Why the study?
Accurate prediction of survival in individualized patients with cardiac resynchronization therapy with a defibrillator is difficult.
A newly developed prediction model using seven routine clinical variables accurately estimates 1- to 3-year survival probability in individual CRT-D recipients.
May inform prognosis discussions in CRT-D recipients; leaves open external validation before clinical use.
Background Accurate prediction for survival in individualized patients with cardiac resynchronization therapy with a defibrillator (CRT‐D) is difficult. Methods We analyzed the New Japan cardiac device treatment registry (JCDTR) database to develop a survival prediction model for CRT‐D recipients. Results Four hundred and eighty‐two CRT‐D recipients, at the implantation year 2018–2021, with a QRS width ≥120 ms and left ventricular ejection fraction (LVEF) ≤35% at baseline, were analyzed. During an average follow‐up of 21 ± 10 months, death occurred in 66 of 482 CRT‐D patients (14%). A prediction model estimating annual survival probability was developed using Cox regression with internal validation. With seven explanation predictors (age >75 years, serum creatinine >1.4 mg/dL, blood hemoglobin <12 g/dL, heart rate ≥90/min, LVEF, prior NSVT, and QRS width <150 ms), the model distinguished patients with and without all‐cause death, with an optimism‐corrected C‐statistics of 0.766, 0.764, and 0.768, and calibration slope of 1.01, 1.00, and 1.00 at 1 year, 2 years, and 3 years. Additionally, we have devised the calculator of survival probability for individual CRT‐D recipients. Conclusions Using routine available variables, we have developed a survival prediction model for individual CRT‐D recipients.
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Yokoshiki et al. (2025) studied this question.
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