Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
June 16, 2006European Heart Journal

CRT significantly reduced all-cause mortality compared to medical therapy (24.7% vs 38.1%; hazard ratio 0.60, 95% CI 0.47-0.77, P<0.0001).

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Does implantation of a cardiac resynchronization therapy (CRT) device reduce all-cause mortality in patients with left ventricular ejection fraction <=35%, markers of cardiac dyssynchrony, and persistent moderate or severe symptoms of heart failure despite pharmacological therapy?

Population

813 patients with left ventricular ejection fraction <=35%, markers of cardiac dyssynchrony, and persistent…

Comparison

Implantation of a cardiac resynchronization… vs Medical therapy

Design

RCT, randomized, open-label

Follow-up

mean 37.4 months

Authors

JCJohn G.F. ClelandJDJean‐Claude DaubertEEErland Erdmann

Discussion

Loading...

Member takes

Overview

Supports CRT implantation in eligible HF patients with dyssynchrony; extends mortality benefit evidence to longer-term RCT follow-up.

Key Points

  • Assess the long-term impact of cardiac resynchronization therapy on all-cause mortality and specific modes of death in patients with moderate-to-severe heart failure and cardiac dyssynchrony.
  • Extension phase of an open-label randomized trial evaluating patients with left ventricular ejection fraction ≤35% and persistent moderate-to-severe heart failure symptoms.
  • A total of 813 patients were randomized to receive either cardiac resynchronization therapy (N=409) or medical therapy alone (N=404) over a mean follow-up of 37.4 months.
  • The primary outcome was all-cause mortality from randomization to extension completion, with mode of death assessed as a secondary endpoint.
  • All-cause mortality occurred in 101 of 409 patients (24.7%) in the cardiac resynchronization group versus 154 of 404 patients (38.1%) receiving medical therapy alone (HR 0.60, 95% CI 0.47–0.77, P<0.0001).
  • Cardiac resynchronization therapy significantly reduced both heart failure-related deaths (38 vs. 64 deaths; HR 0.55, 95% CI 0.37–0.82, P=0.003) and sudden deaths (32 vs. 55 deaths; HR 0.54, 95% CI 0.35–0.84, P=0.005).

Structured PICO

Does implantation of a cardiac resynchronization therapy (CRT) device reduce all-cause mortality in patients with left ventricular ejection fraction <=35%, markers of cardiac dyssynchrony, and persistent moderate or severe symptoms of heart failure despite pharmacological therapy?

P
Population
813 patients with left ventricular ejection fraction <=35%, markers of cardiac dyssynchrony, and persistent moderate or severe symptoms of heart failure despite pharmacological therapy
I
Intervention
Implantation of a cardiac resynchronization therapy (CRT) device
C
Comparator
Medical therapy
O
Outcome
All-cause mortality from the time of randomization to completion of the extension phasehard clinical

The extension phase of the CARE-HF trial demonstrates that the mortality benefits of cardiac resynchronization therapy in heart failure patients with dyssynchrony persist and increase with longer follow-up.

Cite This Study

Cleland et al. (2006) studied this question.

synapsesocial.com/papers/6a7ca119076dbfca02ba5dc7https://doi.org/10.1093/eurheartj/ehl099
View Full Paper
Ask AI
Bookmark
Share