The study sought to determine the outcomes of patients with metabolic syndrome (MetS) who received an implantable cardiovertor defibrillator (ICD) for primary prevention of sudden cardiac death.
This was a retrospective study of 171 patients with systolic heart failure who underwent ICD placement for primary prevention of sudden cardiac death from April 2004 to September 2008. The clinical identification of patients with metabolic syndrome was based on the modified criteria proposed by the National Cholesterol Education Program‐Adult Treatment Panel III The mean follow‐up period was 27.4 months. Outcomes measured were cardiovascular mortality, rehospitalization within 6 months of index ICD placement, and appropriate ICD discharge. Statistical analyses were performed using the X2 test. Fisher's exact test, and logistic regression analysis.
Fifty‐three percent of patients were identified as having MetS, and 71% were obese. The average age of patients with MetS was 70 ± 8 years and of those with No‐Mets was 71 ± 6 years (P > 0.05). Ischemic cardiomyopathy was present in 94% patients with MetS and in 93% with No‐Mets (P > 0.05). Both groups had a higher prevalence of male patients (P > 0.05). The mean EF was 24.6% ± 6.9% in MetS and 26.3% ± 7.8% in No‐MetS (P > 0.05). During the follow‐up period, MetS patients were found to have higher cardiovascular mortality than were No‐MetS patients (21% vs. 7%, P = 0.01). Heart failure‐related readmission rates at 6 months of index hospital discharge after ICD placement were 22% versus 9% for MetS versus No‐MetS, respectively (P = 0.04). CVA was higher in MetS patients than in No‐MetS patients (19% vs. 13%), but we did not find any significant difference (P > 0.05) between the 2 groups. MetS patients were more likely to get appropriate ICD discharges than were No‐MetS patients (18% vs. 6%, P = 0.01). After adjusting for age and sex. multivariate analysis showed MetS to be a significant predictor of cardiovascular mortality (OR 2.44, 95% Cl, 1.03–7.63, P = 0.02) and appropriate ICD discharge (OR 3.13,95% Cl, 1.16–8.03, P = 0.03).
MetS appears to be a poor prognostic marker in patients who received ICD placement for primary prevention of sudden cardiac death.
I. Ahmed, none; W. Nelson, none; C. House, none; R. Dahiya, none; D. Zhu, none.
To cite this abstract:Ahmed I, Nelson W, House C, Dahiya R, Zhu D. Metabolic Syndrome Predicts Poor Outcome in Patients with Systolic Heart Failure Who Received Implantable Cardioverter‐Defibrillators for Primary Prevention of Sudden Cardiac Death. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 7. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/metabolic-syndrome-predicts-poor-outcome-in-patients-with-systolic-heart-failure-who-received-implantable-cardioverterdefibrillators-for-primary-prevention-of-sudden-cardiac-death/. Accessed November 15, 2019.