Mortality among ischemic and nonischemic heart failure patients with a primary implantable cardioverter-defibrillator

Pil Sung Yang, Younghyun Kang, Han Joon Bae, Jung Hoon Sung, Hyung Deuk Park, Boyoung Joung

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The efficacy of implantable cardioverter defibrillators (ICDs) for primary prevention is controversial in patients with nonischemic heart failure (HF). We evaluated the mortality and predictors of mortality in patients with prophylactic ICD implantation for ischemic and nonischemic HF. Methods: From 2008 to 2017, 1097 patients (667, nonischemic HF and 430, ischemic HF) who underwent prophylactic ICD implantation, were identified from the Korean National Health Insurance Service database. We used propensity score overlap weighting to correct the differences between two groups. Results: Those with ischemic HF were older (67.0 ± 10.1 vs 61.8 ± 14.2 years), more often male (71.4% vs 63.7%), and had more comorbidities than patients with nonischemic HF. During a median follow-up of 37.3 months (interquartile range [IQR], 14.2-53.8 months), all-cause mortality was higher in unweighted patients with ischemic HF than in those with nonischemic HF (10.9 vs 6.4 per 100 person-years; hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.38-2.20; P <.001). However, after weighting, the annual all-cause mortality rate was similar in both groups (9.5 vs 8.8 per 100 person-years), with no significant difference in the risk of all-cause mortality (HR, 1.08; 95% CI, 0.68-1.71; P =.755). Older age and chronic kidney disease were independent predictors of all-cause mortality in both groups. There was no significant difference in cardiac and noncardiac mortality between the weighted nonischemic and ischemic HF groups. Conclusions: The all-cause, cardiac, and noncardiac mortality rates were similar between patients with nonischemic and ischemic HF who underwent prophylactic ICD implantation.

Original languageEnglish
Pages (from-to)1537-1545
Number of pages9
Journaljournal of arrhythmia
Volume37
Issue number6
DOIs
Publication statusPublished - 2021 Dec

Bibliographical note

Funding Information:
This work was supported by grants from the Korean Healthcare Technology R&D project funded by the Ministry of Health and Welfare (HI15C1200, HC19C0130) and a CMB-Yuhan research grant from Yonsei University College of Medicine (6-2019-0124). Access to the National Health Information Database was provided by the NHIS of Korea. The authors would like to thank the NHIS for their cooperation.

Funding Information:
This work was supported by grants from the Korean Healthcare Technology R&D project funded by the Ministry of Health and Welfare (HI15C1200, HC19C0130) and a CMB‐Yuhan research grant from Yonsei University College of Medicine (6‐2019‐0124).

Publisher Copyright:
© 2021 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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