Association between the Charlson comorbidity index and outcomes after implantable cardioverter defibrillator generator replacement

Amin, Mustapha; Witt, Chance M.; Waks, Jonathan W.; Mehta, Ramila A.; Friedman, Paul A.; Kramer, Daniel B.; Buxton, Alfred E.; Mulpuru, Siva K.; Hodge, David O.; Frey, Rebecca J.; Frederick, Nicolette K.; Mei, Yong; Brenes-Salazar, Jorge A.; Madhavan, Malini

doi:10.1111/pace.13762

Cited by 3 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is the first study to evaluate the Charlson Comorbidity Index (CCI) in a S-ICD study population. In accordance with several other defibrillator studies ( 39 – 43 ), we used the CCI to visualize and to correct for potential extracardiac comorbidities. We observed particularly high CCI scores (for S-ICD patients a median CCI of 4; for TV-ICD patients a median CCI of 5) in our study cohort compared to the existing literature ( 39 , 40 , 42 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although the results are in line with recent reports, there was a limited number of patients included in this study. Strengths of this study are detailed evaluation of clinical outcome data, incorporation of a real-world study cohort and evaluation of the Charlson Comorbidity Index, although the CCI has been evaluated but not validated in TV-ICD patients ( 39 – 43 ) or S-ICD patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical outcomes of subcutaneous vs. transvenous implantable defibrillator therapy in a polymorbid patient cohort

Kattih

Operhalski

Boeckling

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundThe subcutaneous implantable cardioverter-defibrillator (S-ICD) has been designed to overcome lead-related complications and device endocarditis. Lacking the ability for pacing or resynchronization therapy its usage is limited to selected patients at risk for sudden cardiac death (SCD).ObjectiveThe aim of this single-center study was to assess clinical outcomes of S-ICD and single-chamber transvenous (TV)-ICD in an all-comers population.MethodsThe study cohort comprised a total of 119 ICD patients who underwent either S-ICD (n = 35) or TV-ICD (n = 84) implantation at the University Hospital Frankfurt from 2009 to 2017. By applying an inverse probability-weighting (IPW) analysis based on the propensity score including the Charlson Comorbidity Index (CCI) to adjust for potential extracardiac comorbidities, we aimed for head-to-head comparison on the study composite endpoint: overall survival, hospitalization, and device-associated events (including appropriate and inappropriate shocks or system-related complications).ResultsThe median age of the study population was 66.0 years, 22.7% of the patients were female. The underlying heart disease was ischemic cardiomyopathy (61.4%) with a median LVEF of 30%. Only 52.9% had received an ICD for primary prevention, most of the patients (67.3%) had advanced heart failure (NYHA class II–III) and 16.8% were in atrial fibrillation. CCI was 5 points in TV-ICD patients vs. 4 points for patients with S-ICD (p = 0.209) indicating increased morbidity. The composite endpoint occurred in 38 patients (31.9 %), revealing no significant difference between patients implanted with an S-ICD or TV-ICD (unweighted HR 1.50, 95 % confidence interval (CI) 0.78–2.90; p = 0.229, weighted HR 0.94, 95% CI, 0.61–1.50, p = 0.777). Furthermore, we observed no difference in any single clinical endpoint or device-associated outcome, neither in the unweighted cohort nor following inverse probability-weighting.ConclusionClinical outcomes of the S-ICD and TV-ICD revealed no differences in the composite endpoint including survival, freedom of hospitalization and device-associated events, even after careful adjustment for potential confounders. Moreover, the CCI was evaluated in a S-ICD cohort demonstrating higher survival rates than predicted by the CCI in young, polymorbid (S-)ICD patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of subcutaneous vs. transvenous implantable defibrillator therapy in a polymorbid patient cohort

Kattih

Operhalski

Boeckling

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

Patient and Partner Sexual Concerns During the First Year After an Implantable Cardioverter Defibrillator: A Secondary Analysis of the P+P Randomized Clinical Trial

Streur

Rosman

Sears

et al. 2020

The Journal of Sexual Medicine

View full text Add to dashboard Cite

Background Sexual concerns and changes in sexual activity are common among patients and their intimate partners after an implantable cardioverter defibrillator (ICD). Aims Our aims were to (i) describe patient and partner sexual activity and related concerns from the time of an initial ICD implant through 12-month follow-up and (ii) identify factors predictive of return to sexual activity and fears associated with sexual activity. Methods This secondary descriptive analysis was conducted with data from a randomized controlled trial (2009–2015) designed to compare 2 interventions for patients (Patient-Only) and for patients and their partners (Patient+Partner) after implant of an initial ICD. The sample included 105 patients and their intimate partners who reported sexual activity during the 24 months before ICD implant. Outcomes The Sexual Concerns Inventory was used to assess sexual activity and related concerns. Results Study participants comprised 72% male and were of mean age 65.6 ± 10.6 years; partners comprised 64% female and were of mean age 63 ± 11.6 years. Sexual activity increased after ICD: 73% of patients reported no sexual intercourse during 2 months before study enrollment, whereas only 46% reported no sexual intercourse during the 2 months before 12-month follow-up. Reductions in sexual concerns were evident 1 month after implant, with continued reductions through 12 months (patient 6.48 ± 4.03 to 5.22 ± 3.38, P = .004; partner 6.93 ± 4.01 to 5.2 ± 3.56, P < .001). Patient physical health predicted sexual activity 3 months after implant placement (P = .04); general ICD concerns (P < .001) predicted patient ICD-related sexual fears at 3 months. At 12 months, baseline general ICD concerns (P < .02) predicted sexual fears. Clinical Implications ICD patients and partners report low levels of sexual activity at the time of initial ICD implant, with reported increases in sexual activity over the 12-month recovery period: Sexual concerns were highest immediately after ICD implant. Strengths & Limitations Notably, the major strengths of this study were the repeated measures and longitudinal study design; the main limitation of the study was the lack of a “usual care” control group. Conclusion Sexual activity at the time of an initial ICD implant is low, and sexual concerns are most prominent for both patients and partners immediately after implant placement. Baseline physical health predicts subsequent sexual activity at 3 months, while general ICD-related worry predicts sexual fears at 3 and 12 months.

show abstract

Long-term prognosis of patients with chronic heart failure and reduced left ventricular ejection fraction receiving cardiac contractility modulation therapy: the impact of comorbidity burden on outcomes

Pavlovskaya

Sitnikova

Трукшина

et al. 2023

Vestnik aritmologii

View full text Add to dashboard Cite

Association between the Charlson comorbidity index and outcomes after implantable cardioverter defibrillator generator replacement

Cited by 3 publications

References 24 publications

Clinical outcomes of subcutaneous vs. transvenous implantable defibrillator therapy in a polymorbid patient cohort

Clinical outcomes of subcutaneous vs. transvenous implantable defibrillator therapy in a polymorbid patient cohort

Patient and Partner Sexual Concerns During the First Year After an Implantable Cardioverter Defibrillator: A Secondary Analysis of the P+P Randomized Clinical Trial

Long-term prognosis of patients with chronic heart failure and reduced left ventricular ejection fraction receiving cardiac contractility modulation therapy: the impact of comorbidity burden on outcomes

Contact Info

Product

Resources

About