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Three-year mortality reduced in Medicare beneficiaries with HF following ICD implantation

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Patients with HF and left ventricular ejection fraction <35% who received an implantable cardioverter defibrillator during hospitalization had better survival at three years than those who received no device.

Researchers enrolled 4,685 Medicare beneficiaries (60% women) with HF who were eligible to receive ICDs in the study. All patients were discharged from the hospital alive and were treated in hospitals participating in the OPTIMIZE-HF trial, as well as GWTG-HF quality improvement programs. The outcome of interest was all-cause mortality within three years of index hospitalization for HF.

According to the study results, 376 patients (8.0%) received ICDs during their hospitalization. Mortality rates during follow-up were 27% at one year (n=1,167), 41.1% at two years (n=1,640) and 51.4% at three years (n=1,872). Observed mortality was lower in patients receiving ICDs vs. those who did not receive them at one year (19.5% vs. 27.6%), at two years (30.9% vs. 41.9%) and at three years (38.1% vs. 52.3%; P<.001 for all comparisons). The adjusted hazard ratio of 0.72 (95% CI, 0.57-0.92), according to the researchers, suggested that patients who received ICDs during hospitalization had lower mortality over three years than those who did not receive ICDs.

“Medicare beneficiaries hospitalized with HF and LVEF of 35% or less who were eligible for ICD therapy had significantly lowered adjusted risk of death over three years compared with patients discharged without an ICD,” the researchers concluded. “These findings are consistent with the results of randomized clinical trials of ICD therapy.”