AIMS: Recent observational studies have shown that implantable cardioverter defibrillator (ICD) patients with chronic kidney disease (CKD) have increased mortality and therefore the value of device therapy in this group has been questioned. The purpose of this meta-analysis was to systematically analyse the effect of renal dysfunction on mortality of ICD patients. METHODS AND RESULTS: Pubmed, Cochrane clinical trials database, and EMBASE were searched until December 2008. In addition, a manual search was performed using review articles, reference lists of papers, and abstracts from conference reports. Of the 90 initially identified studies, 11 observational studies with 3010 patients were analysed. The meta-analysis of these studies showed that CKD was associated with higher mortality risk (HR = 3.44, 95% CI 2.82-4.21, Z = 12.09, P < 0.001) while there were no significant differences between individual trials (P = 0.09, I(2) = 37.8%). A subgroup analysis which included the four studies that used estimated glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) to define CKD showed a higher mortality in the CKD group as well (HR = 3.06, 95% CI 2.31-4.04, Z = 7.84, P < 0.001) without significant heterogeneity (P = 0.38, I(2) = 5.2%). CONCLUSION: Our meta-analysis suggests that CKD is associated with increased mortality in patients who receive ICD therapy. Undoubtedly, prospective studies are needed in order to elucidate the impact of different stages of CKD in this setting. Given that the CKD prevalence is rapidly increasing, there is an imperative need for better risk stratification of ICD therapy candidates.
AIMS: Recent observational studies have shown that implantable cardioverter defibrillator (ICD) patients with chronic kidney disease (CKD) have increased mortality and therefore the value of device therapy in this group has been questioned. The purpose of this meta-analysis was to systematically analyse the effect of renal dysfunction on mortality of ICDpatients. METHODS AND RESULTS: Pubmed, Cochrane clinical trials database, and EMBASE were searched until December 2008. In addition, a manual search was performed using review articles, reference lists of papers, and abstracts from conference reports. Of the 90 initially identified studies, 11 observational studies with 3010 patients were analysed. The meta-analysis of these studies showed that CKD was associated with higher mortality risk (HR = 3.44, 95% CI 2.82-4.21, Z = 12.09, P < 0.001) while there were no significant differences between individual trials (P = 0.09, I(2) = 37.8%). A subgroup analysis which included the four studies that used estimated glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) to define CKD showed a higher mortality in the CKD group as well (HR = 3.06, 95% CI 2.31-4.04, Z = 7.84, P < 0.001) without significant heterogeneity (P = 0.38, I(2) = 5.2%). CONCLUSION: Our meta-analysis suggests that CKD is associated with increased mortality in patients who receive ICD therapy. Undoubtedly, prospective studies are needed in order to elucidate the impact of different stages of CKD in this setting. Given that the CKD prevalence is rapidly increasing, there is an imperative need for better risk stratification of ICD therapy candidates.
Authors: Mohammed Shurrab; Dennis T Ko; Yazan Zayed; Sankar D Navaneethan; Nour Yadak; Abeer Yaseen; Anna Kaoutskaia; Waad Qamhia; Zakaria Hamdan; Saleem Haj-Yahia; Douglas S Lee; David Newman; Jeff S Healey; Paula Harvey; Eugene Crystal Journal: J Interv Card Electrophysiol Date: 2018-07-30 Impact factor: 1.900
Authors: Wolfgang Dichtl; Thomas Wolber; Ursula Paoli; Thomas Theurl; Simon Brüllmann; Markus Stühlinger; Thomas Berger; Karin Spuller; Alexander Strasak; Otmar Pachinger; Laurent Haegeli; Firat Duru; Florian Hintringer Journal: Wien Klin Wochenschr Date: 2011-09-02 Impact factor: 1.704
Authors: Giuseppe Boriani; Irina Savelieva; Gheorghe-Andrei Dan; Jean Claude Deharo; Charles Ferro; Carsten W Israel; Deirdre A Lane; Gaetano La Manna; Joseph Morton; Angel Moya Mitjans; Marc A Vos; Mintu P Turakhia; Gregory Y H Lip Journal: Europace Date: 2015-06-24 Impact factor: 5.214
Authors: A B Gopalamurugan; G Ganesha Babu; Dominic P Rogers; Adam L Simpson; Syed Y Ahsan; Pier D Lambiase; Anthony W Chow; Martin D Lowe; Edward Rowland; Oliver R Segal Journal: Front Physiol Date: 2014-09-17 Impact factor: 4.566