Risk Factors for Short-Term Versus Long-Term Mortality in Patients Who Underwent Cardiac Resynchronization Therapy

Cardiac resynchronization therapy (CRT) is an effective therapy in selected patients with advanced heart failure that reduces all-cause mortality at short-term follow-up. However, data regarding long-term mortality after CRT implantation are scarce, with no separate analysis available of the covaria...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of cardiology 2023-06, Vol.197, p.34-41
Main Authors: Galloo, Xavier, Khidir, Mand, Stassen, Jan, Hirasawa, Kensuke, Cosyns, Bernard, van der Bijl, Pieter, Delgado, Victoria, Ajmone Marsan, Nina, Bax, Jeroen J.
Format: Article
Language:English
Subjects:
Aged
Body mass index
Cardiac Resynchronization Therapy
Cardiology
Cardiovascular disease
Congestive heart failure
Decision making
Defibrillators, Implantable
Diabetes
Etiology
Female
Heart failure
Heart Failure - complications
Humans
Implantation
Information systems
Male
Middle Aged
Mortality
Parameters
Prognosis
Pulmonary arteries
Regression analysis
Risk assessment
Risk Factors
Survival analysis
Survival Rate
Therapy
Treatment Outcome
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Cardiac resynchronization therapy (CRT) is an effective therapy in selected patients with advanced heart failure that reduces all-cause mortality at short-term follow-up. However, data regarding long-term mortality after CRT implantation are scarce, with no separate analysis available of the covariates associated with respectively short-term and long-term outcomes. Accordingly, the present study evaluated the risk factors associated with short-term (2-year follow-up) versus long-term (10-year follow-up) mortality after CRT implantation. Patients who underwent CRT implantation and had echocardiographic evaluation before implantation were included in the present study. The primary end point was all-cause mortality, and independent associates of short-term (2-year follow-up) and long-term (10-year follow-up) mortality were compared. In total, 894 patients (mean age 66 ± 10 years, 76% males) who underwent CRT implantation were included in the present study. The cumulative overall survival rates for the total population were 91%, 71%, and 45% at 2-, 5- and 10-year follow-up, respectively. Multivariable Cox regression analysis showed that short-term mortality was associated with both clinical and echocardiographic variables at the moment of CRT implantation; whereas long-term mortality was predominantly associated with baseline clinical parameters and was less strongly associated with baseline echocardiographic parameters. In conclusion, at long-term (10-year) follow-up, a significant proportion (45%) of patients with advanced heart failure who underwent CRT implantation were still alive. Importantly, the risk assessment for short-term (2-year follow-up) and long-term (10-year follow-up) mortality differ considerably, which may influence clinical decision making.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2023.03.026