Chronic renal insufficiency is an independent predictor of mortality in implantable cardioverter-defibrillator recipients.
BACKGROUND
Chronic renal insufficiency (CRI) has been associated with increased risk of cardiovascular morbidity and mortality. However, there is limited knowledge regarding this association and the effect of renal dysfunction on survival benefit in patients with implantable cardioverter-defibrillators (ICDs).


METHODS
We investigated whether there was an association between CRI (defined as serum creatinine levels >or=1.5 mg/dL) and increased risk of mortality in ICD recipients. We retrospectively studied all patients (n = 336) followed within our ICD clinic in a 2.5-year period. CRI, ventricular tachycardia (VT), cardiomyopathy (CM), and mortality were recorded. Ischemic CM was defined as the presence of coronary artery disease (CAD) and left ventricular ejection fraction <or= 30%.


RESULTS
Despite no significant difference in CAD and VT occurrence between CRI and non-CRI groups in the overall population, there was a significantly higher mortality rate in the CRI group (P < 0.0001).


CONCLUSIONS
CRI is a significant independent predictor of mortality in ICD recipients. Further investigation is needed to determine whether prevention, early detection, and more aggressive intervention in the treatment of CRI will reduce the incidence of mortality in this population.
Chen-Scarabelli
Carol
C
VA Ann Arbor Healthcare System, Ann Arbor, Michigan 48105, USA. carol.chen-scarabelli@med.va.gov
Scarabelli
Tiziano M
TM
D000368:Aged; D015897:Comorbidity; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D004554:Electric Countershock / Q000295:instrumentation / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000401:mortality*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate