Ethnic differences among implantable cardioverter defibrillators recipients in Israel

Area of Science:

• Cardiology
• Public Health
• Genetics

Background:

• Heart failure is a growing global health concern.
• Limited data exists on the specific characteristics of Israeli Arab patients with heart failure undergoing cardiac device implantation.

Purpose of the Study:

• To investigate and compare the demographic, clinical, and echocardiographic features, device indications, and outcomes of Israeli Arab versus Jewish patients in the national Implantable Cardioverter Defibrillator registry.
• To identify unique clinical characteristics of Israeli Arab patients with heart failure.

Main Methods:

• Retrospective analysis of 4,671 patients from the Israeli Implantable Cardioverter Defibrillator registry (July 2010 - December 2013).
• Comparison of Israeli Arabs (n=733) and Jews (n=3,938) based on demographics, clinical data, echocardiography, device indications, and follow-up outcomes.
• Statistical analysis to determine significant differences between the two ethnic groups.

Main Results:

• Israeli Arabs (15.7% of cohort) were younger at presentation (57±15 vs. 66±12 years) and had higher rates of comorbidities like diabetes, COPD, and smoking.
• Non-ischemic cardiomyopathy was more prevalent in Israeli Arabs (40.2% vs. 24.6%), often with a family history of sudden cardiac death.
• Follow-up (15±9 months) showed similar mortality rates and appropriate device therapy between groups.

Conclusions:

• Israeli Arab patients receiving implantable cardioverter defibrillators exhibit distinct clinical profiles, notably a higher prevalence of early-onset, rapidly progressing non-ischemic cardiomyopathy.
• Despite these differences, outcomes regarding mortality and device therapy were comparable between Israeli Arab and Jewish populations.
• These findings highlight the need for tailored management strategies for heart failure in diverse ethnic groups.