PMID- 18687703
OWN - NLM
STAT- MEDLINE
DCOM- 20081030
LR  - 20081125
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 10
IP  - 9
DP  - 2008 Sep
TI  - Long-term predictors of mortality in ICD patients with non-ischaemic cardiac 
      disease: impact of renal function.
PG  - 1052-9
LID - 10.1093/europace/eun186 [doi]
AB  - BACKGROUND: Randomized trials have demonstrated that implantable cardioverter 
      defibrillator (ICD) therapy may reduce the risk of death in patients with 
      non-ischaemic cardiomyopathy (CMP). In this study, we aimed at determining the 
      long-term benefit of ICD therapy among patients with dilated CMP (DCM) and among 
      those with other non-ischaemic cardiac diseases (NICDs). METHODS AND RESULTS: We 
      performed a single-centre longitudinal study to assess the outcomes of 176 
      patients with NICDs who were implanted with an ICD for primary or secondary 
      prevention of cardiac death. The cumulative survival rate after 1, 2, 5, and 10 
      years was 91, 87, 78, and 65%, respectively. Mortality risk did not differ 
      significantly between patients with DCM and those with other NICDs. Atrial 
      fibrillation, recurrent ventricular arrhythmias requiring ICD therapy, and right 
      ventricular pacing, but not delayed intrinsic ventricular conduction, were 
      associated with higher risk. New York Heart Association (NYHA) functional class > 
      or =III was an independent predictor of adverse outcome among patients with DCM 
      [hazard ratio (HR) 5.27, P = 0.01], whereas reduced left ventricular function 
      with ejection fraction <35% (HR 12.1, P < 0.001) and anti-arrhythmic drug use (HR 
      4.82, P = 0.03) were independent predictors among those with other NICDs. Renal 
      insufficiency with estimated glomerular filtration rate <60 mL/min/1.73 m(2) (HR 
      5.9, P < 0.001) was a strong independent predictor of mortality among all 
      patients with NICD, irrespective of underlying cardiac condition. CONCLUSION: In 
      ICD patients with DCM, higher NYHA functional class is associated with adverse 
      outcomes. Impaired left ventricular function and anti-arrhythmic drug use predict 
      higher mortality among patients with non-dilated, NICDs. Impaired renal function 
      is a strong predictor of mortality in all patients with NICD.
FAU - Schefer, Thomy
AU  - Schefer T
AD  - Cardiovascular Center, Cardiology, University Hospital Zurich, Raemistr. 100, 
      CH-8091 Zurich, Switzerland.
FAU - Wolber, Thomas
AU  - Wolber T
FAU - Binggeli, Christian
AU  - Binggeli C
FAU - Holzmeister, Johannes
AU  - Holzmeister J
FAU - Brunckhorst, Corinna
AU  - Brunckhorst C
FAU - Duru, Firat
AU  - Duru F
LA  - eng
PT  - Journal Article
DEP - 20080807
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiomyopathies/*mortality/*prevention & control
MH  - Comorbidity
MH  - Defibrillators, Implantable/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Kidney Diseases/diagnosis/*mortality
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/mortality/prevention & control
MH  - Prognosis
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Survival Analysis
MH  - Survival Rate
EDAT- 2008/08/09 09:00
MHDA- 2008/10/31 09:00
CRDT- 2008/08/09 09:00
PHST- 2008/08/09 09:00 [pubmed]
PHST- 2008/10/31 09:00 [medline]
PHST- 2008/08/09 09:00 [entrez]
AID - eun186 [pii]
AID - 10.1093/europace/eun186 [doi]
PST - ppublish
SO  - Europace. 2008 Sep;10(9):1052-9. doi: 10.1093/europace/eun186. Epub 2008 Aug 7.