1. The effect of cardiac resynchronization without a defibrillator on morbidity and mortality: an individual-patient-data meta-analysis of COMPANION and CARE-HF
- Author
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Cleland, John G.F., Bristow, Michael R., Freemantle, Nicholas, Olshansk, Brian, Gras, Daniel, Saxon, Leslie, Tavazzi, Luigi, Boehmer, John, Ghio, Stefano, Feldman, Arthur M., Daubert, Jean-Claude, and deMets, David
- Abstract
Background: \ud Cardiac resynchronization therapy (CRT) reduces morbidity and mortality for patients with heart failure, reduced left ventricular ejection fraction, QRS duration >130 ms and in sinus rhythm.\ud \ud Objectives: \ud To identify patient-characteristics that predict the effect, specifically, of CRT-pacemakers (CRT-P) on all-cause mortality or the composite of hospitalisation for heart failure or all-cause mortality.\ud \ud Methods: \ud An individual patient-data meta-analysis of the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) and Cardiac Resynchronization – Heart Failure (CARE-HF) trials. Only patients assigned to CRT-P or control (n = 1738) were included in order to avoid confounding from concomitant defibrillator therapy. The influence of baseline characteristics on treatment effects was investigated.\ud \ud Results: \ud Median age was 67 (59–73) years, most patients were men (70%), 68% had a QRS duration of 150-199 ms and 80% had left bundle branch block (LBBB). Patients assigned to CRT-P had lower rates for all-cause mortality (HR 0.68 (95% CI 0.56 to 0.81; p
- Published
- 2022