TY - JOUR
T1 - Developing a risk score to predict mortality in the first year after implantable cardioverter defibrillator implantation
T2 - Data from the Israeli ICD Registry
AU - On behalf of the Israeli working group of pacing and electrophysiology, the Israel Heart Society
AU - Nevzorov, Roman
AU - Goldenberg, Ilan
AU - Konstantino, Yuval
AU - Golovchiner, Gregory
AU - Strasberg, Boris
AU - Souleiman, Mahmoud
AU - Khalameizer, Vladimir
AU - Ben-Zvi, Shlomit
AU - Sela, Ron
AU - Rosenheck, Shimon
AU - Freedberg, Nahum A.
AU - Geist, Michael
AU - Cohen, Michal Einhorn
AU - Cohen, Tal
AU - Shlomo, Nir
AU - Gabrielov-Yusim, Natalie
AU - Geva, Diklah
AU - Glikson, Michael
AU - Haim, Moti
N1 - Publisher Copyright:
© 2018 Wiley Periodicals, Inc
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Introduction: Life expectancy of less than 1 year is usually a contraindication for implantable cardioverter defibrillator (ICD) implantation. The aim was to identify patients at risk of death during the first year after implantation. Methods and Results: Data were derived from a prospective Israeli ICD Registry. Two groups of patients were compared, those who died and those who were alive 1 year after ICD implantation. Factors associated with 1-year mortality were identified on a derivation cohort. A risk score was established and validated. A total of 2617 patients have completed 1 year of follow-up after ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantation. Age greater than 75 years (hazard ratio [HR], 2.7; 95% confidence interval [95% CI], 1.6 to 4.4), atrial fibrillation (AF; HR, 1.9; 95% CI, 1.12 to 3.17), chronic lung disease (HR, 2.0; 95% CI, 1.1 to 3.76), anemia (HR, 2.3; 95% CI, 1.3 to 3.93) and chronic renal failure (CRF; HR, 3.4; 95% CI, 1.74 to 6.6) were independent risk factors for 1-year mortality. We propose a simple AAACC (“triple A double C”) score for prediction of 1-year mortality after ICD implantation: Age greater than 75 years (3 points(pts)), anemia (2 pts), AF (1 pt), CRF (3 pts) and chronic lung disease (1 pt). Mortality risk increased with rising number of points (from 1% with 0 pts to 12.5% with >4 pts). The risk score was evaluated with receiver operating characteristic curve and the area under the curve of the validation curve is 0.71 (95% CI, 0.66 to 0.76). Conclusions: Age greater than 75, AF, chronic lung disease, anemia, and CRF were independent risk factors for 1-year mortality. AAACC risk score identifies patients at high risk of death during 1 year after ICD implantation.
AB - Introduction: Life expectancy of less than 1 year is usually a contraindication for implantable cardioverter defibrillator (ICD) implantation. The aim was to identify patients at risk of death during the first year after implantation. Methods and Results: Data were derived from a prospective Israeli ICD Registry. Two groups of patients were compared, those who died and those who were alive 1 year after ICD implantation. Factors associated with 1-year mortality were identified on a derivation cohort. A risk score was established and validated. A total of 2617 patients have completed 1 year of follow-up after ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantation. Age greater than 75 years (hazard ratio [HR], 2.7; 95% confidence interval [95% CI], 1.6 to 4.4), atrial fibrillation (AF; HR, 1.9; 95% CI, 1.12 to 3.17), chronic lung disease (HR, 2.0; 95% CI, 1.1 to 3.76), anemia (HR, 2.3; 95% CI, 1.3 to 3.93) and chronic renal failure (CRF; HR, 3.4; 95% CI, 1.74 to 6.6) were independent risk factors for 1-year mortality. We propose a simple AAACC (“triple A double C”) score for prediction of 1-year mortality after ICD implantation: Age greater than 75 years (3 points(pts)), anemia (2 pts), AF (1 pt), CRF (3 pts) and chronic lung disease (1 pt). Mortality risk increased with rising number of points (from 1% with 0 pts to 12.5% with >4 pts). The risk score was evaluated with receiver operating characteristic curve and the area under the curve of the validation curve is 0.71 (95% CI, 0.66 to 0.76). Conclusions: Age greater than 75, AF, chronic lung disease, anemia, and CRF were independent risk factors for 1-year mortality. AAACC risk score identifies patients at high risk of death during 1 year after ICD implantation.
KW - AAACC score
KW - ICD registry
KW - implantable cardioversion defibrillator
KW - predictors of mortality
KW - risk score
UR - http://www.scopus.com/inward/record.url?scp=85053801335&partnerID=8YFLogxK
U2 - 10.1111/jce.13725
DO - 10.1111/jce.13725
M3 - Article
C2 - 30168227
AN - SCOPUS:85053801335
SN - 1045-3873
VL - 29
SP - 1540
EP - 1547
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
IS - 11
ER -