Key result
Combined cardiac resynchronisation and defibrillator therapy reduced deaths vs medical therapy (OR 0.57; 95% CI 0.40-0.80) but did not improve survival vs resynchronisation alone (OR 0.85).
Why the study?
Does combined cardiac resynchronisation and implantable cardioverter defibrillator therapy reduce overall deaths compared to medical therapy alone, ICD alone, or CRT alone in patients with left ventricular impairment and symptomatic heart failure?
Population
8,307 patients from 12 RCTs with impaired left ventricular systolic function and symptomatic heart failure
Comparison
Combined cardiac resynchronisation and… vs Medical therapy alone, implantable cardioverter…
Design
Meta-analysis
Authors
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CRT-D reduces mortality versus medical therapy in symptomatic HF with LV impairment; reinforces CRT benefit but challenges incremental survival gain from added defibrillator.
Meta-Analysis (n=8,307)
Does combined cardiac resynchronisation and implantable cardioverter defibrillator therapy reduce overall deaths compared to medical therapy alone, ICD alone, or CRT alone in patients with left ventricular impairment and symptomatic heart failure?
Effect estimate: OR 0.57 (95% CI 0.40-0.80)
Combined CRT-D reduces mortality compared to medical therapy alone but does not show superiority over CRT alone or ICD alone in patients with left ventricular impairment.
Lam et al. (2007) conducted a meta-analysis in Left ventricular impairment and symptomatic heart failure (n=8,307). Combined cardiac resynchronisation and implantable defibrillator therapy vs. Medical therapy alone, implantable defibrillator therapy, or resynchronisation therapy alone was evaluated on Overall number of deaths (OR 0.57, 95% CI 0.40-0.80). Combined cardiac resynchronisation and defibrillator therapy reduced deaths vs medical therapy (OR 0.57; 95% CI 0.40-0.80) but did not improve survival vs resynchronisation alone (OR 0.85).
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