with similar mortality but higher rates of heart failure rehospitalization compared to those without a device.
Cite This Study
Wang et al. (2010) conducted a cohort in Heart failure with reduced left ventricular ejection fraction (n=3,702). Implantable cardioverter-defibrillator (ICD) vs. No electrophysiological device was evaluated on All-cause mortality (HR 1.01, 95% CI 0.83-1.22). In patients hospitalized for worsening heart failure with LVEF ≤40%, baseline ICD presence was associated with similar adjusted all-cause mortality (HR 1.01; 95% CI 0.83-1.22) but higher HF rehospitalization.