Long-Term Outcomes in ICD: All-Causes Mortality and First Appropriate Intervention in Ischemic and Nonischemic Etiologies
Real-life data comparing the long-term outcome in patients with different heart diseases carrying an implantable cardioverter defibrillator (ICD) are scarce. This study aimed to compare the long-term risk of the first appropriate ICD intervention and overall survival in patients with ICD and heart d...
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Veröffentlicht in: | The American journal of cardiology 2024-12, Vol.233, p.35-44 |
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creator | Cittar, Marco Zecchin, Massimo Merlo, Marco Piccinin, Francesca Baggio, Chiara Salvatore, Luca Longaro, Fulvia Carriere, Cosimo Zorzin, Anna Fantasia Saitta, Monica Pagura, Linda Barbati, Giulia Lardieri, Gerardina Sinagra, Gianfranco |
description | Real-life data comparing the long-term outcome in patients with different heart diseases carrying an implantable cardioverter defibrillator (ICD) are scarce. This study aimed to compare the long-term risk of the first appropriate ICD intervention and overall survival in patients with ICD and heart disease of different etiologies. Patients with an ICD implanted between January 1, 2010, and December 31, 2022, followed in our center were included. Study outcomes were all-cause mortality and first appropriate ICD intervention. A comparison between ischemic heart disease (IHD) and non-IHD (NIHD) was performed. In NIHD different etiologies of dilated cardiomyopathy (DCM) were analyzed. Overall, 1184 patients (592 IDH; 592 NIHD) were included. During a median follow-up of 53 months all-cause death occurred in 399 patients (34%) whereas first appropriate ICD intervention occurred in 320 (27%). All-cause mortality was significantly higher in IHD vs NIHD patients (60% vs 43%; p |
doi_str_mv | 10.1016/j.amjcard.2024.09.026 |
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This study aimed to compare the long-term risk of the first appropriate ICD intervention and overall survival in patients with ICD and heart disease of different etiologies. Patients with an ICD implanted between January 1, 2010, and December 31, 2022, followed in our center were included. Study outcomes were all-cause mortality and first appropriate ICD intervention. A comparison between ischemic heart disease (IHD) and non-IHD (NIHD) was performed. In NIHD different etiologies of dilated cardiomyopathy (DCM) were analyzed. Overall, 1184 patients (592 IDH; 592 NIHD) were included. During a median follow-up of 53 months all-cause death occurred in 399 patients (34%) whereas first appropriate ICD intervention occurred in 320 (27%). All-cause mortality was significantly higher in IHD vs NIHD patients (60% vs 43%; p <0.0001) but no differences in appropriate ICD intervention rate at 10 years (34% vs 40%; p = 0.125) were observed. In patients with NIHD, a higher 10-year mortality rate was found in valvular heart disease, post-radio/chemotherapy DCM (rctDCM), and hypertensive DCM. Hypertrophic cardiomyopathy, alcoholic DCM, and rctDCM were the least arrhythmic phenotypes in NIHD. Of note, inappropriate interventions in alcoholic DCM and rctDCM were higher than appropriate ones. In conclusion, the rate of ICD-appropriate interventions and mortality is different according to the etiology of heart disease and cardiovascular risk profile; this should be taken into consideration in the prognostic stratification of these patients at the time of implantation.</description><identifier>ISSN: 0002-9149</identifier><identifier>ISSN: 1879-1913</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2024.09.026</identifier><identifier>PMID: 39370093</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; all-cause mortality ; appropriate ; Cardiac arrhythmia ; Cardiomyopathy ; Cardiomyopathy, Dilated - complications ; Cardiomyopathy, Dilated - mortality ; Cardiomyopathy, Dilated - therapy ; Cardiovascular disease ; Cardiovascular diseases ; Cause of Death - trends ; Chemotherapy ; Clinical outcomes ; Congenital diseases ; Death, Sudden, Cardiac - epidemiology ; Death, Sudden, Cardiac - prevention & control ; Defibrillators, Implantable ; Diabetes ; Dilated cardiomyopathy ; Disease prevention ; etiologies ; Etiology ; Female ; Follow-Up Studies ; Heart diseases ; Heart failure ; Heart rate ; Humans ; Hypertension ; implantable cardioverter defibrillator ; inappropriate ; Intervention ; Ischemia ; Male ; Middle Aged ; Mortality ; Myocardial Ischemia - complications ; Myocardial Ischemia - mortality ; Myocardial Ischemia - therapy ; Myocarditis ; nonischemic ; Outpatient care facilities ; Pacemakers ; Phenotypes ; Retrospective Studies ; Survival Rate - trends ; Time Factors ; Transplants & implants</subject><ispartof>The American journal of cardiology, 2024-12, Vol.233, p.35-44</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><rights>2024. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c271t-58dcaa80c82d4468f0777e2f5dc25866990279c33dacfe57718861e3228d7ce3</cites><orcidid>0000-0003-0577-6281</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.amjcard.2024.09.026$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39370093$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cittar, Marco</creatorcontrib><creatorcontrib>Zecchin, Massimo</creatorcontrib><creatorcontrib>Merlo, Marco</creatorcontrib><creatorcontrib>Piccinin, Francesca</creatorcontrib><creatorcontrib>Baggio, Chiara</creatorcontrib><creatorcontrib>Salvatore, Luca</creatorcontrib><creatorcontrib>Longaro, Fulvia</creatorcontrib><creatorcontrib>Carriere, Cosimo</creatorcontrib><creatorcontrib>Zorzin, Anna Fantasia</creatorcontrib><creatorcontrib>Saitta, Monica</creatorcontrib><creatorcontrib>Pagura, Linda</creatorcontrib><creatorcontrib>Barbati, Giulia</creatorcontrib><creatorcontrib>Lardieri, Gerardina</creatorcontrib><creatorcontrib>Sinagra, Gianfranco</creatorcontrib><title>Long-Term Outcomes in ICD: All-Causes Mortality and First Appropriate Intervention in Ischemic and Nonischemic Etiologies</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Real-life data comparing the long-term outcome in patients with different heart diseases carrying an implantable cardioverter defibrillator (ICD) are scarce. This study aimed to compare the long-term risk of the first appropriate ICD intervention and overall survival in patients with ICD and heart disease of different etiologies. Patients with an ICD implanted between January 1, 2010, and December 31, 2022, followed in our center were included. Study outcomes were all-cause mortality and first appropriate ICD intervention. A comparison between ischemic heart disease (IHD) and non-IHD (NIHD) was performed. In NIHD different etiologies of dilated cardiomyopathy (DCM) were analyzed. Overall, 1184 patients (592 IDH; 592 NIHD) were included. During a median follow-up of 53 months all-cause death occurred in 399 patients (34%) whereas first appropriate ICD intervention occurred in 320 (27%). All-cause mortality was significantly higher in IHD vs NIHD patients (60% vs 43%; p <0.0001) but no differences in appropriate ICD intervention rate at 10 years (34% vs 40%; p = 0.125) were observed. In patients with NIHD, a higher 10-year mortality rate was found in valvular heart disease, post-radio/chemotherapy DCM (rctDCM), and hypertensive DCM. Hypertrophic cardiomyopathy, alcoholic DCM, and rctDCM were the least arrhythmic phenotypes in NIHD. Of note, inappropriate interventions in alcoholic DCM and rctDCM were higher than appropriate ones. In conclusion, the rate of ICD-appropriate interventions and mortality is different according to the etiology of heart disease and cardiovascular risk profile; this should be taken into consideration in the prognostic stratification of these patients at the time of implantation.</description><subject>Aged</subject><subject>all-cause mortality</subject><subject>appropriate</subject><subject>Cardiac arrhythmia</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Dilated - complications</subject><subject>Cardiomyopathy, Dilated - mortality</subject><subject>Cardiomyopathy, Dilated - therapy</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cause of Death - trends</subject><subject>Chemotherapy</subject><subject>Clinical outcomes</subject><subject>Congenital diseases</subject><subject>Death, Sudden, Cardiac - epidemiology</subject><subject>Death, Sudden, Cardiac - prevention & control</subject><subject>Defibrillators, Implantable</subject><subject>Diabetes</subject><subject>Dilated cardiomyopathy</subject><subject>Disease prevention</subject><subject>etiologies</subject><subject>Etiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Hypertension</subject><subject>implantable cardioverter defibrillator</subject><subject>inappropriate</subject><subject>Intervention</subject><subject>Ischemia</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Ischemia - complications</subject><subject>Myocardial Ischemia - mortality</subject><subject>Myocardial Ischemia - therapy</subject><subject>Myocarditis</subject><subject>nonischemic</subject><subject>Outpatient care facilities</subject><subject>Pacemakers</subject><subject>Phenotypes</subject><subject>Retrospective Studies</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Transplants & implants</subject><issn>0002-9149</issn><issn>1879-1913</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9v1DAQxS0EokvhI4AiceGS4D9JbHNBq6UtKy30snfL2JPiKLEX26m03x63u-2BC6fRjH5v5mkeQu8Jbggm_eex0fNodLQNxbRtsGww7V-gFRFc1kQS9hKtMMa0lqSVF-hNSmNpCen61-iCScYxlmyFjrvg7-o9xLm6XbIJM6TK-Wq7-falWk9TvdFLKqMfIWY9uXystLfVtYspV-vDIYZDdDpDtfUZ4j347IJ_1CfzG2ZnHvGfwbun_qoQU7hzkN6iV4OeErw710u0v77ab77Xu9ub7Wa9qw3lJNedsEZrgY2gtm17MWDOOdChs4Z2ou-lxJRLw5jVZoCOcyJET4BRKiw3wC7Rp9PaYvbPAimruZiBadIewpIUI4TxlrOeFvTjP-gYluiLuUIxIghrW1yo7kSZGFKKMKjyg1nHoyJYPUSjRnWORj1Eo7BUJZqi-3DevvyawT6rnrIowNcTAOUb9w6iSsaBN2BdBJOVDe4_J_4CFVKhkw</recordid><startdate>20241215</startdate><enddate>20241215</enddate><creator>Cittar, Marco</creator><creator>Zecchin, Massimo</creator><creator>Merlo, Marco</creator><creator>Piccinin, Francesca</creator><creator>Baggio, Chiara</creator><creator>Salvatore, Luca</creator><creator>Longaro, Fulvia</creator><creator>Carriere, Cosimo</creator><creator>Zorzin, Anna Fantasia</creator><creator>Saitta, Monica</creator><creator>Pagura, Linda</creator><creator>Barbati, Giulia</creator><creator>Lardieri, Gerardina</creator><creator>Sinagra, Gianfranco</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0577-6281</orcidid></search><sort><creationdate>20241215</creationdate><title>Long-Term Outcomes in ICD: All-Causes Mortality and First Appropriate Intervention in Ischemic and Nonischemic Etiologies</title><author>Cittar, Marco ; Zecchin, Massimo ; Merlo, Marco ; Piccinin, Francesca ; Baggio, Chiara ; Salvatore, Luca ; Longaro, Fulvia ; Carriere, Cosimo ; Zorzin, Anna Fantasia ; Saitta, Monica ; Pagura, Linda ; Barbati, Giulia ; Lardieri, Gerardina ; Sinagra, Gianfranco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c271t-58dcaa80c82d4468f0777e2f5dc25866990279c33dacfe57718861e3228d7ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>all-cause mortality</topic><topic>appropriate</topic><topic>Cardiac arrhythmia</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Dilated - complications</topic><topic>Cardiomyopathy, Dilated - mortality</topic><topic>Cardiomyopathy, Dilated - therapy</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cause of Death - trends</topic><topic>Chemotherapy</topic><topic>Clinical outcomes</topic><topic>Congenital diseases</topic><topic>Death, Sudden, Cardiac - epidemiology</topic><topic>Death, Sudden, Cardiac - prevention & control</topic><topic>Defibrillators, Implantable</topic><topic>Diabetes</topic><topic>Dilated cardiomyopathy</topic><topic>Disease prevention</topic><topic>etiologies</topic><topic>Etiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Hypertension</topic><topic>implantable cardioverter defibrillator</topic><topic>inappropriate</topic><topic>Intervention</topic><topic>Ischemia</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial Ischemia - complications</topic><topic>Myocardial Ischemia - mortality</topic><topic>Myocardial Ischemia - therapy</topic><topic>Myocarditis</topic><topic>nonischemic</topic><topic>Outpatient care facilities</topic><topic>Pacemakers</topic><topic>Phenotypes</topic><topic>Retrospective Studies</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cittar, Marco</creatorcontrib><creatorcontrib>Zecchin, Massimo</creatorcontrib><creatorcontrib>Merlo, Marco</creatorcontrib><creatorcontrib>Piccinin, Francesca</creatorcontrib><creatorcontrib>Baggio, Chiara</creatorcontrib><creatorcontrib>Salvatore, Luca</creatorcontrib><creatorcontrib>Longaro, Fulvia</creatorcontrib><creatorcontrib>Carriere, Cosimo</creatorcontrib><creatorcontrib>Zorzin, Anna Fantasia</creatorcontrib><creatorcontrib>Saitta, Monica</creatorcontrib><creatorcontrib>Pagura, Linda</creatorcontrib><creatorcontrib>Barbati, Giulia</creatorcontrib><creatorcontrib>Lardieri, Gerardina</creatorcontrib><creatorcontrib>Sinagra, Gianfranco</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cittar, Marco</au><au>Zecchin, Massimo</au><au>Merlo, Marco</au><au>Piccinin, Francesca</au><au>Baggio, Chiara</au><au>Salvatore, Luca</au><au>Longaro, Fulvia</au><au>Carriere, Cosimo</au><au>Zorzin, Anna Fantasia</au><au>Saitta, Monica</au><au>Pagura, Linda</au><au>Barbati, Giulia</au><au>Lardieri, Gerardina</au><au>Sinagra, Gianfranco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Outcomes in ICD: All-Causes Mortality and First Appropriate Intervention in Ischemic and Nonischemic Etiologies</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2024-12-15</date><risdate>2024</risdate><volume>233</volume><spage>35</spage><epage>44</epage><pages>35-44</pages><issn>0002-9149</issn><issn>1879-1913</issn><eissn>1879-1913</eissn><abstract>Real-life data comparing the long-term outcome in patients with different heart diseases carrying an implantable cardioverter defibrillator (ICD) are scarce. This study aimed to compare the long-term risk of the first appropriate ICD intervention and overall survival in patients with ICD and heart disease of different etiologies. Patients with an ICD implanted between January 1, 2010, and December 31, 2022, followed in our center were included. Study outcomes were all-cause mortality and first appropriate ICD intervention. A comparison between ischemic heart disease (IHD) and non-IHD (NIHD) was performed. In NIHD different etiologies of dilated cardiomyopathy (DCM) were analyzed. Overall, 1184 patients (592 IDH; 592 NIHD) were included. During a median follow-up of 53 months all-cause death occurred in 399 patients (34%) whereas first appropriate ICD intervention occurred in 320 (27%). All-cause mortality was significantly higher in IHD vs NIHD patients (60% vs 43%; p <0.0001) but no differences in appropriate ICD intervention rate at 10 years (34% vs 40%; p = 0.125) were observed. In patients with NIHD, a higher 10-year mortality rate was found in valvular heart disease, post-radio/chemotherapy DCM (rctDCM), and hypertensive DCM. Hypertrophic cardiomyopathy, alcoholic DCM, and rctDCM were the least arrhythmic phenotypes in NIHD. Of note, inappropriate interventions in alcoholic DCM and rctDCM were higher than appropriate ones. In conclusion, the rate of ICD-appropriate interventions and mortality is different according to the etiology of heart disease and cardiovascular risk profile; this should be taken into consideration in the prognostic stratification of these patients at the time of implantation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39370093</pmid><doi>10.1016/j.amjcard.2024.09.026</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0577-6281</orcidid></addata></record> |
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subjects | Aged all-cause mortality appropriate Cardiac arrhythmia Cardiomyopathy Cardiomyopathy, Dilated - complications Cardiomyopathy, Dilated - mortality Cardiomyopathy, Dilated - therapy Cardiovascular disease Cardiovascular diseases Cause of Death - trends Chemotherapy Clinical outcomes Congenital diseases Death, Sudden, Cardiac - epidemiology Death, Sudden, Cardiac - prevention & control Defibrillators, Implantable Diabetes Dilated cardiomyopathy Disease prevention etiologies Etiology Female Follow-Up Studies Heart diseases Heart failure Heart rate Humans Hypertension implantable cardioverter defibrillator inappropriate Intervention Ischemia Male Middle Aged Mortality Myocardial Ischemia - complications Myocardial Ischemia - mortality Myocardial Ischemia - therapy Myocarditis nonischemic Outpatient care facilities Pacemakers Phenotypes Retrospective Studies Survival Rate - trends Time Factors Transplants & implants |
title | Long-Term Outcomes in ICD: All-Causes Mortality and First Appropriate Intervention in Ischemic and Nonischemic Etiologies |
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