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‐defibrilla...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 2007-03, Vol.30 (3), p.371-376
Main Authors: CHEN-SCARABELLI, CAROL, SCARABELLI, TIZIANO M.
Format: Article
Language:English
Subjects:
Aged
Comorbidity
Defibrillators, Implantable - statistics & numerical data
Electric Countershock - instrumentation
Electric Countershock - mortality
Female
Humans
implantable cardioverter-defibrillators
Male
Michigan - epidemiology
mortality
Proportional Hazards Models
renal insufficiency
Renal Insufficiency, Chronic - mortality
Risk Assessment - methods
Risk Factors
Survival Analysis
Survival Rate
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Summary: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 ≥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 ≤ 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). Conclusion: 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.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.2007.00677.x