Association Between Demographic, Organizational, Clinical, and Socio-Economic Characteristics and Underutilization of Cardiac Resynchronization Therapy: Results from the Swedish Heart Failure Registry
Key result
Among heart failure patients with a CRT indication, non-use was associated with demographic and organizational factors, including HF duration <6 months (RR 1.21; 95% CI 1.17-1.24).
Why the study?
What demographic, organizational, clinical, and socio-economic characteristics are associated with underutilization of cardiac resynchronization therapy in patients with heart failure?
Population
12,807 patients with heart failure from the Swedish Heart Failure Registry, mean age 71 ± 12 years, 28%…
Design
Cohort
Authors
Discussion
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Member takes
Implication
May inform initiatives to reduce CRT underuse; leaves open whether targeting factors improves outcomes.
Study Design
Type
Observational (n=12,807)
Multicenter
Yes
Structured PICO
What demographic, organizational, clinical, and socio-economic characteristics are associated with underutilization of cardiac resynchronization therapy in patients with heart failure?
P
Population
12,807 patients with heart failure (EF ≤39% and NYHA II-IV) from the Swedish Heart Failure Registry assessed for cardiac resynchronization therapy utilization.
O
Outcome
Prevalence of CRT indication and CRT use, and association between baseline covariates and CRT non-use
Main Result
Relative Risk: 1.21 (95% CI 1.17–1.24)
p-value: p=<0.05
CRT is significantly underutilized in eligible heart failure patients, driven primarily by demographic and organizational factors such as female sex, older age, and non-cardiology care, rather than clinical or socio-economic factors.
Cite This Study
Lund et al. (2017) conducted an observational in Heart failure (n=12,807). Demographic and organizational factors (e.g., HF duration <6 months) vs. Patients without these characteristics was evaluated on CRT non-use among patients with an indication (RR 1.21, 95% CI 1.17-1.24, p=<0.05). Among heart failure patients with a CRT indication, non-use was associated with demographic and organizational factors, including HF duration <6 months (RR 1.21; 95% CI 1.17-1.24).