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Where patients with mild to moderate heart failure die: results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT).
Am Heart J. 2007 Jun; 153(6):1089-94.AH

Abstract

BACKGROUND

Common locations of death in patients with congestive heart failure (CHF) are unknown. In the SCD-HeFT, mortality of patients with CHF was assessed after randomization to an implantable cardioverter/defibrillator (ICD), amiodarone, or placebo. The aim of this study was to evaluate the location of deaths in SCD-HeFT.

METHODS

Among SCD-HeFT patients whose location of death was identified, we used logistic regression to assess the relationship of randomized treatment arm and other baseline predictors with the location of death. Cause of death was adjudicated by a therapy-blinded events committee.

RESULTS

In SCD-HeFT, 666 (26%) of 2521 patients died. Of the 604 (91%) for whom location of death was known, 58% died in hospital and 29% died at home. Patients randomized to receive an ICD were less likely to die at home than patients randomized to placebo (P = .002). Fewer patients randomized to ICDs died; even fewer randomized to ICDs died at home. Age, sex, etiology of heart failure, left ventricular ejection fraction, and New York Heart Association functional class were not associated with location of death. Sudden cardiac death represented 52% of all out-of-hospital deaths but in hospital deaths exceeded out-of-hospital deaths.

CONCLUSION

Deaths in SCD-HeFT, a well-treated CHF population, were most often in hospital. ICDs were associated with lower total and sudden death rates at home and in hospital. Development of methods to identify which patients will not respond to optimal treatment, including an ICD, remain a challenge.

Authors+Show Affiliations

Department of Internal Medicine, University of Iowa Hospitals, 4426A JCP, 200 Hawkins Dr, Iowa City, IA 52242, USA. brian-olshansky@uiowa.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

17540216

Citation

Olshansky, Brian, et al. "Where Patients With Mild to Moderate Heart Failure Die: Results From the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)." American Heart Journal, vol. 153, no. 6, 2007, pp. 1089-94.
Olshansky B, Wood F, Hellkamp AS, et al. Where patients with mild to moderate heart failure die: results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Am Heart J. 2007;153(6):1089-94.
Olshansky, B., Wood, F., Hellkamp, A. S., Poole, J. E., Anderson, J., Johnson, G. W., Boineau, R., Domanski, M. J., Mark, D. B., Lee, K. L., & Bardy, G. H. (2007). Where patients with mild to moderate heart failure die: results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). American Heart Journal, 153(6), 1089-94.
Olshansky B, et al. Where Patients With Mild to Moderate Heart Failure Die: Results From the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Am Heart J. 2007;153(6):1089-94. PubMed PMID: 17540216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Where patients with mild to moderate heart failure die: results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). AU - Olshansky,Brian, AU - Wood,Freda, AU - Hellkamp,Anne S, AU - Poole,Jeanne E, AU - Anderson,Jill, AU - Johnson,George W, AU - Boineau,Robin, AU - Domanski,Michael J, AU - Mark,Daniel B, AU - Lee,Kerry L, AU - Bardy,Gust H, AU - ,, PY - 2006/09/17/received PY - 2007/02/27/accepted PY - 2007/6/2/pubmed PY - 2007/6/15/medline PY - 2007/6/2/entrez SP - 1089 EP - 94 JF - American heart journal JO - Am Heart J VL - 153 IS - 6 N2 - BACKGROUND: Common locations of death in patients with congestive heart failure (CHF) are unknown. In the SCD-HeFT, mortality of patients with CHF was assessed after randomization to an implantable cardioverter/defibrillator (ICD), amiodarone, or placebo. The aim of this study was to evaluate the location of deaths in SCD-HeFT. METHODS: Among SCD-HeFT patients whose location of death was identified, we used logistic regression to assess the relationship of randomized treatment arm and other baseline predictors with the location of death. Cause of death was adjudicated by a therapy-blinded events committee. RESULTS: In SCD-HeFT, 666 (26%) of 2521 patients died. Of the 604 (91%) for whom location of death was known, 58% died in hospital and 29% died at home. Patients randomized to receive an ICD were less likely to die at home than patients randomized to placebo (P = .002). Fewer patients randomized to ICDs died; even fewer randomized to ICDs died at home. Age, sex, etiology of heart failure, left ventricular ejection fraction, and New York Heart Association functional class were not associated with location of death. Sudden cardiac death represented 52% of all out-of-hospital deaths but in hospital deaths exceeded out-of-hospital deaths. CONCLUSION: Deaths in SCD-HeFT, a well-treated CHF population, were most often in hospital. ICDs were associated with lower total and sudden death rates at home and in hospital. Development of methods to identify which patients will not respond to optimal treatment, including an ICD, remain a challenge. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/17540216/Where_patients_with_mild_to_moderate_heart_failure_die:_results_from_the_Sudden_Cardiac_Death_in_Heart_Failure_Trial__SCD_HeFT__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(07)00171-8 DB - PRIME DP - Unbound Medicine ER -