Cause-specific death and risk factors of 1-year mortality after implantable cardioverter-defibrillator implantation: a nationwide study
Research output: Contribution to journal › Journal article › Research › peer-review
Aims Current treatment guidelines recommend implantable cardioverter-defibrillators (ICDs) in eligible patients with an estimated survival beyond 1 year. There is still an unmet need to identify patients who are unlikely to benefit from an ICD. We determined cause-specific 1-year mortality after ICD implantation and identified associated risk factors.
Methods and results Using Danish nationwide registries (2000-2017), we identified 14 516 patients undergoing first-time ICD implantation for primary or secondary prevention. Risk factors associated with 1-year mortality were evaluated using multivariable logistic regression. The median age was 66 years, 81.3% were male, and 50.3% received an ICD for secondary prevention. The 1-year mortality rate was 4.8% (694/14 516). ICD recipients who died within 1 year were older and more comorbid compared to those who survived (72 vs. 66 years, P < 0.001). Risk factors associated with increased 1-year mortality included dialysis [odds ratio (OR): 3.26, confidence interval (CI): 2.37-4.49], chronic renal disease (OR: 2.14, CI: 1.66-2.76), cancer (OR: 1.51, CI: 1.15-1.99), age 70-79 years (OR: 1.65, CI: 1.36-2.01), and age >= 80 years (OR: 2.84, CI: 2.15-3.77). The 1-year mortality rates for the specific risk factors were: dialysis (13.8%), chronic renal disease (13.1%), cancer (8.5%), age 70-79 years (6.9%), and age >= 80 years (11.0%). Overall, the most common causes of mortality were related to cardiovascular diseases (62.5%), cancer (10.1%), and endocrine disorders (5.0%). However, the most common cause of death among patients with cancer was cancer-related (45.7%).
Conclusion Among ICD recipients, mortality rates were low and could be indicative of relevant patient selection. Important risk factors of increased 1-year mortality included dialysis, chronic renal disease, cancer, and advanced age.
Original language | English |
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Journal | European Heart Journal - Quality of Care and Clinical Outcomes |
Volume | 8 |
Issue number | 1 |
Pages (from-to) | 39-49 |
Number of pages | 11 |
ISSN | 2058-5225 |
DOIs | |
Publication status | Published - 2022 |
- Device therapy, Short-term mortality, Risk factors, Comorbidities, Causes of death, Epidemiology, SUDDEN CARDIAC DEATH, PRIMARY PREVENTION, VENTRICULAR-ARRHYTHMIAS, HEART-FAILURE, TASK-FORCE, ASSOCIATION, MANAGEMENT, DISEASE, APPROPRIATE, VALIDATION
Research areas
ID: 346248066