Open AccessThe Relationship Between Glomerular Filtration Rate and Survival in Patients Treated with an Implantable Cardioverter Defibrillator
Author(s) -
Levy Ronni,
DellaValle Andrea,
Atav A. Serdar,
ur Rehman Afazal,
H. Sklar Allan,
J. Stamato Nicolas
Publication year - 2008
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20209
Subject(s) - medicine , renal function , single center , survival rate , retrospective cohort study , diabetes mellitus , gastroenterology , survival analysis , implantable cardioverter defibrillator , mortality rate , surgery , urology , endocrinology
Objectives We explored the association between renal insufficiency (RI) and mortality among patients treated with an implantable cardioverter defibrillator (ICD). Background Randomized trials have shown improvements in survival among select patients treated with an ICD. Renal insufficiency patients have a high risk of cardiac death; however, it is not clear whether the ICD has a positive effect on survival in this group of patients. Methods This was a retrospective review of a single‐center experience of 346 patients treated with an ICD. Patients were stratified into 4 groups according to their glomerular filtration rate (eGFR; expressed as mL/min/ ‐1.73 m 2 ) at implantation: group I, > 75.0; group II, − 60.0 to 74.9; group III, − 45.0 to 59.9; and group IV, − ≤ 45.0. All‐cause mortality was the primary end point, with differences in survival times among the 4 groups of patients expressed in Kaplan‐Meier curves. Results Mean follow‐up was 3.5 y (range 0.1 to 12.9 y), during which 67 patients died (19%). Mortality in each eGFR group was: I − 6.8%, II − 13.8%, III − 11.5%, IV − 45.8% (p < 0.001). Survival times (mean, y) were I, 3.74; II, 3.66; III, 3.38, and IV, 2.82. The presence of diabetes was not a factor in the outcomes. Conclusions Patients treated with an ICD with an eGFR of ≤ 45.0 mL/min/1.73 m 2 have a significantly shorter survival time than those patients with an eGFR > 45.0 mL/min/1.73 m 2 . Patients with an eGFR > 45.0 mL / min /1.73 m 2 appear to have equally good outcomes when treated with an ICD. This may have implications for patient selection for ICD therapy. Copyright © 2008 Wiley Periodicals, Inc.