Key result
Cardiac resynchronization therapy did not significantly improve time to all-cause death or urgent transplantation compared with optimal medical therapy (HR 1.29; 95% CI 0.59-2.83; P=0.52).
Why the study?
Does cardiac resynchronization therapy improve survival or prevent urgent transplantation in NYHA class IV heart failure patients compared with optimal medical therapy?
Cohort (n=80)
Does cardiac resynchronization therapy improve survival or prevent urgent transplantation in NYHA class IV heart failure patients compared with optimal medical therapy?
In NYHA class IV heart failure patients, CRT did not significantly improve survival or reduce the need for urgent transplantation compared to optimal medical therapy.
Answers are grounded in this paper and cite their sources.
CRT was not associated with survival benefit in NYHA IV HF; leaves open whether RCTs would alter findings in advanced disease.
AIMS: Although the benefit of cardiac resynchronization therapy (CRT) in selected patients with heart failure is well established, its effect on mortality in New York Heart Association (NYHA) class IV patients remains unclear. Our study evaluated the effect of CRT on urgent transplant-free survival in NYHA class IV patients treated with CRT, compared with medication-only treatment. METHODS AND RESULTS: Forty NYHA class IV patients treated with CRT (80% men, 62.5% ischaemic, mean age of 65) were matched 1:1 by age, gender and aetiology of cardiomyopathy with patients treated with optimal medical therapy (OPT group). No significant differences were found between the groups in left ventricular diastolic diameter (71 +/- 6 vs. 73 +/- 9 mm), left ventricular systolic diameter (58 +/- 7 vs. 61 +/- 11 mm), and left ventricular ejection fraction (23 +/- 5 vs. 22 +/- 6%). Mean follow-up was 13.2 +/- 9.5 months for the CRT group and 17.3 +/- 11.6 months for the OPT group. Time to all-cause death or urgent transplantation [hazard ratios (HR), 1.29; 95% CI: 0.59-2.83; P = 0.52] or to cardiovascular death or urgent transplantation (HR, 1.53; 95% CI: 0.64-3.67; P = 0.34) was not reduced significantly in patients treated with CRT. CONCLUSION: In this study, CRT did not significantly improve survival of NYHA class IV heart failure patients compared with pharmacological therapy.
No takes yet. Share an insight, caveat, or question.
Castel et al. (2010) conducted a cohort in NYHA class IV heart failure (n=80). Cardiac resynchronization therapy (CRT) vs. Optimal medical therapy (OPT) was evaluated on Time to all-cause death or urgent transplantation (HR 1.29, 95% CI 0.59-2.83, p=0.52). Cardiac resynchronization therapy did not significantly improve time to all-cause death or urgent transplantation compared with optimal medical therapy (HR 1.29; 95% CI 0.59-2.83; P=0.52).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: