Outcomes of ICDs and CRTs in patients with chronic kidney disease: a meta-analysis of 21,000 patients |
| |
| Authors: | Mohammed Shurrab Yazan Zayed Sankar D. Navaneethan Nour Yadak Abeer Yaseen Anna Kaoutskaia Waad Qamhia Zakaria Hamdan Saleem Haj-Yahia Douglas S. Lee David Newman Jeff S. Healey Paula Harvey Eugene Crystal |
| |
| Affiliation: | 1.Cardiology Department,Health Sciences North,Sudbury,Canada;2.Health Sciences North Research Institute,Sudbury,Canada;3.Northern Ontario School of Medicine,Laurentian University,Sudbury,Canada;4.Institute of Health Policy, Management and Evaluation,University of Toronto,Toronto,Canada;5.Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre,University of Toronto,Toronto,Canada;6.Institute for Clinical Evaluative Sciences,Toronto,Canada;7.Department of Medicine,Hurley Medical Center,Flint,USA;8.Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine,Baylor College of Medicine,Houston,USA;9.Cardiology Department, An-Najah National University Hospital, Faculty of Medicine and Health Sciences,An-Najah National University,Nablus,Palestine;10.School of Clinical Sciences,University of Bristol,Bristol,UK;11.Peter Munk Cardiac Centre and the Joint Department of Medical Imaging, University Health Network,University of Toronto,Toronto,Canada;12.Population Health Research Institute,McMaster University,Hamilton,Canada;13.Division of Cardiology, Women’s College Hospital,University of Toronto,Toronto,Canada |
| |
| Abstract: | PurposeThe efficacy of implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) in patients with chronic kidney disease (CKD) remains unclear. The aim of this meta-analysis is to explore the association between ICD/CRT and mortality in CKD patients.MethodsAn electronic search was conducted using MEDLINE. We included studies that reported outcomes of interest in CKD patients stratified by the presence of ICD, CRT, or none. The primary outcome was all-cause mortality. Outcomes were pooled using random effects model. Odds ratios (OR) were reported for dichotomous variables.ResultsThe literature search resulted in 11 studies (observational studies) including 21,136 adult patients: seven studies compared ICD vs. no ICD and four studies compared CRT vs. ICD. All-cause mortality was significantly lower in the ICD group in comparison to that in the no ICD group (OR 0.66 (95% confidence interval [CI] 0.45; 0.98), P?=?0.04). Among dialysis-only patients, all-cause mortality was significantly lower in the ICD group (OR 0.49 (95% CI 0.38; 0.64), P?P?=?0.01).ConclusionsThe use of ICDs is associated with lower all-cause mortality in observational studies of CKD patients. CRT use was also associated with lower all-cause mortality in CKD patients in comparison to ICDs. A randomized controlled trial is required to definitively define the role of ICDs/CRTs in CKD patients. |
| |
| Keywords: | |
| 本文献已被 SpringerLink 等数据库收录！ |
|
