Indications, prognosis, and complications of de Novo implantable cardioverter defibrillators in patients with and without type 2 diabetes: a nationwide registry-based cohort study
Main finding · All-cause mortality (adjusted)Result — go to the resultHazard ratio 1.95 95% CI 1.81–2.11Authors' conclusion
Patients with type 2 diabetes more often received ICDs for PP and ischemic indications than No-DM patients and had a worse prognosis despite similar one-year infection risk. This likely reflects greater comorbidity burden and diabetes-specific factors, indicating the need for tailored risk management strategies beyond device implantation in patients with type 2 diabetes.
Study context
- Population
- Patients with de novo implantable cardioverter defibrillators (ICDs) implanted 2010–2021, Sweden
- Participants
- 12,885 patients
- Exposure
- T2D vs no diabetes in patients with de novo ICDs
- T2Dn = 2,843
- Outcome
- All-cause mortality (adjusted)
Methodological detailsnationwide, registry-based, six national registries
- Nationwide
- Registry-based
- Six national registries
Main finding
As reported in the abstract
Hazard ratio
1.95
95% CI 1.81–2.11
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| MACE (adjusted)More pronounced risk in SP than PP | 1.87 (1.71–2.05) | |
| 0.512Hazard ratio (log scale) |
Primary prevention (PP) ICD indication
P < 0.0001
Ischemic heart disease etiology
P < 0.0001
Age and sex T2D mean 67.9 years · No-DM 62.1 years · both p < 0.0001
Male
- Dilated cardiomyopathy etiology
- P = 0.007
Dilated cardiomyopathy etiology
- Non-ischemic etiologies, e.g. dilated cardiomyopathy, more common in No-DM
Safety
Infection · one year
Infection · one year
- Infection rates comparable
Original publication
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