Evidence map›Paper›PMID 30565983›Full record

ArticleCirculation2018

Is Time From Last Hospitalization for Heart Failure to Placement of a Primary Prevention Implantable Cardioverter-Defibrillator Associated With Patient Outcomes?

Andrew P Ambrosy, Craig S Parzynski, Daniel J Friedman, Marat Fudim, Adrian F Hernandez, Gregg C Fonarow, Frederick A Masoudi, Sana M Al-Khatib

Open access · bronzeAbstract read
In one paragraph

Article in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Andrew P AmbrosyDivision of Cardiology, The Permanente Medical Group, San Francisco, CA (A.P.A.).
Craig S ParzynskiCenter for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT (C.S.P.).
Daniel J FriedmanDivision of Cardiology, Duke University Medical Center, Durham, NC (D.J.F., M.F., A.F.H., S.M.A.-K.).
Marat FudimDivision of Cardiology, Duke University Medical Center, Durham, NC (D.J.F., M.F., A.F.H., S.M.A.-K.).
Adrian F HernandezDivision of Cardiology, Duke University Medical Center, Durham, NC (D.J.F., M.F., A.F.H., S.M.A.-K.).
Gregg C FonarowDivision of Cardiology, Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, University of California (G.C.F.).
Frederick A MasoudiDivision of Cardiology, University of Colorado Anschutz Medical Campus, Aurora (F.A.M.).
Sana M Al-KhatibDivision of Cardiology, Duke University Medical Center, Durham, NC (D.J.F., M.F., A.F.H., S.M.A.-K.).
Colorado Permanente Medical Group · USUniversity of Colorado Anschutz Medical Campus · US

Funding

MULTIDISCIPLINARY HEART &VASCULAR DISEASEST32HL007101 · NHLBI · DUKE UNIVERSITY · PI FREEDMAN, NEIL J. · 1985 to 2020
$9.8M
Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
NHLBI NIH HHS T32 HL007101NHLBI NIH HHS T32 HL069749
6 · The paper itself

Abstract

backgroundLandmark studies have demonstrated the safety and efficacy of implantable cardioverter-defibrillators (ICDs) in selected stable ambulatory patients with heart failure (HF) with a reduced ejection fraction receiving optimal medical therapy. It is not known whether a recent hospitalization for HF before ICD placement is associated with subsequent outcomes.

methodsA post hoc analysis was performed of Medicare beneficiaries enrolled in the National Cardiovascular Data Registry's ICD Registry with a known diagnosis of HF and an ejection fraction ≤35% underdoing a new ICD placement for primary prevention. Patients were grouped based on the timing of ICD placement from the last hospitalization for HF. The association between timing of ICD placement and outcomes was assessed by using multivariable logistic regression models.

resultsThe final analytic cohort included 81 180 patients undergoing initial ICD placement for primary prevention who were currently hospitalized for HF (n=11 563, 14%), hospitalized for HF within 3 months (n=6252, 8%), or hospitalized for HF >3 months previously or had no previous hospitalizations for HF (n=63 365, 78%). Patients currently or recently hospitalized for HF had a higher unadjusted composite periprocedural complication rate (2.60% versus 1.71% versus 1.25%, P<0.001). After adjusting for potential confounders, patients currently hospitalized for HF were at higher risk for death (odds ratio, 2.25; 95% CI, 2.02-2.52; P <0.001) and all-cause readmission (odds ratio, 1.89; 95% CI, 1.79-1.99; P <0.001) at 90 days.

conclusionOlder patients currently or recently hospitalized for HF undergoing initial ICD placement for primary prevention experienced a higher rate of periprocedural complications and were at increased risk of death in comparison with those receiving an ICD without recent HF hospitalization. Additional prospective, real-world, pragmatic, comparative effectiveness studies should be conducted to define the optimal timing of ICD placement.

Indexed as

Defibrillators, ImplantableAgedAged, 80 and overAnti-Arrhythmia AgentsFemaleHeart FailureHospitalizationHospital MortalityHumansMaleOdds RatioPatient ReadmissionPrimary PreventionRegistriesTime FactorsTreatment OutcomeAnti-Arrhythmia Agentsdefibrillators, implantableheart failurehospitalizationtreatment outcome

Identifiers

PMID30565983
PMCPMC6931009
OpenAlexW2890649629

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.