Background: The impact on long-term outcomes of implantable cardioverter defibrillators (ICDs) and biventricular defibrillators for cardiac resynchronization (CRT-D) devices in ‘real world’ patients with heart failure (HF) needs to be assessed in terms of clinical effectiveness. Methods and results: A registry including consecutive HF patients who underwent a first implant of an ICD (891 patients) or a CRT-D device (709 patients) in 2006–2010 was followed (median 1487 days and 1516 days, respectively), collecting administrative data on survival, all-cause hospitalizations, cardiovascular or HF hospitalizations, and days alive and out of hospital (DAOH). Survival free from death/cardiac transplant was 61.9% and 63.8% at 5 years for ICD and CRT-D patients, respectively. Associated comorbidities (Charlson Comorbidity Index) had a significant impact on death/cardiac transplant, as well as on hospitalizations. The median values of DAOH% were 97.4% for ICD and 97.7% for CRT-D patients, but data were highly skewed, with the lower quartile of DAOH% values including values ranging between 0% and 52.8% for ICD and between 0% and 56.1% for CRT-D patients. Charlson Comorbidity Index was a very strong predictor of DAOH%. Conclusions: Patients who were implanted in ‘real world’ clinical practice with an ICD or a CRT-D device have, on average, a relatively favourable outcome, with a survival of around 62–64% at 5 years, but with an important burden of hospitalizations. Comorbidities, as evaluated by means of the Charlson Comorbidity Index, have a significant impact on outcomes in terms of mortality/heart transplant, hospitalizations and days spent alive and out of hospital.

Cardiac device therapy in patients with left ventricular dysfunction and heart failure: ‘real-world’ data on long-term outcomes (mortality, hospitalizations, days alive and out of hospital) / Boriani, Giuseppe; Berti, Elena; Belotti, Laura Maria Beatrice; Biffi, Mauro; De Palma, Rossana; Malavasi, Vincenzo L.; Bottoni, Nicola; Rossi, Luca; De Maria, Elia; Mantovan, Roberto; Zardini, Marco; Casali, Edoardo; Marconi, Marco; Bandini, Alberto; Tomasi, Corrado; Boggian, Giulio; Barbato, Gaetano; Toselli, Tiziano; Zennaro, Mauro; Sassone, Biagio. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 18:6(2016), pp. 693-702. [10.1002/ejhf.509]

Cardiac device therapy in patients with left ventricular dysfunction and heart failure: ‘real-world’ data on long-term outcomes (mortality, hospitalizations, days alive and out of hospital)

BORIANI, Giuseppe;ROSSI, Luca;ZENNARO, Mauro;
2016

Abstract

Background: The impact on long-term outcomes of implantable cardioverter defibrillators (ICDs) and biventricular defibrillators for cardiac resynchronization (CRT-D) devices in ‘real world’ patients with heart failure (HF) needs to be assessed in terms of clinical effectiveness. Methods and results: A registry including consecutive HF patients who underwent a first implant of an ICD (891 patients) or a CRT-D device (709 patients) in 2006–2010 was followed (median 1487 days and 1516 days, respectively), collecting administrative data on survival, all-cause hospitalizations, cardiovascular or HF hospitalizations, and days alive and out of hospital (DAOH). Survival free from death/cardiac transplant was 61.9% and 63.8% at 5 years for ICD and CRT-D patients, respectively. Associated comorbidities (Charlson Comorbidity Index) had a significant impact on death/cardiac transplant, as well as on hospitalizations. The median values of DAOH% were 97.4% for ICD and 97.7% for CRT-D patients, but data were highly skewed, with the lower quartile of DAOH% values including values ranging between 0% and 52.8% for ICD and between 0% and 56.1% for CRT-D patients. Charlson Comorbidity Index was a very strong predictor of DAOH%. Conclusions: Patients who were implanted in ‘real world’ clinical practice with an ICD or a CRT-D device have, on average, a relatively favourable outcome, with a survival of around 62–64% at 5 years, but with an important burden of hospitalizations. Comorbidities, as evaluated by means of the Charlson Comorbidity Index, have a significant impact on outcomes in terms of mortality/heart transplant, hospitalizations and days spent alive and out of hospital.
6-apr-2016
18
6
693
702
Cardiac device therapy in patients with left ventricular dysfunction and heart failure: ‘real-world’ data on long-term outcomes (mortality, hospitalizations, days alive and out of hospital) / Boriani, Giuseppe; Berti, Elena; Belotti, Laura Maria Beatrice; Biffi, Mauro; De Palma, Rossana; Malavasi, Vincenzo L.; Bottoni, Nicola; Rossi, Luca; De Maria, Elia; Mantovan, Roberto; Zardini, Marco; Casali, Edoardo; Marconi, Marco; Bandini, Alberto; Tomasi, Corrado; Boggian, Giulio; Barbato, Gaetano; Toselli, Tiziano; Zennaro, Mauro; Sassone, Biagio. - In: EUROPEAN JOURNAL OF HEART FAILURE. - ISSN 1388-9842. - 18:6(2016), pp. 693-702. [10.1002/ejhf.509]
Boriani, Giuseppe; Berti, Elena; Belotti, Laura Maria Beatrice; Biffi, Mauro; De Palma, Rossana; Malavasi, Vincenzo L.; Bottoni, Nicola; Rossi, Luca; De Maria, Elia; Mantovan, Roberto; Zardini, Marco; Casali, Edoardo; Marconi, Marco; Bandini, Alberto; Tomasi, Corrado; Boggian, Giulio; Barbato, Gaetano; Toselli, Tiziano; Zennaro, Mauro; Sassone, Biagio
File in questo prodotto:
File Dimensione Formato  
ejhf.509.pdf

accesso aperto

Tipologia: Versione dell'editore (versione pubblicata)
Dimensione 582.72 kB
Formato Adobe PDF
582.72 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/1139552
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 39
  • ???jsp.display-item.citation.isi??? 42
social impact