Abstract | BACKGROUND: METHODS: The study included 696 patients who underwent ICD placement for clinical reasons (59% primary, 41% secondary prevention) at the University of Alabama at Birmingham between January 2002 and September 2007. CKD was defined as an estimated glomerular filtration rate<60 ml/min/1.73 m(2) but not on dialysis. Outcomes of interest included overall mortality and first appropriate ICD therapy (shocks or anti- tachycardia pacing). RESULTS: After a follow-up of 50 ± 24 months, 213 patients died (31%) and 111 (16%) received appropriate ICD therapy. Patients with CKD had higher mortality than patients with no CKD in the primary (43% vs. 15%, p<0.001) and secondary prevention (37% vs. 23%, p = 0.003) groups. Patients with CKD were at higher risk of receiving an appropriate ICD therapy than patients without CKD in the primary (p<0.001) but not secondary prevention (p = 0.9) cohort. After adjusting for age, gender and multiple risk factors, CKD was independently associated with all-cause mortality and ICD therapy in the primary prevention group (HR 2.08 [1.34-3.23] and 3.53 [1.75-7.10], p = 0.001 and <0.0001, respectively) but not in the secondary prevention group (HR 1.27 [0.81-2.00], and 0.63 [0.35-1.13], p=0.3 and 0.2, respectively). CONCLUSIONS: CKD is independently associated with increased mortality and appropriate ICD therapy in patients undergoing ICD implantation for primary but not secondary prevention.
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Authors | Fadi G Hage, Wael Aljaroudi, Himanshu Aggarwal, Vikas Bhatia, John Miller, Harish Doppalapudi, Oussama Wazni, Ami E Iskandrian |
Journal | International journal of cardiology
(Int J Cardiol)
Vol. 165
Issue 1
Pg. 113-6
(Apr 30 2013)
ISSN: 1874-1754 [Electronic] Netherlands |
PMID | 21862150
(Publication Type: Comparative Study, Journal Article)
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Copyright | Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Topics |
- Adult
- Aged
- Cohort Studies
- Defibrillators, Implantable
(trends)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Primary Prevention
(trends)
- Renal Insufficiency, Chronic
(mortality, therapy)
- Secondary Prevention
(trends)
- Survival Rate
(trends)
- Treatment Outcome
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