Mortality risk score in primary prevention implantable cardioverter defibrillator recipients with non-ischaemic or ischaemic heart disease.
OBJECTIVE
To assess survival and to construct a baseline mortality risk score in primary prevention implantable cardioverter defibrillator (ICD) patients with non-ischaemic or ischaemic heart disease.


RESULTS
Since 1996, data of all consecutive patients who received an ICD system in the Leiden University Medical Center were collected and assessed at implantation. For the current study, all 1036 patients [age 63 (SD 11) years, 81% male] with a primary indication for defibrillator implantation were evaluated and followed for 873 (SD 677) days. During follow-up, 138 patients (13%) died. Non-ischaemic and ischaemic patients demonstrated similar survival but exhibited different factors that influence risk for mortality. A risk score, consisting of simple baseline variables could stratify patients in low, intermediate, and high risk for mortality. In non-ischaemic patients, annual mortality was 0.4% (95% CI 0.0-2.2%) in low risk and 9.4% (95% CI 6.6-13.1%) in high risk patients. In ischaemic patients, mortality was 1.0% (95% CI 0.2-3.0%) in low risk and 17.8% (95% CI 13.6-22.9%) in high risk patients.


CONCLUSIONS
Utilization of an easily applicable baseline risk score can create an individual patient-tailored estimation on mortality risk to aid clinicians in daily practice.
Borleffs
C Jan Willem
CJ
Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
van Welsenes
Guido H
GH
van Bommel
Rutger J
RJ
van der Velde
Enno T
ET
Bax
Jeroen J
JJ
van Erven
Lieselot
L
Putter
Hein
H
van der Bom
Johanna G
JG
Rosendaal
Frits R
FR
Schalij
Martin J
MJ
D000368:Aged; D002423:Cause of Death; D017147:Defibrillators, Implantable; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality; D011322:Primary Prevention; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*