Posted on 12/16/2009

Three-year mortality reduced in Medicare beneficiaries with
HF following ICD implantation

Patients with heart failure (HF) and left ventricular
ejection fraction (EF)  <35% who
received an implantable cardioverter defibrillator (ICD) during hospitalization
had better survival at three years than those who received no device.

Researchers enrolled 4,685 Medicare beneficiaries (60%
women) with HF who were eligible to receive ICDs in the study. All patients
were discharged from the hospital alive and were treated in hospitals
participating in the OPTIMIZE-HF trial, as well as GWTG-HF quality improvement
programs. The outcome of interest was all-cause mortality within three years of
index hospitalization for HF.

According to the study results, 376 patients (8.0%) received
ICDs during their hospitalization. Mortality rates during follow-up were 27% at
one year (n=1,167), 41.1% at two years (n=1,640) and 51.4% at three years
(n=1,872). Observed mortality was lower in patients receiving ICDs vs. those
who did not receive them at one year (19.5% vs. 27.6%), at two years (30.9% vs.
41.9%) and at three years (38.1% vs. 52.3%; P<.001 for all comparisons). The
adjusted hazard ratio of 0.72 (95% CI, 0.57-0.92), according to the
researchers, suggested that patients who received ICDs during hospitalization
had lower mortality over three years than those who did not receive ICDs.

“Medicare beneficiaries hospitalized with HF and LVEF of 35%
or less who were eligible for ICD therapy had significantly lowered adjusted
risk of death over three years compared with patients discharged without an
ICD,” the researchers concluded. “These findings are consistent with the
results of randomized clinical trials of ICD therapy.”

SOURCE: Cardiology Today