Heart failure & cardiomyopathies
Is it time to consider a “time-out” before primary prevention implantable cardioverter-defibrillator placement in currently or recently hospitalized older patients with heart failure?
Authors' conclusion
Primary prevention ICD placement during or soon after hospitalization for any reason was associated with worse mortality with diminishing risks after 90 days.
Study context
- Population
- Older patients with HF undergoing primary prevention implantable cardioverter-defibrillator (ICD) placement, Medicare 2008–2018 (mean age 76 years; 35% female)
- Participants
- 61,710 patients
- Exposure
- Primary prevention ICD placement during or within 90 days of hospitalization vs chronic stable setting
- Current-Hn = 11,947
- Recent-Hn = 15,147
- Chronic stablen = 34,616reference
- Outcome
- Interval mortality rates and hazard ratios (HRs) after ICD placement
- Follow-up
- 0-30, 31-90 and 91-365 days
Methodological details20% Medicare data
- 20% Medicare data
Main finding
As reported in the abstract
Mortality (per 100 person-years) · 0-30 days
Each group vs chronic stableHazard ratio (CI)
Current-H
5.5(4.5–6.8)
Recent-H
3.4(2.8–4.2)
Observational data: associations, not effects.
Further findings
Per 100 person-years
| Outcome | Current-H | Recent-H | HR (CI) | |
|---|---|---|---|---|
| Mortality (per 100 person-years) · 91-365 daysCurrent-Hvs Chronic stable | 21 (CI 20–22) | 16 (CI 15–17) | 2.0 (1.8–2.1) | |
| Mortality (per 100 person-years) · 91-365 daysRecent-Hvs Chronic stable | 1.6 (1.5–1.7) | |||
| 0.512Hazard ratio (log scale) |
HR patterns, cardiac vs non-cardiac hospitalization
- HR patterns similar for cardiac and non-cardiac hospitalizations
Original publication
Is it time to consider a “time-out” before primary prevention implantable cardioverter-defibrillator placement in currently or recently hospitalized older patients with heart failure? Heart Rhythm. Published 13 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →