Heart Disease
16 Sep Heart Failure: Serum Uric Acid As Predictor Of Poor Outcome
MedicalResearch.com Interview with:
Muthiah Vaduganathan, MD MPH
Department of Medicine
Massachusetts General Hospital
Boston, Mass
Medical Research: What are the main findings of the study?
Dr. Vaduganathan: Based on data from a large, multinational randomized controlled trial of patients hospitalized for heart failure and reduced ejection fraction (HFrEF), we conducted a retrospective analyses of the clinical profiles associated with baseline serum uric acid levels. Serum uric acid was commonly elevated in patients hospitalized for heart failure and reduced ejection fraction (mean ~9 mg/dL), especially in men and black patients. Higher uric acid levels were associated with lower systolic blood pressure and EF, higher natriuretic peptides, and more impaired renal function. After accounting for 24 known baseline covariates, serum uric acid was independently predictive of post-discharge mortality and rehospitalization in patients with relatively preserved renal function, but not in those with poor renal function.
13 Sep VA Hospitals CART Program Provides Quality Oversight Of All VA Heart Cath Labs
MedicalResearch.com Interview with:
Thomas M. Maddox, MD MSc FACC FAHA
Cardiology, VA Eastern Colorado Health Care System
Associate Director, VA CART Program
Associate Professor, Department of Medicine, University of Colorado School of Medicine
Medical Research: What are the main findings of the study?
Dr. Maddox: We were curious to know if the VA, as a provider of PCI at centers without on-site CT surgery, was providing better access to its veterans without compromising their safety. We were pleased to find that there was evidence of better access, with patients reducing their drive time to PCI facilities by, on average, 90 minutes. In addition, there was no compromised safety. Rates of both peri-procedural and 1-year adverse outcomes were low and no different between centers with and without on-site CT surgery.
13 Sep Inflammation May Explain Why Glycemic Control Alone May Not Prevent Diabetic Heart Disease
MedicalResearch.com Interview with:
Carlos F. Sánchez-Ferrer, M.D., Ph.D.
Professor of Pharmacology
Universidad Autónoma de Madrid, Spain.
Medical Research: What are the main findings of the study?
Dr. Sánchez-Ferrer: We were studying the possible ways of interaction between high glucose levels, which are found in diabetes mellitus, with vascular damage,
which is the most common and devastating consequence of this disease.
An intriguing fact is that a very strict control of blood sugar in
diabetic patients is not sufficient to avoid the development of such
diabetes-induced cardiovascular diseases. We think our results can
explain why this is happening.
Using cultured smooth muscle cells from the main human artery (aorta)
in the presence of high concentrations of extracellular glucose, we
observed:
1. In the absence of inflammation, excess glucose in the culture fluid
didn’t enter the cells.
2. When extra glucose was forced into the cells, no harm was done in
the absence of inflammation.
3. When the inflammation-stimulating protein interleukin-1 (IL-1) was
introduced, more glucose entered the cells.
4. With IL-1, the glucose entering the cells was metabolized via
chemical pathways that spur escalating inflammation, overwhelming the
cells’ ability to counteract it.
5. In the presence of the anti-inflammatory drug anakinra, which blocks
the activity of IL-1, the deleterious changes didn’t occur.
12 Sep Diabetes: Incretin-Based Drugs Not Linked To Congestive Heart Failure
MedicalResearch.com Interview with:
Kristian Filion, PhD FAHA
Assistant Professor of Medicine
Division of Clinical Epidemiology
Jewish General Hospital/McGill University
Montreal, Quebec H3T 1E2 Canada
Medical Research: What are the main findings of the study?
Dr. Filion: Previous studies have raised concerns that the use of incretin-based drugs, a type of medication used to treat diabetes, may increase the risk of congestive heart failure. We therefore examined this potential drug safety issue using a large, population-based database, which allowed us to study the safety of these medications in a real world setting. In doing so, we found that the use of incretin-based drugs was not associated with an increased risk of congestive heart failure among patients with type 2 diabetes. Similar results were obtained among both classes of incretin-based drugs (glucagon like peptide-1 [GLP-1] analogs and dipeptidyl peptidase-4 [DPP-4] inhibitors), and no duration-response relationship was observed.
11 Sep Sleep Apnea May Be Improved By Moderate Calorie Restriction
MedicalResearch.com Interview with: Marcia Klein M.D., Ph.D. Adjunctive professor Rio de Janeiro State University This study was conducted at the Discipline of Clinical and Experimental Pathophysiology - Rio de Janeiro State University and the financial support of FAPERJ. Medical Research: What was the main findings of the study? Dr. Klein: The main findings were that a diet with moderate calories restriction in obese patients with obstructive sleep apnea may be able not only to reduce body fat but also to reduce obstructive sleep apnea severity and blood pressure.11 Sep Diabetics on Statins May Have Fewer Microvascular Complications
MedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej Herlev, Denmark Medical Research: What are the main findings of the study? Dr. Nordestgaard: Among all patients with diabetes in Denmark during 1996-2009 and compared with non-statin users, statin users had a 40% lower risk of diabetic retinopathy, a 34% lower risk of diabetic neuropathy, and a 12% lower risk of gangrene of the foot, while the risk of diabetic nephropathy was similar.10 Sep Medical Research Citation Rate May Lead To Treatment Bias
MedicalResearch.com Interview with:
Mintu Turakhia, MD MAS, FHRS FACC FAHA
Assistant Professor of Medicine and (by courtesy) of Health Research & Policy
Stanford University School of Medicine
Director of Cardiac Electrophysiology
Core Investigator, Center for Innovation to Implementation
VA Palo Alto Healthcare System
Medical Research: What are the main findings of the study
Dr. Turakhia: We found that the reported success rate of a study correlated with the number of times the study was cited in the literature, even after adjustment for a wide range of factors.
09 Sep Post Stent: Delaying Non-Emergency Surgery Reduced Adverse Events
MedicalResearch.com Interview with: Laura A. Graham, MPH Center for Surgical, Medical Acute Care Research, and Transitions Birmingham Veterans Affairs Medical Center Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at Birmingham, Birmingham Medical Research: What are the main findings of the study? Answer: The main findings of the study are that the recommendations made in the guidelines published by the American College of Cardiology / American Heart Association in 2007 were effective at reducing postoperative major adverse cardiac events following noncardiac surgery in patients with a cardiac stent.1 These guidelines recommended the delay of noncardiac surgeries in patients with a drug-eluting stent for 365 days if the surgery was not emergent or the delay of surgery for 4 to 6 weeks among patients with a bare metal stent.1 In addition to a 26% reduction in postoperative major adverse cardiac events, we also found an increase in the time between drug-eluting stent placement and non-cardiac surgery consistent with the guideline recommendations.04 Sep High Estrogen, Low Testosterone Linked To Sudden Cardiac Arrest
MedicalResearch.com Interview with:
Sumeet S. Chugh MD
Pauline and Harold Price Endowed Professor
Associate Director, the Heart Institute
Section Chief, Clinical Cardiac Electrophysiology
Cedars-Sinai Medical Center, Los Angeles, CA
Medical Research: What are the main findings of the study?
Dr. Chugh: Our study, conducted in the community, showed that there are unique alterations in sex hormone levels identified among patients who have sudden cardiac arrest. Male victims have lower testosterone and both males and females have higher estrogren levels.
04 Sep Faster Resting Heart Rate Linked To Metabolic Syndrome
MedicalResearch.com Interview with:
Dr Weiguo Zhang, MD PhD
Cardiovascular and Neurological Institute
6771 San Fernando,
Irving, TX 75039, USA
Medical Research: What are the main findings of the study?
Prof. Zhang: Higher heart rate has emerged as a cardiovascular risk factor and is associated with higher mortality rate. However the mechanistic link between heart rate and mortality outcome in population has been missing. The main findings of the present study in a relatively large population are two-fold: Firstly, there is a strong and positive association between resting heart rate and metabolic syndrome, which is defined when an adult has 3 of the following: obesity (waist circumference ≥90 cm for men or ≥80 for women); hypertriglyceridemia (triglycerides ≥1.7 mmol/L); low plasma level of high-density lipoprotein <1.03 mmol/L for men or <1.30 mmol/L for women); hypertension (systolic blood pressure/ diastolic blood pressure≥130/85 mmHg or current use of antihypertensive medications); hyperglycemia (fast blood glucose ≥5.6 mmol/L or previously diagnosed type 2 diabetes or current use of hypoglycaemic agents or insulin). Secondly and more importantly, those without metabolic syndrome but with higher resting heart rate will have greater risk in developing metabolic syndrome in the near future. As such, the findings from both cross-sectional and longitudinal studies provide evidence that resting heart rate is an independent risk factor for existing metabolic syndrome and a powerful predictor for its future incidence.
04 Sep Increased Ectopic Heart Beats Linked to Less Effective Pacing with CRT Therapy
MedicalResearch.com Interview with:
Martin Huth Ruwald, MD, PhD
Post doctoral research fellow
Heart Research Follow-up Program
University of Rochester Medical Center
Rochester, NY, US
Medical Research: What are the main findings of the study?
Dr. Ruwald: A high percentage of biventricular pacing is required for optimal outcome in patients treated with cardiac resynchronization therapy (CRT), but the influence of ectopic beats on the success of biventricular pacing has not been well established.
We found that patients with increasing amount of ectopic beats (the ectopic burden) (≥0.1%) were more likely to achieve low biventricular pacing <97% and had higher risk of heart failure or death and ventricular arrhythmias. Similarly the study identified patients with a very low amount of ectopic beats, less than 1 in 1000, who are very likely to obtain high biventricular pacing and who have very low risk of adverse outcomes.
03 Sep Simple Facial Webcam Can Detect Atrial Fibrillation
MedicalResearch.com: Interview with:
Jean-Philippe Couderc, PhD, MBA
Associate Professor of Medicine
Research Associate professor of Electrical and Computer Engineering
University of Rochester, NY
Heart Research Follow-Up Program - Cardiology Department
Rochester, New-York 14642
Medical Research: What are the main findings of the study?
Dr. Couderc: We have developed a unique technology which enables any individual to evaluate if he/she suffers from atrial fibrillation (AF) by using a simple video camera (webcam). There are approximately 3.2 million people with AF in the US, and estimated 30 million people in the world. It has been shown that around 30% of people suffering from AF are not aware of their disease, this form is called 'silent' atrial fibrillation. AF is a progressive disease leading to stroke and heart failure. It results in significant morbidity and mortality. The total cost of AF in the US is estimated to $7billion and 75% of this cost is associated with patient hospitalization.
01 Sep Heart Attack: Antiplatelet Use in Ambulance May Decrease Stent Thrombosis
MedicalResearch.com Interview with:
Gilles Montalescot M.D., Ph.D.
Professor of Cardiology
University of Paris VI; Director, Cardiac Care Unit
Institute of Cardiology, Pitié-Salpêtrière University Hospital
Paris, France
Medical Research: What are the main findings of the study?
Dr. Montalescot : Among the 1862 patients with ongoing STEMI who were enrolled in the ATLANTIC study, we found no difference between those randomized to pre-hospital (in-ambulance) ticagrelor 180 mg and those randomized to in-hospital (in-catheterization laboratory) ticagrelor 180 mg in terms of either pre-PCI ST-segment elevation resolution (≥70%) or pre-PCI TIMI 3 flow in the culprit artery, which were the co-primary endpoints. There was also no difference between the groups in terms of major adverse cardiovascular events at 30 days, with the exception that rates of definite stent thrombosis were lower in the pre-hospital ticagrelor group than in the in-hospital group, both in the first 24 hours (0% versus 0.8%, p= 0.008) and at 30 days (0.2% versus 1.2%, p = 0.02). The safety of pre-hospital ticagrelor did not appear to be an issue, since the incidence of non-CABG-related major bleeding was low and similar in both treatment groups, whichever bleeding definition was used (PLATO, TIMI, STEEPLE, GUSTO, ISTH or BARC).
31 Aug COPPS-2 Evaluates Colchicine Pre-Cardiac Surgery To Prevent AFib and Effusions
MedicalResearch.com Interview with:
Massimo Imazio on behalf of the COPPS-2 Investigators
Massimo Imazio. MD, FESC
Dipartimento di Cardiologia/Cardiology Department
Maria Vittoria Hospital and University of Torino
Torino, Italia
Medical Research: What is the background for this investigation?
Dr. Imazio: Post-pericardiotomy syndrome, post-operative atrial fibrillation (AF), and post-operative effusions may be responsible for increased morbidity and healthcare costs after cardiac surgery. Postoperative use of colchicine prevented these complications in a single trial (the COPPS trial published on EHJ in 2010).
Here all events occurred within 3 months and colchicine was given after cardiac surgery starting from postoperative day 3 for 1 month. However most postoperative AF events are reported in the first 3 days and thus pre-treatment with colchicine may give better outcomes. Thus we performed the COPPS-2 giving colchicine 48 to 72 hours before surgery for 1 month without a loading dose and weight adjusted doses (i.e. 0.5 mg twice daily for patients >70kg or 0.5 mg once for patients <70Kg) in order to improve patients compliance.The Colchicine for Prevention of the Post-pericardiotomy Syndrome and post-operative atrial fibrillation (COPPS-2 trial) is an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial. A total of 360 consecutive candidates for cardiac surgery, 180 for each arm, were enrolled in 11 Italian centers between March 2012 and March 2014. Main exclusion criteria were absence of sinus rhythm at enrollment, cardiac transplantation, and contraindications to .
30 Aug New Angiotensin–Neprilysin Inhibitor Bests Enalapril for Heart Failure
MedicalResearch.com Interview with:
John J.V. McMurray, M.D
Professor of Medical Cardiology
British Heart Foundation,
Cardiovascular Research Centre
University of Glasgow,
Glasgow, United Kingdom
Medical Research: What are the main findings of the study?
Dr. McMurray: That compared to an evidence-based dose of an evidence-based ACE inhibitor (enalapril 10 mg bid), LCZ696 reduced the primary composite outcome of cardiovascular death or heart failure hospitalization by 20%, both the components of that composite and all-cause mortality (the latter by 16%) - all reductions are highly statistically significant and clinically important. LCZ696 treated patients also reported fewer symptoms and physical limitations due to heart failure. We think this is a remarkable finding - to beat what has been the gold-standard, cornerstone, therapy for around 25 years. The findings show conclusively that adding neprilysin inhibition to renin-angiotensin system blockade is superior to renin-angiotensin system blockade alone in patients with heart failure and reduced ejection fraction .
28 Aug Shorter Telomeres Associated With Risk of Coronary Heart Disease
MedicalResearch.com Interview with: Philip Haycock, PhD Post-Doctoral Research Assistant MRC Integrative Epidemiology Unit University of Bristol Bristol, BS8 2BN, UK Medical Research: What are the main findings of the study? Dr. Haycock: We found that shorter telomeres were significantly associated with risk of coronary heart disease and that the association was independent of conventional vascular risk factors, including age, sex, body mass index, smoking, history of diabetes, blood pressure and lipid markers.27 Aug Sulfonylurea For Diabetes Linked To Increased Heart Disease Risk
MedicalResearch.com Interview with:
Dr. Frank B. Hu
Department of Nutrition
Harvard School of Public Health
Boston, MA
Medical Research: What are the main findings of the study?
Dr. Hu: in this study among approximately 5000 patients with type 2 diabetes followed for up to 10 years, longer duration of sulfonylurea therapy was associated with a higher risk of coronary heart disease. The continuous sulfonylurea therapy for 10 years was associated with almost two times greater risk of coronary heart disease compared with nonusers. However, given the observational nature of the study, we cannot make causal inference from these findings.
27 Aug Blood Pressure Control Improved By Patient Self-Management
MedicalResearch.com Interview with
Prof Richard McManus MA PhD FRCGP
NIHR School for Primary Care Research,
Nuffield Department of Primary Care Health
Sciences, University of Oxford,
Oxford, Oxfordshire United Kingdom
Medical Research: What are the main findings of the study?
Prof. McManus: The TASMIN-SR clinical trial followed 552 patients with an average age of 70 and high blood pressure with pre-existing cardiovascular disease, diabetes or chronic kidney disease.
After training in how to self-monitor blood pressuring using a readily available device, patients took readings twice each morning for the first week of each month, and following an individualised management plan were able to request additional medication from their general practitioner without the need for consultation.
At the end of the study, patients who self-managed had significantly lower blood pressure (by 9.2 / 3.4 mmHg) than those who were visiting their GP for blood pressure monitoring, which would be expected to lower stroke risk by around 30% if sustained.
26 Aug EKG Changes Identify Older Adults At Risk of Heart Disease
MedicalResearch.com Interview with: Dr. Peter Godsk Jørgensen Copenhagen City Heart Study Frederiksberg Hospital, Frederiksberg, Denmark Medical Research: What are the main findings of your study? Dr. Jørgensen: In the coming decades, a larger and larger proportion of the population will be aged 65 years or above. At present, no risk prediction models have been developed specifically for estimation of risk in this population. ECG changes are easily recognized and identify subclinical signs of end-organ disease. Our data reveal that not only are ECG changes a very frequent finding that independently predicts cardiovascular disease, they significantly improve risk prediction when added to the most used European and US risk models. Thus, our data demonstrate that adding ECG changes will correctly reclassify more than one third of the persons aged 65 years and above without cardiovascular disease.26 Aug Coronary Stents and Elective PCI Rates Vary By Hospital
MedicalResearch.com Interview with
Steven M. Bradley, MD, MPH
Veterans Affairs, Eastern Colorado Health CareSystem
Denver, Colorado
Medical Research: What are the main findings of the study?
Dr. Bradley: In 539 hospitals participating in the CathPCI Registry that performed elective coronary angiography on more than 500,000 patients, 22% of patients were asymptomatic at the time of coronary angiography. We observed marked variation in the hospital rate of angiography performed in asymptomatic patients, ranging from 0.2% to 66.5%, suggesting broad variation in the quality of patient selection for coronary angiography across hospitals. Additionally, hospitals with higher rates of asymptomatic patients at diagnostic angiography also had higher rates of inappropriate PCI, due to greater use of PCI in asymptomatic patients. These findings suggest that patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria. By addressing patient selection upstream of the catheterization laboratory, we may improve on the optimal use of both angiography and PCI.
26 Aug Patients Often Misinformed About Benefits of PCI for Heart Attack Prevention
MedicalResearch Interview with:
Michael B. Rothberg, MD, MPH
Department of Internal Medicine
Medicine Institute, Vice Chair for Research
Cleveland Clinic, Cleveland, Ohio
Medical Research: What are the main findings of the study?
Dr. Rothberg: In this randomized study we found that when people are presented with no information about the benefits of elective PCI, most assumed that it would prevent a heart attack. Unfortunately, this is incorrect, so people may choose to have the procedure based on false information. We also found that simply telling them that PCI would not prevent a heart attack successfully dispelled this belief for most, but not all, participants. Explaining why PCI does not prevent heart attacks in this circumstance was the most effective way to change people's beliefs. We also found that most people were willing to take medications, but when they were told that PCI does not prevent heart attacks, they were more likely to agree to medication.
25 Aug Study Questions Supplemental Vitamin D for Heart Disease Prevention
MedicalResearch.com Interview with Esther Ooi & Børge G Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej 75, DK-2730 Herlev, Denmark Medical Research: What are the main findings of the study? Answer: Our findings suggest that low 25(OH)D levels observationally is simply a marker for elevated atherogenic lipoproteins, and thus question a role for vitamin D supplementation in the prevention of cardiovascular disease.21 Aug Coronary Arteries Supply Stem Cells To Generate New Heart Muscle
MedicalResearch.com Interview with:
Antonis Hatzopoulos, PhD, FAHA
Associate Professor of Medicine- Division of Cardiovascular Medicine
Associate Professor of Cell & Developmental Biology
Vanderbilt Center for Stem Cell Biology
Vanderbilt University
Nashville, TN 37232-6300
Medical Research: What are the main findings of the study?
Dr. Hatzopoulos: Using cell tracking in the normal adult mouse heart, we found that endothelial cells can function as cardiac stem cells to generate new heart muscle. Our results show that besides heart muscle, endothelial cells produce quiescent and proliferating cardiac progenitor cells that reside in the media and adventitia layers of the coronary arteries, respectively.
21 Aug Atrial Fibrillation Risk Lower In Postmenopausal Women Who Exercise
Posted at 10:41h
in AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease, Stanford
MedicalResearch.com Interview with
Marco Perez, MD
Instructor in Cardiovascular Medicine
Director, Inherited Cardiac Arrhythmia Clinic
Stanford University Medical Center
Cardiac Electrophysiology & Arrhythmia Service
Stanford, CA 94305-5233
Medical Research: What are the main findings of the study?
Dr. Perez: It was already known that obesity is an important risk factor for atrial fibrillation. We studied over 80,000 postmenopausal women enrolled in the Women’s Health Initiative who were followed for the onset of atrial fibrillation, an irregular heart rhythm associated with stroke and death. We found that those who exercised more than 9 MET-hours/week (equivalent to a brisk walk of 30 minutes six days a week) were 10% less likely to get atrial fibrillation than those who were sedentary. Importantly, the more obese the women were, the more they benefited from the exercise in terms of atrial fibrillation risk reduction.
20 Aug Implantable Defibrillators Decrease Mortality in Heart Failure Patients
MedicalResearch.com Interview with:
Gregg C. Fonarow, MD, FACC, FAHA
Eliot Corday Professor of Cardiovascular Medicine and Science
Director, Ahmanson-UCLA Cardiomyopathy Center
Co-Chief of Clinical Cardiology, UCLA Division of Cardiology
Co-Director, UCLA Preventative Cardiology Program
David Geffen School of Medicine at UCLA
Los Angeles, CA, 90095-1679
Medical Research: What are the main findings of the study?
Dr. Fonarow: Drawing on data from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF), 15,177 heart failure patients were followed over two years to measure the benefits of implantable device therapy on survival in community practice settings. The study demonstrated that ICD device therapy reduced the likelihood of death during the two-year period by 36 percent, with no significant differences by race or ethnicity. The study also demonstrated a 45 percent reduction in mortality during the two-year period with CRT therapy, again without any significant differences device benefit by race or ethnicity.
19 Aug Fenofibrate Improves Cholesterol Profile in Diabetes
MedicalResearch.com Interview with: Prof. Michael d’Emden Endocrine Research Unit Royal Brisbane Hospital, Brisbane, Australia Medical Research: What are the main findings of the study? Prof. d’Emden: Our study is the largest trial of women having type 2 diabetes assessing the role of a fibric acid derivative, in this case fenofibrate, ever conducted. There were 3657 female subjects randomized to placebo or fenofibrate. The study demonstrated greater reductions in women of total cholesterol, triglycerides and LDL-cholesterol and greater increases in HDL-cholesterol. In women, fenofibrate decreased total cardiovascular end-points by 30% compared with only 13% in men, although there was no-treatment-by-sex interaction. The majority of end points assessed revealed a consistent trend to increased benefit being seen in women.18 Aug Gender Linked To Health-Related Quality of Life in Young Adults with Heart Disease
MedicalResearch.com Interview with: Sylvie S.L. Leung Yinko, RD MSc Epidemiology '14 Division of Clinical Epidemiology Research Institute of McGill University Health Centre (RI MUHC) Montreal (QC) H3A 1A1 Medical Research: What are the main findings of the study? Answer: Our study indicates that young female patients with premature acute coronary syndrome (ACS) have lower health-related quality of life (HRQL) than their male counterparts. Whereas “sex” refers to whether an individual is biologically male or female, “gender” is a more complex term that refers to social norms, roles, and expectations that are traditionally ascribed to males and females in a society. We found that gender, rather than sex, may larger explain the differences in health-related quality of life between men and women. Particularly, higher femininity score, lower social support and greater housework responsibilities appear to be important gender-related factors linked with poorer HRQL post-ACS.16 Aug Implantable Cardioverter Defibrillators and Reduction in Mortality, Readmissions
MedicalResearch.com Interview with:
Ryan T. Borne MD
University of Colorado Anschutz Medical Campus
Division of Cardiology
Aurora, CO 80045
Medical Research: What are the main findings of the study?
Dr. Borne: Using the NCDR ICD Registry, we identified Medicare beneficiaries aged 65 years and older with low left ventricular ejection fraction (≤ 35%) who underwent primary prevention implantable cardioverter defibrillator implantation, including those receiving cardiac resynchronization therapy with defibrillator, between 2006 and 2010 who could be matched to Medicare claims. We found that while there were modest changes in the patient characteristics undergoing ICD implantation, there were significant improvements over time in mid-term outcomes including 6-month mortality, re-hospitalization, and device-related complications.