{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:00:16Z","timestamp":1772164816423,"version":"3.50.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    The clinical effectiveness of implantable cardioverter-defibrillators (ICDs) in older patients with heart failure has not been established, and older patients have been underrepresented in previous studies.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    We identified patients with heart failure who were aged 65 years or older and were eligible for an ICD, had left ventricular ejection fraction of 35% or less, and were discharged alive from hospitals participating in the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure and the Get With the Guidelines\u2013Heart Failure quality-improvement programs during the period January 1, 2003, through December 31, 2006. We matched the patients to Medicare claims to examine long-term outcomes. The main outcome measure was all-cause mortality over 3 years. The study population included 4685 patients who were discharged alive and were eligible for an ICD. Mean age was 75.2 years, 60% of the patients were women, mean ejection fraction was 25%, and 376 (8.0%) patients received an ICD before discharge. Mortality was significantly lower among patients who received an ICD compared with those who did not (19.8% versus 27.6% at 1 year, 30.9% versus 41.9% at 2 years, and 38.1% versus 52.3% at 3 years;\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001 for all comparisons). The inverse probability-weighted adjusted hazard of mortality at 3 years for patients receiving an ICD was 0.71 (95% CI, 0.56 to 0.91).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Medicare beneficiaries hospitalized with heart failure and left ventricular ejection fraction of 35% or less who were selected for ICD therapy had lower risk-adjusted long-term mortality compared with those who did not receive an ICD.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Clinical Trial Registration\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    clinicaltrials.gov. Identifier: NCT00344513.\n                  <\/jats:p>","DOI":"10.1161\/circheartfailure.109.884395","type":"journal-article","created":{"date-parts":[[2009,12,15]],"date-time":"2009-12-15T23:33:45Z","timestamp":1260920025000},"page":"7-13","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":56,"title":["Clinical Effectiveness of Implantable Cardioverter-Defibrillators Among Medicare Beneficiaries With Heart Failure"],"prefix":"10.1161","volume":"3","author":[{"given":"Adrian F.","family":"Hernandez","sequence":"first","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley G.","family":"Hammill","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana M.","family":"Al-Khatib","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clyde W.","family":"Yancy","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"O'Connor","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin A.","family":"Schulman","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley H.","family":"Curtis","sequence":"additional","affiliation":[{"name":"From the Duke Clinical Research Institute (A.F.H., B.G.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.) and Department of Medicine (A.F.H., S.M.A., C.M.O., K.A.S., E.D.P., L.H.C.), Duke University School of Medicine, Durham, NC; Ahmanson-UCLA Cardiomyopathy Center, UCLA Medical Center (G.C.F.), Los Angeles, Calif; and Division of Cardiology, Baylor University Medical Center (C.W.Y.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-4-200708210-00007"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.553370"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circualtionaha.108.189742"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.56"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.13.1564"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.03.004"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.13.1525"},{"key":"e_1_3_2_10_2","unstructured":"Joint Commission. Specifications Manual for National Hospital Quality Measures. 2006. Available at: http:\/\/www.jointcommission.org\/PerformanceMeasurement\/PerformanceMeasurement\/Historical+NHQM+manuals.htm. 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