{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:14:07Z","timestamp":1778692447061,"version":"3.51.4"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,8,25]]},"abstract":"\n Background<\/jats:title>\n \n Implantable cardioverter\u2010defibrillator (\n ICD<\/jats:styled-content>\n ) therapy is associated with improved outcomes in patients with heart failure (\n HF<\/jats:styled-content>\n ), but whether this association holds among older patients with multiple comorbid illnesses and worse\n HF<\/jats:styled-content>\n burden remains unclear.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Using the National Cardiovascular Data Registry's\n ICD<\/jats:styled-content>\n Registry and the Get With The Guidelines\u2013Heart Failure (\n GWTG<\/jats:styled-content>\n \u2010\n HF<\/jats:styled-content>\n ) registry linked with Medicare claims, we examined outcomes associated with primary\u2010prevention\n ICD<\/jats:styled-content>\n versus no\n ICD<\/jats:styled-content>\n among\n HF<\/jats:styled-content>\n patients aged \u226565\u00a0years in clinical practice. We included patients with an ejection fraction \u226435% who received (\n ICD<\/jats:styled-content>\n Registry) and who did not receive (\n GWTG<\/jats:styled-content>\n \u2010\n HF<\/jats:styled-content>\n ) an\n ICD<\/jats:styled-content>\n . Compared with patients with an\n ICD<\/jats:styled-content>\n , patients in the non\u2010\n ICD<\/jats:styled-content>\n group were older and more likely to be female and white. In matched cohorts, the 3\u2010year adjusted mortality rate was lower in the\n ICD<\/jats:styled-content>\n group versus the non\u2010\n ICD<\/jats:styled-content>\n group (46.7% versus 55.8%; adjusted hazard ratio [\n HR<\/jats:styled-content>\n ] 0.76; 95%\n CI<\/jats:styled-content>\n 0.69 to 0.83). There was no associated difference in all\u2010cause readmission (\n HR<\/jats:styled-content>\n 0.99; 95%\n CI<\/jats:styled-content>\n 0.92 to 1.08) but a lower risk of\n HF<\/jats:styled-content>\n readmission (\n HR<\/jats:styled-content>\n 0.88; 95%\n CI<\/jats:styled-content>\n 0.80 to 0.97). When compared with no ICD,\n ICD<\/jats:styled-content>\n s were also associated with better survival in patients with \u22643 comorbidities (\n HR<\/jats:styled-content>\n 0.77; 95%\n CI<\/jats:styled-content>\n 0.69 to 0.87) and >3 comorbidities (\n HR<\/jats:styled-content>\n 0.77; 95%\n CI<\/jats:styled-content>\n 0.64 to 0.93) and in patients with no hospitalization for\n HF<\/jats:styled-content>\n (\n HR<\/jats:styled-content>\n 0.75; 95%\n CI<\/jats:styled-content>\n 0.65 to 0.86) and at least 1 prior\n HF<\/jats:styled-content>\n hospitalization (\n HR<\/jats:styled-content>\n 0.69; 95%\n CI<\/jats:styled-content>\n 0.58 to 0.82). In subgroup analyses, there were no interactions between\n ICD<\/jats:styled-content>\n and mortality risk for comorbidity burden (\n P<\/jats:italic>\n =0.95) and for prior\n HF<\/jats:styled-content>\n hospitalization (\n P<\/jats:italic>\n =0.46).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Among older\n HF<\/jats:styled-content>\n patients,\n ICD<\/jats:styled-content>\n s for primary prevention were associated with lower risk of mortality even among those with high comorbid illness burden and prior\n HF<\/jats:styled-content>\n hospitalization.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002061","type":"journal-article","created":{"date-parts":[[2015,8,7]],"date-time":"2015-08-07T02:19:53Z","timestamp":1438913993000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Association Between Comorbidities and Outcomes in Heart Failure Patients With and Without an Implantable Cardioverter\u2010Defibrillator for Primary Prevention"],"prefix":"10.1161","volume":"4","author":[{"given":"Prateeti","family":"Khazanie","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"},{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne S.","family":"Hellkamp","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson\u2010UCLA Cardiomyopathy Center, Los Angeles, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick A.","family":"Masoudi","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Anstrom","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"},{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Veterans Affairs Palo Alto Health Care System, Palo Alto, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clyde W.","family":"Yancy","sequence":"additional","affiliation":[{"name":"Northwestern University, Chicago, IL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley H.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"},{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian F.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"},{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"},{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana M.","family":"Al\u2010Khatib","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC"},{"name":"Department of Medicine, Duke University School of Medicine, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612263352601"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912163412503"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.816884"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.08.058"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.07.028"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.043"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.56"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.07.015"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.07.020"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.03.004"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.04.002"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e31829e8776"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCUALTIONAHA.108.189742"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318276ce9b"},{"key":"e_1_3_3_18_2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1080\/00031305.1985.10479383","article-title":"Constructing 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Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Stat. 1985;39:33\u201338.","journal-title":"Am Stat"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176350951"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.157182"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.109.884395"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.13.1525"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.066605"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.115.002061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:43:01Z","timestamp":1715596981000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.115.002061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,25]]},"references-count":22,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2015,8,25]]}},"alternative-id":["10.1161\/JAHA.115.002061"],"URL":"https:\/\/doi.org\/10.1161\/jaha.115.002061","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,25]]},"assertion":[{"value":"2015-05-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-05-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-08-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e002061"}}