{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:33:31Z","timestamp":1790962411233,"version":"4.1.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":56,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medtronic PLC medical device company","award":["The study funding does not have a grant number."],"award-info":[{"award-number":["The study funding does not have a grant number."]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heart failure (HF) remains a leading cause of death in Latin America, yet access to cardiac implantable electronic devices (CIEDs) is limited. Chile provides HF treatment through the AUGE\/GES (Universal Access with Explicit Guarantees in Health) program, while Mexico\u2019s public sector lacks such mechanisms for people without health insurance. This study aims to identify demographic and clinical factors associated with not receiving ICD or CRT-D among HF patients in Chile and Mexico.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This secondary analysis of the PLASMA study included 246 HF patients eligible for implantable cardioverter-defibrillators (ICDs) or cardiac resynchronization therapy with defibrillator (CRT-D) based on the 2017 ACC\/AHA\/HRS criteria. Variables included sociodemographic and clinical factors. We performed the Chi-square test and multivariable logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 246 eligible patients, 41.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009101) received ICD or CRT-D. The mean age of non-recipients was 64.1 years, compared to 58.5 years for recipients. Device implantation rates were higher in Chile (56%) than in Mexico (21%). Compared to Chile, Mexico had more recipients with NYHA class I (11.4% vs. 50%), even though the 2017 ACC\/AHA\/HRS criteria recommend ICDs and CRT-Ds mainly for symptomatic NYHA II\u2013III patients, with stricter criteria for NYHA I (such as Left Bundle Branch Block, \u2265\u200940 days post-myocardial infarction, or QRS\u2009\u2265\u2009150 ms with optimal therapy). Notably, Mexican patients had 7.6 times higher odds of not receiving a device compared to Chilean patients (aOR 7.58, 95%CI: 3.21\u201317.91). Care in public hospitals, older age, and NYHA III\u2013IV were also associated with higher odds of not receiving a device, while ventricular arrhythmia and prior revascularization were associated with a lower likelihood of non-implantation (aOR 0.09, 95%CI: 0.04\u20130.18, and aOR 0.57, 95%CI: 0.33\u20130.99, respectively), indicating that these patients were substantially more likely to receive a device. No significant sex-related differences were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There are substantial inequities in access to life-saving cardiac devices between Chile and Mexico: structural and demographic factors, particularly the supply capacity of public hospitals and older age, significantly limit access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-026-05924-4","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T09:05:20Z","timestamp":1778490320000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Inequities in access to life-saving cardiac devices for heart failure: a comparative analysis of Chile and Mexico"],"prefix":"10.1186","volume":"26","author":[{"given":"Fernando","family":"Lanas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco A.","family":"Alcocer-Gamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A.","family":"Narv\u00e1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e9n","family":"Aguayo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Verdejo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Riesgo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Levy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana V.","family":"Doubova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Perez-Cuevas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Muratore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"issue":"38","key":"5924_CR1","doi-asserted-by":"publisher","first-page":"4019","DOI":"10.1093\/eurheartj\/ehae466","volume":"45","author":"A Timmis","year":"2024","unstructured":"Timmis A, Aboyans V, Vardas P, Townsend N, Torbica A, Kavousi M, et al. 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The study was approved by the Ethics Committee of participated hospitals. These include Ethics Committees of the Hospital San Juan de Dios in Santiago, Chile; Hospital Dr. Hern\u00e1n Henr\u00edquez Aravena in Temuco City, Chile; Pontificia Universidad Cat\u00f3lica de Chile in Santiago, Chile; Hospital Dr. Guillermo Grant Benavente, in Concepci\u00f3n City, Chile; Hospital Dr. Gustavo Fricke, in Vi\u00f1a del Mar, Chile; Hospital de Talagante in Santiago, Chile; Hospital General ISSSTE Tacuba in Mexico City, Mexico; Centro de Imagen y Tecnolog\u00eda en Intervenci\u00f3n Vascular in Mexico City, Mexico; Centro M\u00e9dico ABC Santa Fe in Mexico City, M\u00e9xico; Instituto Nacional de Cardiolog\u00eda Ignacio Ch\u00e1vez in Mexico City, Mexico; Helimedica in Naucalpan de Ju\u00e1rez, Mexico; Centro de Estudios Cl\u00ednicos de Quer\u00e9taro S.C. in Santiago de Quer\u00e9taro, Mexico; Instituto Cardiovascular de m\u00ednima invasi\u00f3n in Jalisco, M\u00e9xico. The authors have followed their institution\u2019s confidentiality protocols. The SAGER guidelines were followed according to the nature of the study. All participants signed the informed consent form before their enrollment.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent for publication was not required by the Ethics Committees of participated hospitals.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare the following competing interests: Judith Riesgo, Federico Levy and Claudio Muratore are employees of Medtronic and Ricardo Perez-Cuevas was temporally hired as a Medtronic Consultant. Fernando Lanas, Marco A Alcocer-Gamba, Carlos A Narv\u00e1ez, Rub\u00e9n Aguayo, Pablo L\u00f3pez and Hugo Verdejo participated as the researchers and received payment from Medtronic during the course of the study, corresponding to the hours spent collecting data and completing the database. Svetlana V. Doubova has an immediate family member who worked as a consultant for Medtronic. All authors declare their complete independence from Medtronic during the entire research process and are solely responsible for the methods, results, concepts, and conclusions in this manuscript. Medtronic PLC did not influence the analysis and interpretation of the data, nor the preparation and publication of this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable, as this is a secondary data analysis of the observational study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}}],"article-number":"567"}}