Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study
ABSTRACT Background Frailty predisposes individuals to morbidity and mortality. Increasing numbers of elderly and comorbid individuals are undergoing primary prevention implantable cardioverter defibrillator (ICD) device placement. Little is known about the association of frailty with post‐device im...
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| Format: | Article |
| Language: | English |
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Wiley
2025-03-01
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| Series: | Annals of Noninvasive Electrocardiology |
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| Online Access: | https://doi.org/10.1111/anec.70061 |
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| author | Dmitry Neymark Christopher Lee William F. McIntyre Maria Higgins James W. Tam Colette Seifer |
| author_facet | Dmitry Neymark Christopher Lee William F. McIntyre Maria Higgins James W. Tam Colette Seifer |
| author_sort | Dmitry Neymark |
| collection | DOAJ |
| description | ABSTRACT Background Frailty predisposes individuals to morbidity and mortality. Increasing numbers of elderly and comorbid individuals are undergoing primary prevention implantable cardioverter defibrillator (ICD) device placement. Little is known about the association of frailty with post‐device implantation outcomes. Methods We conducted a single‐center, prospective cohort study of 71 patients who underwent primary prevention ICD insertion and who had their baseline frailty status assessed using the Fried index. Participants were followed for a median period of 7.8 years. Results The mean age (± SD) was 70.6 ± 4.5 years. 12 (17%) patients met the criteria for frailty. 23 (33%) patients received cardiac resynchronization therapy. Frailty was associated with a significantly higher incidence of mortality (HR [95% CI]; 3.9 [1.2–12.1]), ED visits (2.7 [1.1–6.7]), and hospitalizations (2.8 [1.1–7.6]). Within the non‐frail cohort, there was no association between Fried frailty scores and adverse outcomes. None of the frail patients received appropriate shock therapy. Conclusion Among primary prevention ICD recipients, frailty is associated with worse mortality and morbidity. Clinicians should consider frailty when discussing risks and benefits with this patient population. |
| format | Article |
| id | doaj-art-9b35ffbc0a5b4174862531bae2914aa5 |
| institution | OA Journals |
| issn | 1082-720X 1542-474X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj-art-9b35ffbc0a5b4174862531bae2914aa52025-08-20T01:49:36ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-03-01302n/an/a10.1111/anec.70061Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort StudyDmitry Neymark0Christopher Lee1William F. McIntyre2Maria Higgins3James W. Tam4Colette Seifer5Section of Cardiology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba CanadaDivision of Cardiology University of Calgary Calgary Alberta CanadaSection of Cardiology, Department of Internal Medicine McMaster University Hamilton Ontario CanadaSection of Cardiology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba CanadaSection of Cardiology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba CanadaSection of Cardiology, Department of Internal Medicine University of Manitoba Winnipeg Manitoba CanadaABSTRACT Background Frailty predisposes individuals to morbidity and mortality. Increasing numbers of elderly and comorbid individuals are undergoing primary prevention implantable cardioverter defibrillator (ICD) device placement. Little is known about the association of frailty with post‐device implantation outcomes. Methods We conducted a single‐center, prospective cohort study of 71 patients who underwent primary prevention ICD insertion and who had their baseline frailty status assessed using the Fried index. Participants were followed for a median period of 7.8 years. Results The mean age (± SD) was 70.6 ± 4.5 years. 12 (17%) patients met the criteria for frailty. 23 (33%) patients received cardiac resynchronization therapy. Frailty was associated with a significantly higher incidence of mortality (HR [95% CI]; 3.9 [1.2–12.1]), ED visits (2.7 [1.1–6.7]), and hospitalizations (2.8 [1.1–7.6]). Within the non‐frail cohort, there was no association between Fried frailty scores and adverse outcomes. None of the frail patients received appropriate shock therapy. Conclusion Among primary prevention ICD recipients, frailty is associated with worse mortality and morbidity. Clinicians should consider frailty when discussing risks and benefits with this patient population.https://doi.org/10.1111/anec.70061cardiac resynchronization therapycardiovascular diseaseCRTCVDfrailty assessmentICD |
| spellingShingle | Dmitry Neymark Christopher Lee William F. McIntyre Maria Higgins James W. Tam Colette Seifer Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study Annals of Noninvasive Electrocardiology cardiac resynchronization therapy cardiovascular disease CRT CVD frailty assessment ICD |
| title | Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study |
| title_full | Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study |
| title_fullStr | Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study |
| title_full_unstemmed | Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study |
| title_short | Association of Frailty With Clinical Outcomes in Patients Receiving Primary Prevention Implantable Cardioverter Defibrillators: A Prospective Cohort Study |
| title_sort | association of frailty with clinical outcomes in patients receiving primary prevention implantable cardioverter defibrillators a prospective cohort study |
| topic | cardiac resynchronization therapy cardiovascular disease CRT CVD frailty assessment ICD |
| url | https://doi.org/10.1111/anec.70061 |
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