Mortality rates of HFrEF patients with ICD, CRT-D improved in past decade

Issue: November 2013

ORLANDO, Fla. — Each year, from 2003 to 2011, mortality rates improved for patients with HF and reduced ejection fraction, or HFrEF, who have received an implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator, according to a new analysis of the Altitude Registry.

“Mortality has improved in patients who received CRT-D and primary or secondary ICDs from 2003 to 2011, and the improvement has been consistent,” JoAnn Lindenfeld, MD, director of the heart transplantation program at the University of Colorado Anschutz Medical Campus, said during a presentation at the Annual Scientific Meeting of the Heart Failure Society of America.

Researchers analyzed records from the real-world ALTITUDE registry, supported by Boston Scientific, which includes about 200,000 patients who received primary or secondary prevention ICDs and approximately 130,000 patients who received CRT-D devices from 2003 to 2011.

From 2003 to 2006, median survival for patients who received CRT-Ds improved by a mean of 14 months and time to 75% survival for patients who received ICDs improved by 5.5 months. Survival times in months by implant year improved annually for patients who received ICDs and CRT-Ds (P<.001 for both), said Lindenfeld, who is the incoming HFSA president.

The most interesting finding of the registry analysis, she said, is that “current trends indicate that over half of CRT-D patients who were implanted in 2008 will live longer than 84 months … and those implanted in 2010, more than half will live longer than 90 to 96 months … much longer than we had thought in the past. Smaller but significant improvements in survival have also occurred in ICD recipients.”

Although the registry data do not indicate whether appropriate use plays a role in the improved survival rates, one factor could be that, as time has gone on, “there’s more and better [medical] therapy applied to these patients,” she said.

Data on deaths were collected from the Social Security Death Index and from reports to the Boston Scientific. – by Erik Swain

For more information:

Lindenfeld J. Abstract #059. Presented at: the Annual Scientific Meeting of the Heart Failure Society of America; Sept. 22-25, 2013; Orlando, Fla.

Disclosure: The ALTITUDE registry is supported by Boston Scientific. All of the researchers are consultants for Boston Scientific. Lindenfeld reports financial ties with several companies.