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Predictors of All‐Cause 1‐Year Mortality in Implantable Cardioverter Defibrillator Patients with Chronic Chagas’ Cardiomyopathy
Author(s) -
TORO DARÍO DI,
MURATORE CLAUDIO,
AGUINAGA LUIS,
BATISTA LUIZ,
MALAN ANTONIO,
GRECO OSWALDO,
BENCHETRIT CHAMIA,
DUQUE MAURICIO,
BARANCHUK ADRIAN,
MALONEY JENNIFER
Publication year - 2011
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2011.03108.x
Subject(s) - medicine , ejection fraction , implantable cardioverter defibrillator , cardiology , hazard ratio , cardiomyopathy , ventricular tachycardia , ventricular fibrillation , atrial fibrillation , confidence interval , chagas disease , heart failure , pathology
Background: Implantable cardioverter defibrillators (ICDs) have been used in the treatment of either sustained ventricular tachycardia or ventricular fibrillation in patients with Chagas’ cardiomyopathy. This study aimed at determining mortality rate and risk factors of all‐cause 1‐year mortality in primary and secondary ICD patients with Chagas’ cardiomyopathy.Methods: One hundred and forty‐eight Chagas’ patients with ICDs were included from the Medtronic ICD Registry Latin America. All patients were followed for 1 year.Results: At implant, mean age was 60.1 ± 9.4 years and 72.9% were male. Mean left ventricular ejection fraction (LVEF) was 40.1 ± 11%. Mean follow‐up was 12 ± 7 months. During the follow‐up, 15 patients died (10.2%). Patients who died were older (64 ±10.8 years vs 59 ± 9.1; P = 0.04), had more atrial fibrillation (13.3% vs 3.8%; P = 0.02), had lower LVEF (33.4%± 9.8 vs 40.9%± 11.3; P = 0.01), and worse functional class (III/IV 40% vs 21.8%; P = 0.03). The multivariate analysis showed that two independent predictors of all‐cause 1‐year mortality remained statistically significant: age more than 65 (hazard ratio [HR] = 2.85, 95% confidence interval [CI] 1.77–3.92; P = 0.03) and LVEF less than 30% (HR = 2.68, 95% CI 1.57–3.79; P = 0.04).Conclusion: This analysis showed that patients older than 65 years of age and with LVEF less than 30% were independent predictors of all‐cause 1‐year mortality in patients with chronic Chagas’ cardiomyopathy. (PACE 2011; 34:1063–1069)