PMID- 30327699
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230928
IS  - 1880-4276 (Print)
IS  - 1883-2148 (Electronic)
IS  - 1880-4276 (Linking)
VI  - 34
IP  - 5
DP  - 2018 Oct
TI  - Mortality outcome and predictive risk factors for death in patients with heart 
      failure and reduced ejection fraction who declined implantable cardioverter 
      defibrillator implantation in Singapore.
PG  - 536-540
LID - 10.1002/joa3.12106 [doi]
AB  - BACKGROUND: There have been conflicting data regarding the risk of sudden cardiac 
      death (SCD) in Asian population with reduced left ventricular ejection fraction 
      (LVEF). We aim to study mortality outcome and its risk predictors in patients 
      with reduced LVEF who declined an implantable cardioverter defibrillator (ICD) 
      implantation and assess whether current ICD guidelines for primary prevention are 
      applicable to the population in Singapore. METHODS: This prospective 
      observational study involved 240 consecutive patients who fulfilled the 
      ACC/AHA/HRS criteria for ICD implantation for primary prevention of SCD but 
      declined ICD implantation. Baseline characteristics and mortality outcomes 
      through May 2017 were collected via case-note review after a mean follow-up of 
      44.8 +/- 16.6 months. RESULTS: Majority of our patients were Chinese (71.3%), 
      followed by Malays (16.2%) and Indians (10.8%). Mean age (+/-SD) was 61 +/- 10 years, 
      and 84% were male. Majority were in New York Heart Association (NYHA) functional 
      classes I (46.7%) and II (46.3%). Over a mean follow-up of 44.8 +/- 16.6 months, 
      all-cause mortality rate was 34.6%. Diabetes mellitus (HR = 1.57; 95% CI, 
      1.01-2.44; P = 0.047) and chronic kidney disease (CKD; HR = 1.95; 95% CI, 
      1.17-3.23; P = 0.010) were independent predictors of mortality. Patients in NYHA 
      classes II (HR = 2.15; 95% CI, 1.32-3.50; P = 0.002) and III (HR = 2.82; 95% CI, 
      1.34-5.96; P = 0.007) showed higher risk of death. CONCLUSION: The mortality rate 
      was comparable with major primary prevention trials. ICD guideline 
      recommendations for primary prevention may thus be applicable to our local 
      population. Patients with diabetes, CKD, and poorer NYHA status exhibited higher 
      mortality rates.
FAU - Khoo, Chun Yuan
AU  - Khoo CY
AUID- ORCID: 0000-0001-6558-1182
AD  - Department of Cardiology National Heart Centre Singapore City Singapore.
FAU - Allen, John Carson
AU  - Allen JC
AD  - Duke-NUS Graduate Medical School Singapore Singapore City Singapore.
FAU - Chia, Shaw Yang
AU  - Chia SY
AD  - Singapore Cardiac Data Bank National Heart Centre Singapore City Singapore.
FAU - Chan, Laura Lihua
AU  - Chan LL
AD  - Department of Cardiology National Heart Centre Singapore City Singapore.
FAU - Lim, Choon Pin
AU  - Lim CP
AD  - Department of Cardiology National Heart Centre Singapore City Singapore.
FAU - Sim, David
AU  - Sim D
AD  - Department of Cardiology National Heart Centre Singapore City Singapore.
FAU - Ching, Chi Keong
AU  - Ching CK
AD  - Department of Cardiology National Heart Centre Singapore City Singapore.
LA  - eng
PT  - Journal Article
DEP - 20180818
PL  - Japan
TA  - J Arrhythm
JT  - Journal of arrhythmia
JID - 101263026
PMC - PMC6174497
OTO - NOTNLM
OT  - Asian population
OT  - heart failure
OT  - implantable cardioverter defibrillator
OT  - mortality outcomes
OT  - primary prevention
EDAT- 2018/10/18 06:00
MHDA- 2018/10/18 06:01
PMCR- 2018/08/18
CRDT- 2018/10/18 06:00
PHST- 2018/04/11 00:00 [received]
PHST- 2018/07/07 00:00 [revised]
PHST- 2018/07/10 00:00 [accepted]
PHST- 2018/10/18 06:00 [entrez]
PHST- 2018/10/18 06:00 [pubmed]
PHST- 2018/10/18 06:01 [medline]
PHST- 2018/08/18 00:00 [pmc-release]
AID - JOA312106 [pii]
AID - 10.1002/joa3.12106 [doi]
PST - epublish
SO  - J Arrhythm. 2018 Aug 18;34(5):536-540. doi: 10.1002/joa3.12106. eCollection 2018 
      Oct.