January 16, 2019European Journal of Heart Failure
Cardiac Contractility Modulation Improves Long-Term Survival and Hospitalizations in Heart Failure with Reduced Ejection Fraction
Key result
Cardiac contractility modulation decreased hospitalizations from 1.2 to 0.35 per patient-year (P<0.0001) and yielded 3-year survival comparable to or better than SHFM predictions.
Why the study?
Although CCM improved symptoms, exercise tolerance, and 6-month HF hospitalizations in prior trials, its longer-term impact on hospitalizations and mortality in real-world clinical experience remained to be assessed.
Does cardiac contractility modulation reduce hospitalizations and improve survival in patients with heart failure and LVEF 25-45%?
Population
140 patients with 25% <= LVEF <= 45% receiving CCM therapy
Comparison
CCM therapy compared with pre-treatment hospitalizations and SHFM-predicted mortality
Design
Prospective registry study
Follow-up
Through 3 years
Authors
Discussion
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Member takes
Implication
May reduce hospitalizations in HF with LVEF 25-45%; leaves open need for randomized confirmation.
Study Design
Type
Cohort (n=140)
Structured PICO
Does cardiac contractility modulation reduce hospitalizations and improve survival in patients with heart failure and LVEF 25-45%?
P
Population
140 patients with heart failure and 25% ≤ LVEF ≤ 45% receiving cardiac contractility modulation therapy, followed for up to 3 years.
E
Exposure
Cardiac contractility modulation (CCM) therapy
C
Comparator
Historical control (hospitalizations the year prior) and Seattle Heart Failure Model (SHFM) predictions for mortality
O
Outcome
Cardiovascular and HF hospitalizations over 2 years, and mortality over 3 yearshard clinical
Main Result
Effect estimate: 75% decrease
Absolute Event Rate: 0.35% vs 1.2%
p-value: p=<0.0001
In a real-world registry, cardiac contractility modulation significantly reduced hospitalizations and improved symptoms in patients with heart failure and LVEF 25-45%, with survival comparable to or better than predicted models.
Cite This Study
Anker et al. (2019) conducted a cohort in Heart failure with reduced ejection fraction (n=140). Cardiac contractility modulation vs. Prior year (for hospitalizations) and Seattle Heart Failure Model predictions (for mortality) was evaluated on Hospitalizations (75% decrease, p=<0.0001). Cardiac contractility modulation decreased hospitalizations from 1.2 to 0.35 per patient-year (P<0.0001) and yielded 3-year survival comparable to or better than SHFM predictions.