Comparative Effectiveness of Primary Prevention Implantable Cardioverter‐Defibrillators in Older Heart Failure Patients With Diabetes Mellitus

Autor: Abhinav Sharma, Jingjing Wu, Haolin Xu, Adrian Hernandez, G. Michael Felker, Sana Al‐Khatib, Jennifer Green, Roland Matsouaka, Gregg C. Fonarow, Jagmeet P. Singh, Paul A. Heidenreich, Justin A. Ezekowitz, Adam DeVore
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 9, Iss 12 (2020)
Druh dokumentu: article
ISSN: 2047-9980
DOI: 10.1161/JAHA.119.012405
Popis: Background There are conflicting data regarding the benefit of primary prevention implantable cardioverter‐defibrillators (ICDs) in patients with diabetes mellitus and heart failure (HF) with reduced ejection fraction. We aimed to assess the comparative effectiveness of ICD placement in patients with diabetes mellitus and HF with reduced ejection fraction. Methods and Results Data were obtained from the Get With the Guidelines–Health Failure registry, linked with claims from the Centers for Medicare & Medicaid Services. We used a Cox proportional hazards model censored at 5 years with propensity score matching. Of the 17 186 patients with HF with reduced ejection fraction from the Centers for Medicare & Medicaid Services claims database (6540 with diabetes mellitus; 38%), 1677 (646 with diabetes mellitus; 39%) received an ICD during their index HF hospitalization or were prescribed an ICD at discharge. Patients with diabetes mellitus and an ICD (n=646), as compared with those without an ICD (n=1031), were more likely to be younger (74 versus 78 years of age) and have coronary artery disease (68% versus 60%). After propensity matching, ICD use among patients with diabetes mellitus, as compared with those without an ICD, was associated with a reduced risk of all‐cause mortality at 5 years after HF discharge (54% versus 59%; multivariable hazard ratio, 0.73; 95% CI, 0.64–0.82; P
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