Key result
CRT-D was associated with significantly lower all-cause mortality compared to CRT-P in patients with nonischemic cardiomyopathy (log HR -0.169, p=0.002).
Why the study?
Recent studies have questioned the role of implanted cardiac defibrillators in nonischemic cardiomyopathy, prompting an assessment of CRT-P versus CRT-D on mortality.
Does CRT-D reduce all-cause mortality in patients with nonischemic cardiomyopathy compared to CRT-P?
Meta-Analysis (n=22,763)
Does CRT-D reduce all-cause mortality in patients with nonischemic cardiomyopathy compared to CRT-P?
Effect estimate: log HR -0.169
p-value: p=0.002
In patients with nonischemic cardiomyopathy, the use of CRT-D is associated with a significant reduction in all-cause mortality compared to CRT-P.
Supports CRT-D over CRT-P for lower mortality in NICM; extends observational data but leaves randomized confirmation open.
Recent studies have questioned the role of implanted cardiac defibrillators (ICDs) in nonischemic cardiomyopathy (NICM). Cardiac resynchronization therapy (CRT) can be delivered by a pacemaker (CRT-P) or an ICD (CRT-D). This meta-analysis assessed the effect of CRT-P versus CRT-D on mortality in patients with NICM. Databases were searched for studies reporting the effect of CRT on all-cause mortality in patients with nonischemic cardiomyopathy (Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL). The primary endpoint was all-cause mortality. The minimum duration of follow-up required for inclusion was one year. The search was not restricted to time or publication status. The literature search identified 955 candidate studies, 15 studies and 22,763 patients were included. Mean follow-up was 53 months (17–100 months). CRT-D in NICM was associated with lower all-cause mortality (log HR − 0.169, SE 0.055; p = 0.002) compared to CRT-P. Heterogeneity: df = 15 (P 0.03), I2 = 43; test for overall effect: Z = − 3.043 (P = 0.002). CRT-D in NICM was associated with lower all-cause mortality than CRT-P.
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Al‐Sadawi et al. (2023) conducted a meta-analysis in Nonischemic cardiomyopathy (n=22,763). CRT-D vs. CRT-P was evaluated on All-cause mortality (log HR -0.169, p=0.002). CRT-D was associated with significantly lower all-cause mortality compared to CRT-P in patients with nonischemic cardiomyopathy (log HR -0.169, p=0.002).
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