Predictors of mortality amongst recipients of implantable cardioverter defibrillators for secondary prevention of cardiac arrest

Agarwal, Sunil K.; Ish, Singla; Hreybe, Haitham and Saba, Samir (2007) Predictors of mortality amongst recipients of implantable cardioverter defibrillators for secondary prevention of cardiac arrest. Indian Pacing and Electrophysiology Journal, 7 (4). pp. 218-214. ISSN 0972-6292

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Abstract

Background: Implantable Cardioverter-defibrillators (ICD) reduce mortality in survivors of cardiac arrest (CA). We investigated the predictors of mortality after ICD implantation in survivors of CA. Methods: Retrospective review of clinical records and social security death index of all patients who received an ICD in a preexisting database of survivors of CA at the University of Pittsburgh Medical Center was performed. Multivariate analyses using the Cox proportional hazard model were performed with backward elimination to identify independent predictors of the time to death, and Kaplan-Meier curves were plotted. Results: Eighty patients (64 men) with a mean age of 64.4±12.5 years were followed for 4.7±2.3 years after ICD implantation. Survival rates were 93.8%, 65% and 50% at 1, 5, and 10 years, respectively. Independent predictors of time to death were determined to include age (hazard ratio (HR) = 1.91 per 10-year increase, p = 0.003), serum creatinine ≥ 1.3 mg/dL (HR = 2.56, p = 0.004), and QRS width >120 ms (HR = 5.14, p = 0.012). Conclusions: In this sample of ICD recipients secondary to CA, older age, elevated serum creatinine, and wider QRS duration were independent predictors of mortality. The presence of more than one risk factor in the same patient was associated with higher mortality rates. Whether interventions such as biventricular pacing can offset this increase risk of death warrants further investigation.

EPrint Type:Article
Uncontrolled Keywords:Implantable Cardioverter Defibrillators, Cardiac Arrest, Mortality, Predictors
Subjects:Environment and Public Health > Public Health > Epidemiologic Measurements > Demography > Vital Statistics > Mortality
Human Activities > Survival
Investigative Techniques > Epidemiologic Methods
-Journal Repositories > Indian Pacing and Electrophysiology Journal
Cardiovascular Diseases > Heart Diseases > Heart Arrest
Environment and Public Health > Public Health > Epidemiologic Methods
Equipment and Supplies > Electrodes > Defibrillators > Defibrillators, Implantable
Investigative Techniques > Epidemiologic Methods > Data Collection > Vital Statistics > Mortality
ID Code:2713
Deposited By:Indian Pacing and Electrophysiology Journal
Deposited On:11 March 2008

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