Document Detail

Prevalence and prognostic impact of comorbidities in heart failure patients with implantable cardioverter defibrillator.
MedLine Citation:
PMID:  17507354     Owner:  NLM     Status:  MEDLINE    
AIMS: This study assessed the prevalence and the prognostic impact of comorbidities in heart failure patients with implantatable cardioverter-defibrillator (ICD). METHODS AND RESULTS: We prospectively enrolled 146 patients with chronic heart failure, an ICD, and systolic dysfunction (mean ejection fraction 29 +/- 10%). Cardiac death was chosen as the primary endpoint. Death or appropriate ICD therapy, i.e. antitachycardia pacing/shock due to sustained ventricular tachycardia or ventricular fibrillation, was chosen as the secondary endpoint. Seventy-five patients (52%) had chronic kidney disease (defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2)), 39 patients (27%) were anaemic, and 34 patients (23%) had diabetes mellitus. During a follow-up of 663 +/- 400 days, 22 patients (15%) died, and 41 patients (28%) received an appropriate ICD therapy. By multivariate Cox analysis, independent predictors of cardiac death were chronic kidney disease, age, and NYHA functional class. Death/appropriate ICD therapy were independently predicted by chronic kidney disease and QRS duration. In the presence of chronic kidney disease, outcome was significantly worse when compared with the absence (event-free survival rate 51 vs. 76%, P < 0.001). CONCLUSION: In heart failure patients with an ICD, comorbidities are frequent but only the presence of chronic kidney disease is independently associated with increased morbidity and mortality.
Christian Bruch; Chahrebanu Bruch; Jürgen Sindermann; Günter Breithardt; Rainer Gradaus
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2007-05-16
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  9     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-13     Completed Date:  2007-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  681-6     Citation Subset:  IM    
Department of Cardiology and Angiology, Hospital of the University of Münster, Albert-Schweitzer-Str.33, D-48129 Münster, Germany.
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MeSH Terms
Cardiac Output, Low / mortality*,  prevention & control*
Death, Sudden, Cardiac / epidemiology*
Defibrillators, Implantable / statistics & numerical data*
Germany / epidemiology
Middle Aged
Risk Assessment / methods*
Risk Factors
Survival Analysis
Survival Rate
Ventricular Fibrillation / mortality*,  prevention & control*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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