Real-world evidence on the association between cardiac implantable electronic device infection and all-cause mortality

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Patients undergoing cardiac implantable electronic device (CIED) procedures (n=37750). Intervention: Cardiac implantable electronic device (CIED) infection vs. No CIED infection. Primary outcome: All-cause mortality at 12 months post-procedure (aHR 2.73, 95% CI 2.10-3.54).

Q: What does this research mean for the field?

Cardiac implantable electronic device infection is associated with significantly increased risks of both short-term and long-term all-cause mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Md Shajedur Rahman Shawon; Oluwadamisola Temilade Sotade; Michelle Hill; Liesl Strachan; Gabrielle Challis; Sze‐Yuan Ooi; Louisa R. Jorm

doi:10.1093/europace/euad274

August 2, 2023EP EuropaceOpen Access

Real-world evidence on the association between cardiac implantable electronic device infection and all-cause mortality

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Key result

CIED infection is linked to ~173% higher 12-month all-cause mortality.

aHR 2.73
95% CI 2.10-3.54
n=37,750

Figures

Why the study?

The association between cardiac implantable electronic device infection and all-cause mortality is inconsistent across observational studies.

Study Design

Type

Cohort (n=37,750)

Multicenter

Yes

PICO

P

Population

37,750 adult patients (mean age 75.8 years, 36% female) who underwent a CIED procedure in New South Wales, Australia, followed for an average of 25.2 months.

E

Exposure / Comparator

Cardiac implantable electronic device (CIED) infection vs No CIED infection

O

Primary Outcome

All-cause mortality at 12 months post-procedure — aHR 2.73 (2.10-3.54)

Main Result

Hazard Ratio: 2.73 (95% CI 2.1–3.54)

Absolute Event Rate: 19.4% vs 6.8%

Limitations

Use of a single diagnostic code to identify CIED infections, which could encompass everything from a localized infection to bacteraemia and septic shock, potentially leading to misclassification of infection severity.

Implication

Elevated short-term mortality risk with CIED infection warrants prevention focus; leaves open causality and need for prospective trials.

Graphical abstract published by EP Europace — Graphical abstract · Published by EP Europace · CC BY-NC

Discussion

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Cite This Study

Shawon et al. (2023) conducted a cohort in Patients undergoing cardiac implantable electronic device (CIED) procedures (n=37,750). Cardiac implantable electronic device (CIED) infection vs. No CIED infection was evaluated on All-cause mortality at 12 months post-procedure (aHR 2.73, 95% CI 2.10-3.54). CIED infection was associated with a significantly higher hazard of all-cause mortality at 12 months post-procedure compared to no infection (aHR 2.73).

synapsesocial.com/papers/6ac5defd7d7ac7ae3bdad643 https://doi.org/10.1093/europace/euad274

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Real-world evidence on the association between cardiac implantable electronic device infection and all-cause mortality

Figures

Study Design

PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

Real-world evidence on the association between cardiac implantable electronic device infection and all-cause mortality

Figures

Study Design

PICO

Main Result

Limitations

Implication

Discussion

Cite This Study

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