{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:51:56Z","timestamp":1753887116223,"version":"3.41.2"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,6,16]]},"abstract":"\n Background<\/jats:title>\n \n There are conflicting data regarding the benefit of primary prevention implantable cardioverter\u2010defibrillators (\n ICD<\/jats:styled-content>\n s) in patients with diabetes mellitus and heart failure (HF) with reduced ejection fraction. We aimed to assess the comparative effectiveness of\n ICD<\/jats:styled-content>\n placement in patients with diabetes mellitus and HF with reduced ejection fraction.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Data were obtained from the Get With the Guidelines\u2013Health Failure registry, linked with claims from the Centers for Medicare & Medicaid Services. We used a Cox proportional hazards model censored at 5\u00a0years with propensity score matching. Of the 17\u00a0186 patients with HF with reduced ejection fraction from the Centers for Medicare & Medicaid Services claims database (6540 with diabetes mellitus; 38%), 1677 (646 with diabetes mellitus; 39%) received an\n ICD<\/jats:styled-content>\n during their index HF hospitalization or were prescribed an\n ICD<\/jats:styled-content>\n at discharge. Patients with diabetes mellitus and an\n ICD<\/jats:styled-content>\n (n=646), as compared with those without an\n ICD<\/jats:styled-content>\n (n=1031), were more likely to be younger (74 versus 78\u00a0years of age) and have coronary artery disease (68% versus 60%). After propensity matching,\n ICD<\/jats:styled-content>\n use among patients with diabetes mellitus, as compared with those without an\n ICD<\/jats:styled-content>\n , was associated with a reduced risk of all\u2010cause mortality at 5 years after\n HF<\/jats:styled-content>\n discharge (54% versus 59%; multivariable hazard ratio, 0.73; 95%\n CI<\/jats:styled-content>\n , 0.64\u20130.82;\n P<\/jats:italic>\n <0.0001). Ischemic heart disease did not modify the association between\n ICD<\/jats:styled-content>\n use and all\u2010cause mortality (\n P<\/jats:italic>\n =0.95 for interaction). Similar results were seen in patients without diabetes mellitus.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Primary prevention\n ICD<\/jats:styled-content>\n use among older patients with HF with reduced ejection fraction and diabetes mellitus was associated with a reduced risk of all\u2010cause mortality. Our analysis supports current guideline recommendations for implantation of primary prevention\n ICD<\/jats:styled-content>\n s among older patients with diabetes mellitus and HF with reduced ejection fraction.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.012405","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T09:10:58Z","timestamp":1590829858000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Effectiveness of Primary Prevention Implantable Cardioverter\u2010Defibrillators in Older Heart Failure Patients With Diabetes Mellitus"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2346-8330","authenticated-orcid":false,"given":"Abhinav","family":"Sharma","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"},{"name":"McGill University Health Centre Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Wu","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haolin","family":"Xu","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Michael","family":"Felker","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana","family":"Al\u2010Khatib","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Green","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Matsouaka","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\u2013UCLA Cardiomyopathy Center Los Angeles CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jagmeet P.","family":"Singh","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Boston MA"}],"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":"Justin A.","family":"Ezekowitz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Canadian VIGOUR Center University of Alberta Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"DeVore","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University School of Medicine Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.117.004646","article-title":"Trends in noncardiovascular comorbidities among patients hospitalized for heart failure","author":"Sharma A","year":"2018","unstructured":"Sharma A, Zhao X, Hammill BG, Hernandez AF, Fonarow GC, Felker GM, Yancy CW, Heidenreich PA, Ezekowitz JA, DeVore AD. 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