| Predictors of death and occurrence of appropriate implantable defibrillator therapies in patients with ischemic cardiomyopathy. | |
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MedLine Citation:
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PMID: 21094356 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Most patients with chronic ischemia and an implantable cardiac defibrillator (ICD) for primary prevention do not experience therapies for ventricular arrhythmias on follow-up. The present study aimed to identify independent clinical, electrocardiographic, and echocardiographic predictors of death and occurrence of ICD therapy in patients with chronic ischemic cardiomyopathy and ICD for primary prevention. A total of 424 patients with chronic ischemic cardiomyopathy, ejection fraction ≤ 35%, and New York Heart Association (NYHA) class ≥ II were recruited. All patients underwent echocardiography before ICD insertion. Primary outcome was all-cause mortality; secondary outcome was occurrence of appropriate ICD therapy on follow-up. Primary and secondary outcomes occurred in 84 and 95 patients, respectively. Patients who died were more likely to have diabetes (hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.00 to 2.79, p = 0.049), higher NYHA class (HR 1.96, 95% CI 1.15 to 3.33, p = 0.013), lower peri-infarct strain on echocardiogram (HR 1.25, 95% CI 1.07 to 1.46, p = 0.005), and lower glomerular filtration rate (HR 1.01, 95% CI 1.00 to 1.03, p = 0.022). Only peri-infarct strain (HR 1.22, 95% CI 1.09 to 1.36, p < 0.001) predicted the occurrence of ICD therapy on follow-up. In conclusion, in chronic ischemic patients with an ICD for primary prevention, the presence of diabetes, renal dysfunction, higher NYHA class, and impaired peri-infarct zone function were predictors of all-cause mortality. In contrast, only impaired peri-infarct zone function determined the occurrence of appropriate ICD therapy on follow-up. |
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Authors:
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Arnold C T Ng; Matteo Bertini; C Jan Willem Borleffs; Victoria Delgado; Eric Boersma; Sebastiaan R D Piers; Joep Thijssen; Gaetano Nucifora; Miriam Shanks; See Hooi Ewe; Mauro Biffi; Nico R L van de Veire; Dominic Y Leung; Martin J Schalij; Jeroen J Bax |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2010-10-14 |
Journal Detail:
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Title: The American journal of cardiology Volume: 106 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-01-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1566-73 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Death, Sudden, Cardiac / epidemiology* Defibrillators, Implantable* Electric Countershock / methods* Electrocardiography Female Follow-Up Studies Humans Male Middle Aged Myocardial Ischemia / complications, mortality, therapy* Prospective Studies Single-Blind Method Survival Rate Tachycardia, Ventricular / etiology, mortality, prevention & control* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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