Higher Survival Tied to Prophylactic ICD
(HealthDay News) — Older patients with a left ventricular ejection fraction (LVEF) between 30–35% have higher survival with a prophylactic implantable cardioverter-defibrillator (ICD), according to a study published in the June 4 issue of the Journal of the American Medical Association.
Sana M. Al-Khatib, MD, from the Duke University Medical Center in Durham, NC, and colleagues retrospectively evaluated data for Medicare beneficiaries in the National Cardiovascular Data Registry ICD registry (2006–2007) with an LVEF between 30–35% who received an ICD during a heart failure hospitalization. These patients were compared with similar patients in the Get With The Guidelines-Heart Failure database (GWTG-HF; 2005–2009) with no ICD.
The researchers found that among patients with an LVEF between 30–35% (3,120 patients) there were 248 deaths in the ICD Registry group over a median follow-up of 4.4 years, and 249 deaths in the GWTG-HF group over 2.9 years. For those with an LVEF between 30–35% and an ICD, the risk of all-cause mortality was significantly lower than that seen in matched patients without an ICD (three-year mortality rates: 51.4 vs. 55.0%; hazard ratio, 0.83; P=0.04). Similar results were seen in patients with an LVEF <30% (three-year mortality rates: 45.0 vs. 57.6%; hazard ratio, 0.72; P<0.001).
"These findings support guideline recommendations to implant prophylactic ICDs in eligible patients with an LVEF of ≤35%," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.