Chagas disease is associated with a worse prognosis at 1-year follow-up after implantable cardioverter-defibrillator for secondary prevention in heart failure patients

Autor: Y M Lira, Luiz Carlos Santana Passos, Natalia Ferreira Cardoso de Oliveira, Rodrigo Morel Vieira de Melo, Diogo F C de Azevedo
Rok vydání: 2019
Předmět:
Adult
Chagas Cardiomyopathy
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Population
Cardiomyopathy
Electric Countershock
030204 cardiovascular system & hematology
Risk Assessment
Ventricular Function
Left
03 medical and health sciences
0302 clinical medicine
Risk Factors
Physiology (medical)
Internal medicine
medicine
Prevalence
Secondary Prevention
Humans
030212 general & internal medicine
education
Aged
Retrospective Studies
Heart Failure
education.field_of_study
Ejection fraction
Ischemic cardiomyopathy
business.industry
Incidence (epidemiology)
Incidence
Hazard ratio
Stroke Volume
Middle Aged
Implantable cardioverter-defibrillator
medicine.disease
Defibrillators
Implantable
Treatment Outcome
Heart failure
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Brazil
Zdroj: Journal of cardiovascular electrophysiology. 30(11)
ISSN: 1540-8167
Popis: Introduction There are conflicting data regarding the efficacy of implantable cardioverter-defibrillator (ICD) in Chagas disease (CD) patients. This study aims to evaluate the short-term outcome after ICD for secondary prevention, in a population where CD is a prevalent cause of heart failure (HF). Methods and results Consecutive patients with HF and reduced left ventricular ejection fraction (LVEF), who underwent ICD implantation for secondary prevention of SCD. Clinical and demographic data were collected to investigate mortality predictors at 1 year. During the study period, 117 patients underwent ICD implantation, of which 108 were included. The most frequent causes of HF was CD: 52 (48.1%) and ischemic cardiomyopathy: 20 (18.5%). Chagas and non-Chagas patients were well balanced-male: 32 (61.5%) vs 38 (67.9%), P = .548; age: 59.2 (±10.9) vs 56.8 (±13.4), P = .681; and LVEF: 34.1 (±0.2) vs 31.3 (±8.7), P = .064, respectively. At the mean follow-up of 15.7 months, overall mortality occurred in 14 (12.9%) patients, with a higher incidence in patients with CD cardiomyopathy, 11 (21.2%) vs 3 (5.4%), P = .021 (log-rank). In the multivariate analysis, CD remained as an independent predictor for death (hazard ratio: 4.62, confidence interval [95% CI]: 1.27-16.81, P = .021). Conclusion CD was associated with a poor short-term outcome in patients with HF submitted to ICD implantation for secondary prevention when compared with other HF etiologies. In this specific HF population, ICD indication should be individualized, considering the worst prognosis of these patients.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje