Ethnic differences among implantable cardioverter defibrillators recipients in Israel.
Heart failure is an increasingly common condition arising from a variety of different pathophysiological processes. Little is known about the unique features of Israeli Arabs who present with heart failure and who undergo cardiac device implantation. The study population comprised of 4,671 patients who were enrolled in the national Israeli Implantable Cardioverter Defibrillator registry. We compared demographic, clinical, and echocardiographic characteristics; device-related indications; and outcomes between Israeli Arabs (n = 733) and Jews (n = 3,938), who were enrolled in the registry from July 2010 through December 2013. Israeli Arabs constituted 15.7% of the study population. They were younger at presentation compared with Jews (57 ± 15 vs 66 ± 12 years, respectively; p <0.001), with a greater burden of co-morbidities, including diabetes mellitus and chronic obstructive lung disease and smoking. In addition, Arab patients had a greater frequency of non-ischemic cardiomyopathy (40.2% vs 24.6%, respectively; p <0.001), which was associated with a greater frequency of familial history of sudden cardiac death. During 15 ± 9 month follow-up, the mortality rates and appropriate device therapy were similar in both ethnic groups. In conclusion, Israeli Arab patients implanted with implantable cardioverter defibrillators display unique clinical features with greater prevalence of non-ischemic cardiomyopathy characterized by an early-onset and rapid deterioration.
The Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Avi
A
Sabbag
The Heart Center, Rambam Health Care Campus, Haifa, Israel.
Mahmoud
M
Suleiman
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Aharon
A
Glick
Department of Cardiology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel.
Aharon
A
Medina
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Cardiology, Rabin Medical Center, Petah Tiqva, Israel.
Gregory
G
Golovchiner
Department of Cardiology, Baruch Padeh Poria Medical Center, Israel.
Hillel
H
Steiner
The Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Michael
M
Arad
The Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ilan
I
Goldenberg
The Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Michael
M
Glikson
The Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: roy.beinart@sheba.health.gov.il.
Roy
R
Beinart
D000368:Aged; D002423:Cause of Death / Q000639:trends; D016757:Death, Sudden, Cardiac / Q000208:ethnology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000208:ethnology / Q000628:therapy*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends