Document Detail

Risk factors for appropriate cardioverter-defibrillator shocks, inappropriate cardioverter-defibrillator shocks, and time to mortality in 549 patients with heart failure.
MedLine Citation:
PMID:  20403488     Owner:  NLM     Status:  MEDLINE    
We investigated the risk factors for appropriate and inappropriate implantable cardioverter-defibrillator (ICD) shocks and mortality in 549 patients (mean age 74 years) with heart failure and ICDs. During a mean follow-up of 1,243 + or - 655 days, of the 549 patients, 163 (30%) had appropriate ICD shocks, 71 (13%) had inappropriate ICD shocks, and 63 (12%) died. Stepwise logistic regression analysis showed that significant independent prognostic factors for appropriate ICD shocks were smoking (odds ratio 3.7) and statins (odds ratio 0.54). The significant independent prognostic factors for inappropriate ICD shocks were atrial fibrillation (odds ratio 6.2) and statins (odds ratio 0.52). Finally, those for the interval to mortality were age (hazard ratio 1.08/1-year increase), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (hazard ratio 0.25), atrial fibrillation (hazard ratio 4.1), right ventricular pacing (hazard ratio 3.6), digoxin (hazard ratio 2.9), hypertension (hazard ratio 5.3), and statins (hazard ratio 0.32). In conclusion, in patients with heart failure and ICDs, smoking increased and statins reduced appropriate ICD shocks, atrial fibrillation increased and statins reduced inappropriate ICD shocks, and the interval to mortality was increased by age, atrial fibrillation, right ventricular pacing, hypertension, and digoxin and reduced by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and statins.
Harit Desai; Wilbert S Aronow; Chul Ahn; Kaushang Gandhi; Sadaf Hussain; Hoang M Lai; Mala Sharma; William H Frishman; Martin Cohen; Carmine Sorbera
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-03-11
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-06-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1336-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY, USA.
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MeSH Terms
Cause of Death / trends
Electric Countershock / methods*
Follow-Up Studies
Heart Failure / mortality,  physiopathology,  therapy*
Retrospective Studies
Risk Factors
Stroke Volume
Survival Rate / trends
Time Factors
Treatment Outcome
United States

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