TY - JOUR
T1 - Clinical and hospital factors affecting treatment with primary prevention implantable cardioverter-defibrillators in ischemic cardiomyopathy patients
AU - Lee, Jae Hyuk
AU - Yu, Hee Tae
AU - Oh, Il Young
AU - Choi, Eue Keun
AU - Sung, Jung Hoon
AU - Lee, Young Soo
AU - Kim, Jong Youn
AU - Baek, Yongsoo
AU - Park, Junbeom
AU - Joung, Boyoung
N1 - Publisher Copyright:
© Yonsei University College of Medicine 2020.
PY - 2020
Y1 - 2020
N2 - Purpose: Implantable cardioverter defibrillators (ICD) are the standard of care for primary prevention (PP) in patients with isch-emic cardiomyopathy (ICM). However, PP ICD implantation is underused in Asian countries. This study investigated ICD implantation rates and factors associated with appropriate PP ICD implants for ICM. Materials and Methods: In this prospective multicenter observational registry (ADVANCE-ICM registry), ICM patients who were eligible for PP ICD were screened and enrolled. Factors associated with appropriate ICD implantation, including hospital and clinical factors, were investigated. Results: Of the 1453 ICM patients eligible for PP ICD [1111 male; median age, 71.0 (61.0–78.0) years], only 76 (5.2%) patients un-derwent ICD implantation. Among hospital factors, a non-monetary incentive for referral (72.4% vs. 52.9%, p=0.001) and total hospital system score (6.0 vs. 5.0, p=0.013) were higher in the ICD than in the no-ICD group. In multivariate analysis, total hospital system score [odds ratio (OR), 1.28; 95% confidence interval (CI), 1.10–1.50] was an independent factor for predicting ICD im-plantation, along with clinical factors, including high New York Heart Association class (≥III: OR, 7.29; 95% CI, 2.97–17.87) and younger age (<70 years: OR, 2.14; 95% CI, 1.30–3.53). Conclusion: PP ICD implantation for ICM patients is underused in Korea. Hospital factors were important for improving PP ICD implantation rate, suggesting that new screening and referral systems for ICM patients would improve the PP ICD implantation rate (Clinical trial registration No. NCT03590925).
AB - Purpose: Implantable cardioverter defibrillators (ICD) are the standard of care for primary prevention (PP) in patients with isch-emic cardiomyopathy (ICM). However, PP ICD implantation is underused in Asian countries. This study investigated ICD implantation rates and factors associated with appropriate PP ICD implants for ICM. Materials and Methods: In this prospective multicenter observational registry (ADVANCE-ICM registry), ICM patients who were eligible for PP ICD were screened and enrolled. Factors associated with appropriate ICD implantation, including hospital and clinical factors, were investigated. Results: Of the 1453 ICM patients eligible for PP ICD [1111 male; median age, 71.0 (61.0–78.0) years], only 76 (5.2%) patients un-derwent ICD implantation. Among hospital factors, a non-monetary incentive for referral (72.4% vs. 52.9%, p=0.001) and total hospital system score (6.0 vs. 5.0, p=0.013) were higher in the ICD than in the no-ICD group. In multivariate analysis, total hospital system score [odds ratio (OR), 1.28; 95% confidence interval (CI), 1.10–1.50] was an independent factor for predicting ICD im-plantation, along with clinical factors, including high New York Heart Association class (≥III: OR, 7.29; 95% CI, 2.97–17.87) and younger age (<70 years: OR, 2.14; 95% CI, 1.30–3.53). Conclusion: PP ICD implantation for ICM patients is underused in Korea. Hospital factors were important for improving PP ICD implantation rate, suggesting that new screening and referral systems for ICM patients would improve the PP ICD implantation rate (Clinical trial registration No. NCT03590925).
KW - Myocardial ischemia
KW - Primary prevention
KW - Defibrillators, implantable
UR - http://www.scopus.com/inward/record.url?scp=85094815921&partnerID=8YFLogxK
U2 - 10.3349/ymj.2020.61.11.942
DO - 10.3349/ymj.2020.61.11.942
M3 - Article
C2 - 33107237
AN - SCOPUS:85094815921
SN - 0513-5796
VL - 61
SP - 942
EP - 950
JO - Yonsei Medical Journal
JF - Yonsei Medical Journal
IS - 11
ER -