Publication: Impact of implantable cardioverter defibrillators on mortality in heart failure receiving quadruple guideline-directed medical therapy: a propensity score-matched study
dc.contributor.coauthor | Sahin, Anil | |
dc.contributor.coauthor | Celik, Ahmet | |
dc.contributor.coauthor | Colluoglu, Inci Tugce | |
dc.contributor.coauthor | Ata, Naim | |
dc.contributor.coauthor | Kanik, Emine Arzu | |
dc.contributor.coauthor | Ulgu, Mustafa Mahir | |
dc.contributor.coauthor | Birinci, Suayip | |
dc.contributor.coauthor | Yilmaz, Mehmet Birhan | |
dc.contributor.department | School of Medicine | |
dc.contributor.kuauthor | Ural, Dilek | |
dc.contributor.schoolcollegeinstitute | SCHOOL OF MEDICINE | |
dc.date.accessioned | 2025-03-06T20:57:41Z | |
dc.date.issued | 2024 | |
dc.description.abstract | BackgroundIn the contemporary management of heart failure with reduced ejection fraction (HFrEF), the recommended quadruple guideline-directed medical therapy (GDMT) consists of angiotensin receptor-neprilysin inhibitor (ARNI), evidence-based beta-blockers (BB), mineralocorticoid receptor antagonists (MRA), and sodium-glucose cotransporter-2 inhibitors (SGLT-2i). This study explored the impact of adding implantable cardioverter-defibrillator (ICD) therapy to this comprehensive regimen in HFrEF patients.MethodsUtilizing deidentified data from the National Electronic Database of the Turkish Ministry of Health, we conducted a nationwide retrospective cohort study on 5450 HFrEF patients receiving quadruple GDMT, including ARNI. Among them, 709 patients underwent additional ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantation. Propensity score matching ensured balanced baseline characteristics between groups. Primary endpoint was determined as all-cause mortality.ResultsIn the matched cohort, all-cause mortality occurred in 108 out of 619 patients (17.4%) in the GDMT group and 101 out of 619 patients (16.3%) in the ICD group, with a hazard ratio (HR) of 0.74 and a 95% confidence interval (CI) ranging from 0.57 to 0.98. The median follow-up time was 1365 days in the matched cohort, 1283 days in the GDMT group. Subgroup analyses consistently demonstrated benefits, particularly among individuals aged 61 years and older (HR: 0.60, 95% CI: 0.42-0.87, p = 0.006), those with sinus rhythm (HR: 0.55, 95% CI: 0.34-0.89, p = 0.013), individuals not using amiodarone (HR: 0.61, 95% CI: 0.42-0.89, p = 0.011), and those with an estimated glomerular filtration rate lower than 61.9 (HR: 0.66, 95% CI: 0.48-0.91, p = 0.011).ConclusionsThis study may offer a glimmer of hope that even after achieving the best current optimal medical therapy, the addition of device therapy could still yield positive outcomes in the management of patients with HFrEF. | |
dc.description.indexedby | WOS | |
dc.description.indexedby | Scopus | |
dc.description.indexedby | PubMed | |
dc.description.publisherscope | International | |
dc.description.sponsoredbyTubitakEu | N/A | |
dc.identifier.doi | 10.1186/s12916-024-03761-w | |
dc.identifier.issn | 1741-7015 | |
dc.identifier.issue | 1 | |
dc.identifier.quartile | Q1 | |
dc.identifier.scopus | 2-s2.0-85209592382 | |
dc.identifier.uri | https://doi.org/10.1186/s12916-024-03761-w | |
dc.identifier.uri | https://hdl.handle.net/20.500.14288/27276 | |
dc.identifier.volume | 22 | |
dc.identifier.wos | 1357244500002 | |
dc.keywords | Quadruple guideline-directed medical therapy | |
dc.keywords | Implantable cardioverter-defibrillator | |
dc.keywords | Mortality | |
dc.language.iso | eng | |
dc.publisher | BMC | |
dc.relation.ispartof | BMC MEDICINE | |
dc.subject | Medicine | |
dc.title | Impact of implantable cardioverter defibrillators on mortality in heart failure receiving quadruple guideline-directed medical therapy: a propensity score-matched study | |
dc.type | Journal Article | |
dspace.entity.type | Publication | |
local.contributor.kuauthor | Ural, Dilek | |
local.publication.orgunit1 | SCHOOL OF MEDICINE | |
local.publication.orgunit2 | School of Medicine | |
relation.isOrgUnitOfPublication | d02929e1-2a70-44f0-ae17-7819f587bedd | |
relation.isOrgUnitOfPublication.latestForDiscovery | d02929e1-2a70-44f0-ae17-7819f587bedd | |
relation.isParentOrgUnitOfPublication | 17f2dc8e-6e54-4fa8-b5e0-d6415123a93e | |
relation.isParentOrgUnitOfPublication.latestForDiscovery | 17f2dc8e-6e54-4fa8-b5e0-d6415123a93e |