The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality: insight from Danish nationwide clinical registers

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The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality : insight from Danish nationwide clinical registers. / Ruwald, Anne Christine; Vinther, Michael; Gislason, Gunnar H; Johansen, Jens Brock; Nielsen, Jens Cosedis; Petersen, Helen Høgh; Riahi, Sam; Jons, Christian.

In: European Journal of Heart Failure, Vol. 19, No. 3, 03.2017, p. 377-386.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Ruwald, AC, Vinther, M, Gislason, GH, Johansen, JB, Nielsen, JC, Petersen, HH, Riahi, S & Jons, C 2017, 'The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality: insight from Danish nationwide clinical registers', European Journal of Heart Failure, vol. 19, no. 3, pp. 377-386. https://doi.org/10.1002/ejhf.685

APA

Ruwald, A. C., Vinther, M., Gislason, G. H., Johansen, J. B., Nielsen, J. C., Petersen, H. H., ... Jons, C. (2017). The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality: insight from Danish nationwide clinical registers. European Journal of Heart Failure, 19(3), 377-386. https://doi.org/10.1002/ejhf.685

Vancouver

Ruwald AC, Vinther M, Gislason GH, Johansen JB, Nielsen JC, Petersen HH et al. The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality: insight from Danish nationwide clinical registers. European Journal of Heart Failure. 2017 Mar;19(3):377-386. https://doi.org/10.1002/ejhf.685

Author

Ruwald, Anne Christine ; Vinther, Michael ; Gislason, Gunnar H ; Johansen, Jens Brock ; Nielsen, Jens Cosedis ; Petersen, Helen Høgh ; Riahi, Sam ; Jons, Christian. / The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality : insight from Danish nationwide clinical registers. In: European Journal of Heart Failure. 2017 ; Vol. 19, No. 3. pp. 377-386.

Bibtex

@article{d73bb71b6c1840bea8e968a8eee6233a,
title = "The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality: insight from Danish nationwide clinical registers",
abstract = "AIMS: In a nationwide cohort of primary (PP-ICD) and secondary prevention (SP-ICD) implantable cardioverter defibrillator (ICD) patients, we aimed to investigate the association between co-morbidity burden and risk of appropriate ICD therapy and mortality.METHODS AND RESULTS: We identified all patients >18 years, implanted with first-time PP-ICD (n = 1873) or SP-ICD (n = 2461) in Denmark from 2007 to 2012. Co-morbidity was identified in administrative registers of hospitalization and drug prescription from pharmacies. Co-morbidity burden was defined as the number of pre-existing non-ICD indication-related co-morbidities including atrial fibrillation, diabetes, chronic obstructive pulmonary disease, chronic renal disease, liver disease, cancer, chronic psychiatric disease, and peripheral and/or cerebrovascular disease, and divided into four groups (co-morbidity burden 0, 1, 2, and ≥3). Through Cox models, we assessed the impact of co-morbidity burden on appropriate ICD therapy and mortality. Increasing co-morbidity burden was not associated with increased risk of appropriate therapy, irrespective of implant indication [all hazard ratios (HRs) 1.0-1.4, P = NS]. Using no co-morbidities as reference, increasing co-morbidity burden was associated with increased mortality risk in PP-ICD patients (co-morbidity burden 1, HR 2.1; comorbidity burden 2, HR 3.7; co-morbidity burden ≥3, HR 6.6) (all P < 0.001) and SP-ICD patients (co-morbidity burden 1, HR 2.2; co-morbidity burden 2, HR 3.8; co-morbidity burden ≥3, HR 5.8). With increasing co-morbidity burden, an increasing frequency of patients died without having utilized their device, with 72{\%} PP-ICD and 45{\%} SP-ICD patients with co-morbidity burden ≥3 dying without prior appropriate ICD therapy.CONCLUSION: Increasing co-morbidity burden was not associated with increased risk of appropriate ICD therapy. With increasing co-morbidity burden, mortality increased, and a higher proportion of patients died, without ever having utilized their device.",
keywords = "Aged, Atrial Fibrillation/epidemiology, Cerebrovascular Disorders/epidemiology, Cohort Studies, Comorbidity, Death, Sudden, Cardiac/epidemiology, Defibrillators, Implantable, Denmark/epidemiology, Diabetes Mellitus/epidemiology, Female, Humans, Liver Diseases/epidemiology, Male, Mental Disorders/epidemiology, Middle Aged, Neoplasms/epidemiology, Peripheral Vascular Diseases/epidemiology, Primary Prevention, Proportional Hazards Models, Pulmonary Disease, Chronic Obstructive/epidemiology, Registries, Renal Insufficiency, Chronic/epidemiology, Retrospective Studies, Secondary Prevention",
author = "Ruwald, {Anne Christine} and Michael Vinther and Gislason, {Gunnar H} and Johansen, {Jens Brock} and Nielsen, {Jens Cosedis} and Petersen, {Helen H{\o}gh} and Sam Riahi and Christian Jons",
note = "{\circledC} 2016 The Authors. European Journal of Heart Failure {\circledC} 2016 European Society of Cardiology.",
year = "2017",
month = "3",
doi = "10.1002/ejhf.685",
language = "English",
volume = "19",
pages = "377--386",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "JohnWiley & Sons Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - The impact of co-morbidity burden on appropriate implantable cardioverter defibrillator therapy and all-cause mortality

T2 - insight from Danish nationwide clinical registers

AU - Ruwald, Anne Christine

AU - Vinther, Michael

AU - Gislason, Gunnar H

AU - Johansen, Jens Brock

AU - Nielsen, Jens Cosedis

AU - Petersen, Helen Høgh

AU - Riahi, Sam

AU - Jons, Christian

N1 - © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

PY - 2017/3

Y1 - 2017/3

N2 - AIMS: In a nationwide cohort of primary (PP-ICD) and secondary prevention (SP-ICD) implantable cardioverter defibrillator (ICD) patients, we aimed to investigate the association between co-morbidity burden and risk of appropriate ICD therapy and mortality.METHODS AND RESULTS: We identified all patients >18 years, implanted with first-time PP-ICD (n = 1873) or SP-ICD (n = 2461) in Denmark from 2007 to 2012. Co-morbidity was identified in administrative registers of hospitalization and drug prescription from pharmacies. Co-morbidity burden was defined as the number of pre-existing non-ICD indication-related co-morbidities including atrial fibrillation, diabetes, chronic obstructive pulmonary disease, chronic renal disease, liver disease, cancer, chronic psychiatric disease, and peripheral and/or cerebrovascular disease, and divided into four groups (co-morbidity burden 0, 1, 2, and ≥3). Through Cox models, we assessed the impact of co-morbidity burden on appropriate ICD therapy and mortality. Increasing co-morbidity burden was not associated with increased risk of appropriate therapy, irrespective of implant indication [all hazard ratios (HRs) 1.0-1.4, P = NS]. Using no co-morbidities as reference, increasing co-morbidity burden was associated with increased mortality risk in PP-ICD patients (co-morbidity burden 1, HR 2.1; comorbidity burden 2, HR 3.7; co-morbidity burden ≥3, HR 6.6) (all P < 0.001) and SP-ICD patients (co-morbidity burden 1, HR 2.2; co-morbidity burden 2, HR 3.8; co-morbidity burden ≥3, HR 5.8). With increasing co-morbidity burden, an increasing frequency of patients died without having utilized their device, with 72% PP-ICD and 45% SP-ICD patients with co-morbidity burden ≥3 dying without prior appropriate ICD therapy.CONCLUSION: Increasing co-morbidity burden was not associated with increased risk of appropriate ICD therapy. With increasing co-morbidity burden, mortality increased, and a higher proportion of patients died, without ever having utilized their device.

AB - AIMS: In a nationwide cohort of primary (PP-ICD) and secondary prevention (SP-ICD) implantable cardioverter defibrillator (ICD) patients, we aimed to investigate the association between co-morbidity burden and risk of appropriate ICD therapy and mortality.METHODS AND RESULTS: We identified all patients >18 years, implanted with first-time PP-ICD (n = 1873) or SP-ICD (n = 2461) in Denmark from 2007 to 2012. Co-morbidity was identified in administrative registers of hospitalization and drug prescription from pharmacies. Co-morbidity burden was defined as the number of pre-existing non-ICD indication-related co-morbidities including atrial fibrillation, diabetes, chronic obstructive pulmonary disease, chronic renal disease, liver disease, cancer, chronic psychiatric disease, and peripheral and/or cerebrovascular disease, and divided into four groups (co-morbidity burden 0, 1, 2, and ≥3). Through Cox models, we assessed the impact of co-morbidity burden on appropriate ICD therapy and mortality. Increasing co-morbidity burden was not associated with increased risk of appropriate therapy, irrespective of implant indication [all hazard ratios (HRs) 1.0-1.4, P = NS]. Using no co-morbidities as reference, increasing co-morbidity burden was associated with increased mortality risk in PP-ICD patients (co-morbidity burden 1, HR 2.1; comorbidity burden 2, HR 3.7; co-morbidity burden ≥3, HR 6.6) (all P < 0.001) and SP-ICD patients (co-morbidity burden 1, HR 2.2; co-morbidity burden 2, HR 3.8; co-morbidity burden ≥3, HR 5.8). With increasing co-morbidity burden, an increasing frequency of patients died without having utilized their device, with 72% PP-ICD and 45% SP-ICD patients with co-morbidity burden ≥3 dying without prior appropriate ICD therapy.CONCLUSION: Increasing co-morbidity burden was not associated with increased risk of appropriate ICD therapy. With increasing co-morbidity burden, mortality increased, and a higher proportion of patients died, without ever having utilized their device.

KW - Aged

KW - Atrial Fibrillation/epidemiology

KW - Cerebrovascular Disorders/epidemiology

KW - Cohort Studies

KW - Comorbidity

KW - Death, Sudden, Cardiac/epidemiology

KW - Defibrillators, Implantable

KW - Denmark/epidemiology

KW - Diabetes Mellitus/epidemiology

KW - Female

KW - Humans

KW - Liver Diseases/epidemiology

KW - Male

KW - Mental Disorders/epidemiology

KW - Middle Aged

KW - Neoplasms/epidemiology

KW - Peripheral Vascular Diseases/epidemiology

KW - Primary Prevention

KW - Proportional Hazards Models

KW - Pulmonary Disease, Chronic Obstructive/epidemiology

KW - Registries

KW - Renal Insufficiency, Chronic/epidemiology

KW - Retrospective Studies

KW - Secondary Prevention

U2 - 10.1002/ejhf.685

DO - 10.1002/ejhf.685

M3 - Journal article

C2 - 27905161

VL - 19

SP - 377

EP - 386

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

IS - 3

ER -

ID: 193896901