Survival Benefit of the Primary Prevention Implantable Cardioverter-Defibrillator Among Older Patients
| Autor: | Arthur J. Moss, J. Thomas Bigger, Daniel B. Mark, Gust H. Bardy, Alan H. Kadish, Sana M. Al-Khatib, Paul Dorian, Richard C. Steinman, Joo Yoon Han, Peter J. Kudenchuk, Rex Edwards, Alfred E. Buxton, Al Hallstrom, Paul L. Hess, Kerry L. Lee, Gillian D Sanders, Lurdes Y. T. Inoue, Riccardo Cappato |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Electric Countershock Comorbidity Kaplan-Meier Estimate Patient Readmission Risk Assessment Article Sudden cardiac death Risk Factors Interquartile range Internal medicine Credible interval Humans Medicine Aged Proportional Hazards Models Retrospective Studies Clinical Trials as Topic Chi-Square Distribution business.industry Hazard ratio Age Factors Bayes Theorem Middle Aged Implantable cardioverter-defibrillator medicine.disease Defibrillators Implantable Surgery Primary Prevention Clinical trial Death Sudden Cardiac Logistic Models Treatment Outcome Heart failure Linear Models Female Cardiomyopathies Cardiology and Cardiovascular Medicine business Multicenter Automatic Defibrillator Implantation Trial |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 8:179-186 |
| ISSN: | 1941-7705 1941-7713 |
| DOI: | 10.1161/circoutcomes.114.001306 |
| Popis: | Background— The impact of patient age on the risks of death or rehospitalization after primary prevention implantable cardioverter-defibrillator (ICD) placement is uncertain. Methods and Results— Data from 5 major ICD trials were merged: the Multicenter Automatic Defibrillator Implantation Trial I (MADIT-I), the Multicenter UnSustained Tachycardia Trial (MUSTT), the Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II), the Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation Trial (DEFINITE), and the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Median age at enrollment was 62 (interquartile range 53–70) years. Compared with their younger counterparts, older patients had a greater burden of comorbid illness. In unadjusted exploratory analyses, ICD recipients were less likely to die than nonrecipients in all age groups: among patients aged Conclusions— In this analysis, the survival benefit of the ICD exists but is attenuated with increasing age. The latter finding may be because of the higher burden of comorbid illness, competing causes of death, or limited sample size of older patients. There was no evidence that age modifies the association between ICD treatment and rehospitalization. |
| Databáze: | OpenAIRE |
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