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  Heart failure

Implantable cardioverter defibrillators in chronic kidney disease

A recent observational study reports that implantable cardioverter defibrillators were not associated with improved survival in patients with heart failure, reduced left ventricular ejection fraction and chronic kidney disease. Further studies are needed to identify which of these high-risk patients are most likely to benefit from this potentially life-saving therapy.

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Fig. 1: Age-specific treatment effects of ICDs in non-ischaemic systolic heart failure.


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The authors wish to acknowledge helpful discussions with D. M. Charytan (Brigham and Women’s Hospital, Boston, USA) and B. Claggett (Brigham and Women’s Hospital, Boston, USA) regarding this manuscript.

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Correspondence to Marc A. Pfeffer.

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Competing interests

M.A.P. receives research support from Novartis and serves as a consultant for AstraZeneca, Bayer, Boehringer Ingelheim, DalCor, Genzyme, Gilead, GlaxoSmithKline, Janssen, Lilly, Novartis, Novo Nordisk, Relypsa, Sanofi, Teva and Thrasos. He also has stock options for DalCor. F.R.M. reports no competing interests.

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Mc Causland, F.R., Pfeffer, M.A. Implantable cardioverter defibrillators in chronic kidney disease. Nat Rev Nephrol 14, 357–358 (2018).

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