Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death
Background: Recent MADIT II and SCD-HeFT trials have led to an expansion of indications for use of prophylactic Implantable Cardioverter Defibrillator (ICD) in patients with severe left-ventricular impairment. This therapy has not been fully adopted in our health care system, mainly due to its high...
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2008
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| Acceso en línea: | https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_0066782X_v90_n5_p311_Hadid http://hdl.handle.net/20.500.12110/paper_0066782X_v90_n5_p311_Hadid |
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paper:paper_0066782X_v90_n5_p311_Hadid2023-06-08T15:06:14Z Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death Death, sudden Defibrillators, implantable Heart failure, congestive/mortality adult aged article clinical practice congestive heart failure controlled study defibrillator disease severity female follow up health care cost health care system heart left ventricle failure human long term care major clinical study male mortality teleconsultation treatment outcome Aged Argentina Death, Sudden, Cardiac Defibrillators, Implantable Epidemiologic Methods Female Heart Failure Humans Male Middle Aged Placebo Effect Randomized Controlled Trials as Topic Treatment Outcome Ventricular Dysfunction, Left Background: Recent MADIT II and SCD-HeFT trials have led to an expansion of indications for use of prophylactic Implantable Cardioverter Defibrillator (ICD) in patients with severe left-ventricular impairment. This therapy has not been fully adopted in our health care system, mainly due to its high cost. Objective: To assess total mortality of SCD-HeFT-like patients from our daily practice who are under stable, optimal medical treatment and who have not received an ICD; and to compare it to that of the placebo arm of the SCD-HeFT Trial. Methods: SCD-HeFT-like patients identified from office medical records were included in our study. Total mortality was assessed by telephone contact. Statistical analysis was performed by Student's t-Test, Mann-Whitney Test or χ2 test, depending on the type of variable. Cumulative mortality rates were calculated according to the Kaplan-Meier method. Results: Our study comprised 102 patients (seventy-four of which were men) with a median age of 64 years, and an overall median ejection fraction of 25%. We found no differences between our patients and SCD-HeFT patients across these 3 variables. Over a 19.6-month follow-up period, 21 patients died (20.6%) vs 28.8% of the SCD-HeFT patients. This difference was not statistically significant (p = 0.08). Conclusion: SCD-HeFT-like patients from our practice had no difference in mortality rate than patients enrolled in the placebo arm of the SCD-HeFT trial. These results suggest that the SCD-HeFT population is representative of our patients. 2008 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_0066782X_v90_n5_p311_Hadid http://hdl.handle.net/20.500.12110/paper_0066782X_v90_n5_p311_Hadid |
| institution |
Universidad de Buenos Aires |
| institution_str |
I-28 |
| repository_str |
R-134 |
| collection |
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) |
| topic |
Death, sudden Defibrillators, implantable Heart failure, congestive/mortality adult aged article clinical practice congestive heart failure controlled study defibrillator disease severity female follow up health care cost health care system heart left ventricle failure human long term care major clinical study male mortality teleconsultation treatment outcome Aged Argentina Death, Sudden, Cardiac Defibrillators, Implantable Epidemiologic Methods Female Heart Failure Humans Male Middle Aged Placebo Effect Randomized Controlled Trials as Topic Treatment Outcome Ventricular Dysfunction, Left |
| spellingShingle |
Death, sudden Defibrillators, implantable Heart failure, congestive/mortality adult aged article clinical practice congestive heart failure controlled study defibrillator disease severity female follow up health care cost health care system heart left ventricle failure human long term care major clinical study male mortality teleconsultation treatment outcome Aged Argentina Death, Sudden, Cardiac Defibrillators, Implantable Epidemiologic Methods Female Heart Failure Humans Male Middle Aged Placebo Effect Randomized Controlled Trials as Topic Treatment Outcome Ventricular Dysfunction, Left Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death |
| topic_facet |
Death, sudden Defibrillators, implantable Heart failure, congestive/mortality adult aged article clinical practice congestive heart failure controlled study defibrillator disease severity female follow up health care cost health care system heart left ventricle failure human long term care major clinical study male mortality teleconsultation treatment outcome Aged Argentina Death, Sudden, Cardiac Defibrillators, Implantable Epidemiologic Methods Female Heart Failure Humans Male Middle Aged Placebo Effect Randomized Controlled Trials as Topic Treatment Outcome Ventricular Dysfunction, Left |
| description |
Background: Recent MADIT II and SCD-HeFT trials have led to an expansion of indications for use of prophylactic Implantable Cardioverter Defibrillator (ICD) in patients with severe left-ventricular impairment. This therapy has not been fully adopted in our health care system, mainly due to its high cost. Objective: To assess total mortality of SCD-HeFT-like patients from our daily practice who are under stable, optimal medical treatment and who have not received an ICD; and to compare it to that of the placebo arm of the SCD-HeFT Trial. Methods: SCD-HeFT-like patients identified from office medical records were included in our study. Total mortality was assessed by telephone contact. Statistical analysis was performed by Student's t-Test, Mann-Whitney Test or χ2 test, depending on the type of variable. Cumulative mortality rates were calculated according to the Kaplan-Meier method. Results: Our study comprised 102 patients (seventy-four of which were men) with a median age of 64 years, and an overall median ejection fraction of 25%. We found no differences between our patients and SCD-HeFT patients across these 3 variables. Over a 19.6-month follow-up period, 21 patients died (20.6%) vs 28.8% of the SCD-HeFT patients. This difference was not statistically significant (p = 0.08). Conclusion: SCD-HeFT-like patients from our practice had no difference in mortality rate than patients enrolled in the placebo arm of the SCD-HeFT trial. These results suggest that the SCD-HeFT population is representative of our patients. |
| title |
Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death |
| title_short |
Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death |
| title_full |
Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death |
| title_fullStr |
Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death |
| title_full_unstemmed |
Long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death |
| title_sort |
long-term follow-up of patients with indication for a implantable defibrillator for primary prevention of death |
| publishDate |
2008 |
| url |
https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_0066782X_v90_n5_p311_Hadid http://hdl.handle.net/20.500.12110/paper_0066782X_v90_n5_p311_Hadid |
| _version_ |
1768546340123443200 |