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Implantable Defibrillator Can Cut Mortality in Heart Failure

OPTIMIZE-HF analysis finds three-year mortality 38.1 percent with ICD, 52.3 percent without

WEDNESDAY, Dec. 16 (HealthDay News) -- Older heart failure patients who received an implantable cardioverter-defibrillator (ICD) had lower mortality over three years than patients who did not receive the device, according to a study published online Dec. 15 in Circulation: Heart Failure.

Adrian F. Hernandez, M.D., of the Duke University School of Medicine in Durham, N.C., and colleagues used data from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF) registry and Medicare claims data to examine the long-term outcomes in 4,685 patients aged 65 years and older who had left ventricular ejection fraction of 35 percent or less, were eligible for an ICD, and were discharged alive from the hospital during 2003 to 2006. The primary outcome was all-cause mortality over three years in the patients who had an ICD compared to those who did not.

In the three-year study period, the researchers found that mortality was significantly lower among patients who had received an ICD compared to those who did not (19.8 versus 27.6 percent at year one, 30.9 versus 41.9 percent at year two, and 38.1 versus 52.3 percent at year three).

"In this study of the clinical effectiveness of ICDs among older Medicare beneficiaries hospitalized with heart failure, ICD therapy was associated with a significantly lower relative risk of mortality over three years compared with no ICD therapy, after adjustment for the probability of treatment, other prognostic variables, and medical therapy at discharge," the authors write.

Several study authors reported receiving research support and speaker and/or consulting fees from pharmaceutical companies and medical device manufacturers.

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