Risk factors and the effect of cardiac resynchronization therapy on cardiac and non-cardiac mortality in MADIT-CRT
Key result
CRT-D was associated with a reduced risk for cardiac death in patients with left bundle branch block (HR 0.56, P=0.029) but an increased risk for non-cardiac death in non-LBBB patients.
Why the study?
Does CRT-D compared to ICD-only affect the risk of cardiac and non-cardiac mortality in patients from the MADIT-CRT trial?
Population
1,820 patients from the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization…
Comparison
Cardiac resynchronization therapy with… vs Implantable cardioverter-defibrillator therapy…
Design
Cohort
Follow-up
4 years
Authors
Discussion
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Member takes
Implication
Reinforces QRS morphology for CRT-D selection; leaves open net mortality effects in non-LBBB.
Study Design
Type
RCT (n=1,820)
Multicenter
Yes
Structured PICO
Does CRT-D compared to ICD-only affect the risk of cardiac and non-cardiac mortality in patients from the MADIT-CRT trial?
P
Population
1,820 patients with myocardial dysfunction treated with CRT-D or ICD, followed for 4 years to assess risk factors for cardiac and non-cardiac mortality.
I
Intervention
Cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D)
C
Comparator
Implantable cardioverter-defibrillator (ICD) therapy only
O
Outcome
Cardiac and non-cardiac mortalityhard clinical
Main Result
Hazard Ratio: 0.56
p-value: p=0.029
CRT-D reduces cardiac death in patients with LBBB but may increase non-cardiac death in those without LBBB, reinforcing the importance of QRS morphology in patient selection.
Cite This Study
Perkiömäki et al. (2015) conducted an RCT in Myocardial dysfunction (n=1,820). Cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D) vs. Implantable cardioverter-defibrillator (ICD) therapy was evaluated on Cardiac death in patients with left bundle branch block (LBBB) (HR 0.56, p=0.029). CRT-D was associated with a reduced risk for cardiac death in patients with left bundle branch block (HR 0.56, P=0.029) but an increased risk for non-cardiac death in non-LBBB patients.