New Study Finds Few Medicare Patients Get Implantable Cardioverter Defibrillators Following Heart Attack
More than 350,000 people experience sudden cardiac death in the United States each year, yet fewer than 1 in 10 Medicare patients receives an implantable cardioverter-defibrillator (ICD) as a preventive measure following a heart attack, according to results of a new study published with an abstract in the June 23 issue of the Journal of the American Medical Association. In this large observational study, funded in part by AHRQ, a research team led by Duke University Medical Center sought to determine ICD implantation rates and associated mortality among patients 65 years and older with previous heart attack and low ejection fraction, a measure that determines how well the heart can pump blood. Evidence indicates that ICDs are underused in routine clinical practice, especially among older patients whose risks of heart attack and heart disease increase with age. Data for the study were drawn from 10,318 Medicare patients whose information was entered into a national cardiovascular registry and who were treated at 441 U.S. hospitals between 2007 and 2010. In addition to the low rate of ICD implantation among older patients, researchers also found that one-year ICD implantation was associated with significantly lower two-year mortality. Patients who had more contact with the health care system through early cardiology follow-up or readmission for heart attack or heart failure were more likely to undergo an ICD implantation, the study found. Further research is needed to determine evidence-based approaches to increase ICD implantation among eligible patients, researchers concluded.
JAMA. 2015 Jun 23-30;313(24):2433-40. doi: 10.1001/jama.2015.6409.
Implantable Cardioverter-Defibrillator Use Among Medicare Patients With Low Ejection Fraction After AcuteMyocardial Infarction.
Pokorney SD1, Miller AL2, Chen AY3, Thomas L3, Fonarow GC4, de Lemos JA5, Al-Khatib SM1, Peterson ED1, Wang TY1.
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- [PubMed - indexed for MEDLINE]