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.
AIMS: This study assessed the prevalence and the prognostic impact of comorbidities in heart failurepatients 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 failurepatients with an ICD, comorbidities are frequent but only the presence of chronic kidney disease is independently associated with increased morbidity and mortality.
Authors: Alexandra M Hajduk; Jerry H Gurwitz; Grace Tabada; Frederick A Masoudi; David J Magid; Robert T Greenlee; Sue Hee Sung; Andrea E Cassidy-Bushrow; Taylor I Liu; Kristi Reynolds; David H Smith; Frances Fiocchi; Robert Goldberg; Thomas M Gill; Nigel Gupta; Pamela N Peterson; Claudio Schuger; Humberto Vidaillet; Stephen C Hammill; Heather Allore; Alan S Go Journal: J Am Geriatr Soc Date: 2019-03-20 Impact factor: 5.562
Authors: J F Gummert; A Funkat; B Osswald; A Beckmann; W Schiller; A Krian; F Beyersdorf; A Haverich; J Cremer Journal: Clin Res Cardiol Date: 2009-03-05 Impact factor: 5.460
Authors: Dominic A M J Theuns; Beat A Schaer; Osama I I Soliman; David Altmann; Christian Sticherling; Marcel L Geleijnse; Stefan Osswald; Luc Jordaens Journal: Europace Date: 2010-09-10 Impact factor: 5.214
Authors: Stefan Sack; Christian Michael Wende; Herbert Nägele; Amos Katz; Wolfgang Rudolf Bauer; Craig Scott Barr; Klaus Malinowski; Harald Schwacke; Francisco Leyva; Jochen Proff; Sergey Berdyshev; Vincent Paul Journal: Eur J Heart Fail Date: 2011-09 Impact factor: 15.534