96-50: Impact of ischemic vs. non-ischemic etiology of heart failure in patients with implanted cardioverter-defibrillator on long-term prognosis – 5 years follow

Abstract

Impact of ischemic vs. non-ischemic etiology of heart failure in patients with implanted cardioverter-defibrillator on long-term prognosis – 5 years follow.Background: Data about the impact of heart failure (HF) etiology on long-term prognosis in patients after ICD or BIV ICD implantation is still not well known.Aim: Asses whether HF-etiology influence on long term prognosis in patients treated with ICD or CRT-D.Methods: We analyzed data of 1165 HF-patients treated between 2010 and 2014 in high-volume implantation center. Characteristics, treatment and in-hospital outcomes were assessed by most prevalent etiology: ischemic and nonischemic (valvular etiology was excluded). Standard regression techniques were adjusted and patient-level characteristics were used to examine association between HF etiology and long-term outcomes.Results: Median age was 63.24 and 54.78 years for ischemic and nonischemic HF, respectively. 769 patients (66%) had ischemic cardiomyopathy and 396 patients (34%) had nonischemic cardiomyopathy (NICM). There were significant differences in baseline characteristics between those with ischemic cardiomyopathy compared with NICM with respect to age (63.24 years vs. 54.78 years), sex (85.3% vs. 75% men), diabetes (42.9% vs. 34.1%), renal failure (31.6% vs. 21.2% ), hypertension (58.1% vs. 40.1%), and atrial fibrillation (24.4% vs. 30.9% ). In-hospital mortality and 5-year follow up did not differ among ischemic compared with NICM patients (0.57% vs 0.55 p = 1 and 19% vs 16.9%, p = 0,41), however risk of rehospitalization in ischemic group was lower 55.27 % vs. 62.85 p = 0.05) when considering exacerbation of HF as the cause of rehospitalizacion. Independent risk factors within 5 years of follow up were: renal failure HR 1.9 ( CL 95% 1.3-2.80; p = 0.0004), ventricular arrhythmias HR 1.9 ( CL 95% 1.2- 2.8; p = 0.0014), AT2-blokers HR 0.3 ( CL 95% 0.18- 0.82; p= 0.013), nitrats HR 2.03 (CL 95% 1.1- 3.6; p= 0.0197), telemonitoring HR 0.2 ( CL 95% 0.12- 0.32; p= <0.0001).Conclusion: Long-term mortality did not differ between analyzed groups.