scholarly journals The mortality outcome after implantable cardioverter-defibrillator implantation according to indication for implantation and underlying etiology: a Nationwide Cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P.S Yang ◽  
Y Kang ◽  
H.D Park ◽  
J.H Sung ◽  
B Joung
Keyword(s):  
Heart Disease ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Mortality Rates ◽  
Ischemic Heart ◽  
Primary And Secondary Prevention ◽  
Icd Implantation ◽  
Mortality Outcome ◽  
Prognostic Group

Abstract Background and objectives There are few nationwide data about the mortality outcome after implantable cardioverter-defibrillator (ICD) implantation. The aim of this study was to evaluate the mortality outcome after ICD implantation according to indication for implantation (primary vs. secondary prevention) and underlying etiology (non-ischemic vs. ischemic heart disease) with a nationwide cohort data of Korea. Methods During the period from January 1, 2008 to December 31, 2017, 3,558 patients (mean age, 67.7±11.4 years) with newly-implanted ICD who were aged 19 years or older were identified by 50-percents random sampling from the Korean National Health Insurance Service database. Results Patients with primary and secondary prevention ICD were 1,097 (30.8%) and 2,461 (69.2%), respectively. Patients with non-ischemic and ischemic heart disease were 2,487 (69.9%) and 1,071 (30.1%), respectively. Overall all-cause mortality was 20.4% during the follow-up period (mean 24 months). The mortality rates in patients with primary and secondary prevention ICD were 26.2% and 17.9%, respectively. The mortality rates in patients with non-ischemic and ischemic heart disease were 16.1% and 30.4%, respectively. In Kaplan-Meier estimates of survival according to both indication for implantation and underlying etiology, the best prognostic group was patients with secondary prevention ICD and having non-ischemic etiology. The worst prognostic group was patients with primary prevention ICD and having ischemic etiology. The survival probability was below 50% (45.2%) 5 years after ICD implantation in patients with primary prevention ICD and having ischemic etiology. Conclusions In Korean nationwide data, patients with primary prevention ICD and having ischemic etiology show the worst prognosis. About half of these patients died of any cause within five years. Funding Acknowledgement Type of funding source: None

scholarly journals Unique referral system contributes to long-term net clinical benefits in patients undergoing secondary prevention therapy after percutaneous coronary intervention

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242707
Author(s):  
Shigetaka Kageyama ◽  
Koichiro Murata ◽  
Ryuzo Nawada ◽  
Tomoya Onodera ◽  
Yuichiro Maekawa
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Referral System ◽  
Clinical Events ◽  
Percutaneous Coronary ◽  
Clinical Benefits

Cardiovascular disease, including ischemic heart disease, is a leading cause of death worldwide. Improvement of the secondary prevention of ischemic heart disease is necessary. We established a unique referral system to connect hospitals and outpatient clinics to coordinate care between general practitioners and cardiologists. Here, we evaluated the impact and long-term benefits of our system for ischemic heart disease patients undergoing secondary prevention therapy after percutaneous coronary intervention. This single-center retrospective observational study included 3658 consecutive patients who underwent percutaneous coronary intervention at Shizuoka City Hospital between 2010 and 2019. After percutaneous coronary intervention, patients were considered conventional outpatients (conventional follow-up group) or subjected to our unique referral system (referral system group) at the attending cardiologist’s discretion. To audit compliance of the treatment with the latest Japanese guidelines, we adopted a circulation-type referral system, whereby general practitioners needed to refer registered patients at least once a year, even if no cardiac events occurred. Clinical events in each patient were evaluated. Net adverse clinical events were defined as a combination of major adverse cardiac, cerebrovascular, and major bleeding events. There were 2241 and 1417 patients in the conventional follow-up and referral system groups, with mean follow-ups of 1255 and 1548 days and cumulative net adverse clinical event incidences of 27.6% and 21.5%, respectively. Kaplan–Meier analysis showed that the occurrence of net adverse clinical events was significantly lower in the referral system group than in the conventional follow-up group (log-rank: P<0.001). Univariate and multivariate analyses revealed that the unique referral system was a significant predictor of the net clinical benefits (hazard ratio: 0.56, 95% confidence interval: 0.37–0.83, P = 0.004). This result was consistent after propensity-score matching. In summary, our unique referral system contributed to long-term net clinical benefits for the secondary prevention of ischemic heart disease after percutaneous coronary intervention.

scholarly journals The prediction model for cardiovascular disease using Yazd's health study data (YaHS)

2019 ◽  
Author(s):  
Seyed MohammadReza Tabatabaei Nodoushan1 ◽  
Fatemeh Saadatjoo ◽  
Masoud Mirzaei
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cost Effective ◽  
Mortality Rates ◽  
Study Data ◽  
Ischemic Heart ◽  
Health Study ◽  
Screening Methods ◽  
The People ◽  
Health And Disease

Introdution: Ischemic heart disease is one of the most common diseases, which has led to high mortality rates all over the world. This disease is caused by narrowing or blockage of coronary arteries, which are the provider of blood to the heart. Identifying the people susceptible to this disease and bringing changes in their lifestyles has been said to reduce the related mortality rates and increase the patient's longevity. Methods: Yazd people Health Study (YaHS) was conducted on a random sample of 10,000 people living in the city of Yazd, Iran in the years 2014-15 for a general health and disease survey. These data were first balanced by bootstrapping technique due to their unbalanced nature. Next, classification methods were used in the training phase. Various classifiers, such as artificial neural network, rule inducer, regression, and AdaBoost were used in order to evaluate the proposed method with two scenarios. Results: The results showed that the screening of the people susceptible to ischemic heart disease had the most significant effect on increasing the sensitivity of the discovery classifier of CN2 subgroup through using balanced data by bootstrapping method followed by their analysis for the purpose of producing a sample of the patients. This classifier proved to have the potential for detecting 83.6% of the people susceptible to this disease. Conclusion: Therefore, it can be concluded that data mining methods are effective in screening for susceptible people with ischemic heart disease. This method can be compared with other traditional screening methods in that it is more cost-effective and faster.

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