Incidence of Appropriate Cardioverter-Defibrillator Shocks and Mortality in Patients With Heart Failure Treated With Combined Cardiac Resynchronization Plus Implantable Cardioverter-Defibrillator Therapy Versus Implantable Cardioverter-Defibrillator Therapy

• Published in: Journal of cardiovascular pharmacology and therapeutics Vol. 15; no. 1; pp. 37 - 40
• Main Authors: Desai, Harit, Aronow, Wilbert S., Ahn, Chul, Tsai, Fausan S., Lai, Hoang M., Gandhi, Kaushang, Amin, Harshad, Frishman, William H., Kalapatapu, Kumar, Cohen, Martin, Sorbera, Carmine
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.03.2010
• Subjects: Aged; Aged, 80 and over; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Cardiopulmonary Resuscitation - methods; Defibrillators, Implantable - utilization; Echocardiography; Female; Follow-Up Studies; Heart Failure - mortality; Heart Failure - therapy; Humans; Incidence; Logistic Models; Male; Middle Aged; Proportional Hazards Models; Risk Factors; Smoking - adverse effects; Treatment Outcome; Ventricular Function, Left; mortality; heart failure; cardiac resynchronization therapy; cardioverter-defibrillator shocks; implantable cardioverter-defibrillator
• ISSN: 1074-2484; 1940-4034
• DOI: 10.1177/1074248409351408

Of 529 patients with heart failure and a mean left ventricular ejection fraction of 29%, 209 (40%) were treated with cardiac resynchronization therapy (CRT) plus an implantable cardioverter-defibrillator (ICD) and 320 (60%) with an ICD. Mean follow-up was 34 months for both groups. Stepwise logistic regression analysis showed that significant independent variables for appropriate ICD shocks were statins (risk ratio = 0.35, P < .0001), smoking (risk ratio = 2.52, P < .0001), and digoxin (risk ratio = 1.92, P = .0001). Significant independent variables for time to deaths were use of CRT (risk ratio = 0.32, P = .0006), statins (risk ratio = 0.18, P < .0001), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (risk ratio = 0.10, P < .0001), hypertension (risk ratio = 24.15, P < .0001), diabetes (risk ratio = 2.54, P = .0005), and age (risk ratio = 1.06, P < .0001). In conclusion, statins reduced and smoking and digoxin increased appropriate ICD shocks. Use of CRT, statins, and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers reduced mortality and hypertension, diabetes, and older age increased mortality.