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
Hauptverfasser: 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
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container_issue
container_start_page 35
container_title The American journal of cardiology
container_volume 233
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
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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 &lt;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 &amp; 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 &amp; 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 &lt;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 &amp; 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 &amp; 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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 &lt;0.0001) but no differences in appropriate ICD intervention rate at 10 years (34% vs 40%; p = 0.125) were observed. 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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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