Key result
Impaired baseline renal function (eGFR <60 mL/min/1.73 m2) was associated with a higher risk of all-cause mortality in patients undergoing CRT (HR 1.66; 95% CI 1.37-2.02; p<0.01).
Why the study?
Does impaired baseline renal function increase all-cause mortality in patients undergoing cardiac resynchronization therapy?
Meta-Analysis
Does impaired baseline renal function increase all-cause mortality in patients undergoing cardiac resynchronization therapy?
Hazard Ratio: 1.66 (95% CI 1.37–2.02)
p-value: p=<0.01
Baseline renal dysfunction is a significant predictor of increased all-cause mortality in heart failure patients undergoing cardiac resynchronization therapy.
Renal dysfunction warrants closer monitoring in CRT recipients; reinforces its prognostic value for risk stratification in trials and practice.
Background Cardiac resynchronization therapy (CRT) improves both morbidity and mortality in selected patients with heart failure and increased QRS duration. However, chronic kidney disease (CKD) may have an adverse effect on patient outcome. The aim of this systematic review was to analyze the existing data regarding the impact of baseline renal function on all‐cause mortality in patients who underwent CRT. Methods Medline database was searched systematically, and studies evaluating the effect of baseline renal function on all‐cause mortality in patients who underwent CRT were retrieved. We performed three separate analyses according to the comparison groups included in each study. Data were analyzed using Review Manager software (RevMan version 5.3; Oxford, UK). Results We included 16 relevant studies in our analysis. Specifically, 13 studies showed a statistically significant higher risk of all‐cause mortality in patients with impaired baseline renal function who underwent CRT. The remaining three studies did not show a statistically significant result. The quantitative synthesis of five studies showed a 19% decrease in all‐cause mortality per 10‐unit increment in estimated glomerular filtration rate (eGFR) [HR: 0.81, 95% CI (0.73–0.90), p<0.01, 86% I2]. Additionally, we demonstrated that patients with an eGFR<60 mL/min/1.73 m2 had an all‐cause mortality rate of 66% [HR: 1.66, 95% CI (1.37–2.02), p<0.01, 0% I2], which was higher than in those with an eGFR≥60 mL/min/1.73 m2. Conclusion Baseline renal dysfunction has an adverse effect on‐all cause mortality in patients who underwent CRT.
No takes yet. Share an insight, caveat, or question.
Bazoukis et al. (2017) conducted a meta-analysis in Heart failure. Impaired baseline renal function (eGFR <60 mL/min/1.73 m2) vs. eGFR ≥60 mL/min/1.73 m2 was evaluated on All-cause mortality (HR 1.66, 95% CI 1.37-2.02, p=<0.01). Impaired baseline renal function (eGFR <60 mL/min/1.73 m2) was associated with a higher risk of all-cause mortality in patients undergoing CRT (HR 1.66; 95% CI 1.37-2.02; p<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: