News

Survival higher with ICD in patients with LVEF of 30%-35%


 

FROM JAMA

Prophylactic implantable cardioverter-defibrillator use was associated with improved 3-year survival in Medicare beneficiaries with heart failure and a left ventricular ejection fraction of 30%-35% and in those with LVEF less than 30%, compared with no prophylactic ICD use in comparable patients in a retrospective cohort study.

All-cause mortality at 3 years in 408 patients with LVEF of 30% -35% who received a prophylactic ICD was 51.4%, compared with 55% in 408 matched controls without an ICD (hazard ratio, 0.83). The all-cause mortality rates at 3 years in 1,088 patients with LVEF of less than 30% was 45% in those with a prophylactic ICD vs. 57.6% in 1,088 matched controls without an ICD (HR, 0.72), Dr. Sana M. Al-Khatib of Duke University, Durham, N.C., and her colleagues reported in the June 4 issue of JAMA.

Study subjects were Medicare beneficiaries in the National Cardiovascular Data Registry ICD registry during 2006-2007, and similar patients in the Get With the Guidelines-Heart Failure database during 2005-2009 (JAMA 2014;311:2209-15).

Prior studies of prophylactic ICD use have included only a minority of patients with LVEF of 30%-35%; the current findings demonstrate a "clearly significant" benefit in this population and support guideline recommendations calling for prophylactic ICD use in eligible patients with an LVEF of 35% or less, the investigators concluded.

This study was funded by a National Heart, Lung, and Blood Institute grant. Dr. Al-Khatib reported having no disclosures. Detailed disclosures for several of the other study authors are available with the full text of the article at jama.com.

Recommended Reading

Intervention manages cardiac patients with depression, anxiety
MDedge Family Medicine
Life partner provides better heart failure outcomes
MDedge Family Medicine
EXACT-HF: Allopurinol flops for heart failure
MDedge Family Medicine
Vast majority of ED visits for acute heart failure become admissions
MDedge Family Medicine
OA-related walking disability on par with diabetes as CVD risk factor
MDedge Family Medicine
20-study analysis finds no MACE increase with saxagliptin
MDedge Family Medicine
FDA rejects serelaxin for acute heart failure
MDedge Family Medicine
Heart failure: Quality of life, diastolic function rose with intensity-interval exercise
MDedge Family Medicine
In diabetes, women far more likely to develop CHD than men
MDedge Family Medicine
Implantable device approved for remotely monitoring PA in heart failure patients
MDedge Family Medicine