Key result
Cardiac resynchronization therapy significantly decreased the incidence of progression of heart failure (OR 0.64) compared to control in patients with asymptomatic and mild heart failure.
Why the study?
Does implantation of cardiac resynchronization therapy improve cardiac function and clinical outcomes in patients with asymptomatic and mild heart failure?
Meta-Analysis (n=5,058)
Does implantation of cardiac resynchronization therapy improve cardiac function and clinical outcomes in patients with asymptomatic and mild heart failure?
Effect estimate: OR 0.64 (95% CI 0.55-0.74)
Absolute Event Rate: 14.2% vs 21.05%
p-value: p=<0.001
In patients with mild or asymptomatic heart failure, CRT improves cardiac function and reduces disease progression, though mortality benefits did not reach statistical significance.
CRT reduces HF progression in asymptomatic/mild patients; extends RCT evidence to earlier disease stages.
This systematic review with meta-analysis sought to determine the efficacy, safety of implantation of cardiac resynchronization therapy (CRT) in mild heart failure (HF). Medline, Embase, Elsevier, and Sciences online database as well as Google scholar literature were used for selecting appropriate studies with randomized controlled design. The literature search of all major databases retrieved 2035 studies. After screening, a total of 10 trials were identified that reported outcomes of interest. Pooled analysis was performed on left ventricular (LV) ejection fraction (P<0.001), LV end-diastolic volume (P<0.001), LV end-systolic volume (P<0.001), LV end-diastolic diameter (P<0.001), LV end-systolic diameter (P<0.001), incidence of progression of heart failure (P<0.001), mortality (P=0.06), infection (P=0.1), and pneumothorax (P=0.08). Overall, implantation of CRT in patients with asymptomatic and mild HF resulted in improved cardiac function, decreased progression of HF, trend to decrease of mortality in short to long-term follow-up.
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Ali‐Hassan‐Sayegh et al. (2016) conducted a meta-analysis in Mild heart failure (n=5,058). Cardiac resynchronization therapy (CRT) vs. Control (ICD, RV pacing, or optimal medical therapy) was evaluated on Progression of heart failure (OR 0.64, 95% CI 0.55-0.74, p=<0.001). Cardiac resynchronization therapy significantly decreased the incidence of progression of heart failure (OR 0.64) compared to control in patients with asymptomatic and mild heart failure.
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