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Survival after primary prevention implantable cardioverter-defibrillator placement among patients with chronic kidney disease.

Publication ,  Journal Article
Hess, PL; Hellkamp, AS; Peterson, ED; Sanders, GD; Al-Khalidi, HR; Curtis, LH; Hammill, BG; Pun, PH; Curtis, JP; Anstrom, KJ; Hammill, SC ...
Published in: Circ Arrhythm Electrophysiol
October 2014

BACKGROUND: Guidelines recommend that implantable cardioverter-defibrillator (ICD) candidates have an estimated longevity of ≥1 year. Longevity can be affected by chronic kidney disease (CKD). METHODS AND RESULTS: Using the National Cardiovascular Data Registry ICD registry linked with the Social Security Death Master File, we assessed the rate of death after primary prevention ICD placement between January 1, 2006, and December 31, 2007, according to CKD stage. Using Cox models, we identified factors associated with death among patients with CKD. Compared with patients without CKD (n=26,056), those with CKD (n=21,226) were older, less commonly men, more often white, and more frequently had comorbid illness. Compared with patients without CKD, patients with a glomerular filtration rate 30 to 60, glomerular filtration rate <30, and end-stage renal disease on dialysis had a higher risk of death after ICD placement (hazard ratio, 2.08; 95% confidence interval, 1.99-2.18; P<0.0001; hazard ratio, 4.20; 95% confidence interval, 3.92-4.50; P<0.0001; and hazard ratio, 4.80; 95% confidence interval, 4.46-5.17; P<0.0001, respectively). Corresponding 1-year death rates were 4.4%, 9.1%, 20.2%, and 22.4%. Among patients with CKD, factors associated with increased risk of death included CKD severity, age >65 years, heart failure symptoms, diabetes mellitus, lung disease, serum sodium <140 mEq/L, atrial fibrillation or flutter, and a lower ejection fraction. CONCLUSIONS: The risk of death after primary prevention ICD placement is proportional to CKD severity. Among patients with CKD, several factors are prognostically significant and could inform clinical decision making on primary prevention ICD candidacy.

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Published In

Circ Arrhythm Electrophysiol

DOI

EISSN

1941-3084

Publication Date

October 2014

Volume

7

Issue

5

Start / End Page

793 / 799

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Severity of Illness Index
  • Risk Factors
  • Risk Assessment
  • Renal Insufficiency, Chronic
  • Registries
  • Prosthesis Design
  • Proportional Hazards Models
 

Citation

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Hess, P. L., Hellkamp, A. S., Peterson, E. D., Sanders, G. D., Al-Khalidi, H. R., Curtis, L. H., … Al-Khatib, S. M. (2014). Survival after primary prevention implantable cardioverter-defibrillator placement among patients with chronic kidney disease. Circ Arrhythm Electrophysiol, 7(5), 793–799. https://doi.org/10.1161/CIRCEP.114.001455
Hess, Paul L., Anne S. Hellkamp, Eric D. Peterson, Gillian D. Sanders, Hussein R. Al-Khalidi, Lesley H. Curtis, Bradley G. Hammill, et al. “Survival after primary prevention implantable cardioverter-defibrillator placement among patients with chronic kidney disease.Circ Arrhythm Electrophysiol 7, no. 5 (October 2014): 793–99. https://doi.org/10.1161/CIRCEP.114.001455.
Hess PL, Hellkamp AS, Peterson ED, Sanders GD, Al-Khalidi HR, Curtis LH, et al. Survival after primary prevention implantable cardioverter-defibrillator placement among patients with chronic kidney disease. Circ Arrhythm Electrophysiol. 2014 Oct;7(5):793–9.
Hess, Paul L., et al. “Survival after primary prevention implantable cardioverter-defibrillator placement among patients with chronic kidney disease.Circ Arrhythm Electrophysiol, vol. 7, no. 5, Oct. 2014, pp. 793–99. Pubmed, doi:10.1161/CIRCEP.114.001455.
Hess PL, Hellkamp AS, Peterson ED, Sanders GD, Al-Khalidi HR, Curtis LH, Hammill BG, Pun PH, Curtis JP, Anstrom KJ, Hammill SC, Al-Khatib SM. Survival after primary prevention implantable cardioverter-defibrillator placement among patients with chronic kidney disease. Circ Arrhythm Electrophysiol. 2014 Oct;7(5):793–799.

Published In

Circ Arrhythm Electrophysiol

DOI

EISSN

1941-3084

Publication Date

October 2014

Volume

7

Issue

5

Start / End Page

793 / 799

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Severity of Illness Index
  • Risk Factors
  • Risk Assessment
  • Renal Insufficiency, Chronic
  • Registries
  • Prosthesis Design
  • Proportional Hazards Models