Risk stratification of cardiovascular and heart failure hospitalizations using integrated device diagnostics in patients with a cardiac resynchronization therapy defibrillator.
Europace
; 20(5): e69-e77, 2018 05 01.
Article
em En
| MEDLINE
| ID: mdl-28679168
ABSTRACT
Aims:
Cardiac resynchronization therapy defibrillators (CRT-D) are able to monitor various parameters that may be combined by an automatic algorithm to provide a heart failure risk status (HFRS). We sought to validate the HFRS for stratifying patient risk, evaluate its association with heart failure (HF) symptoms, and investigate its utility for triage of automatic alerts. Methods andresults:
Data from 722 patients included in the MORE-CARE trial were analysed in a post hoc analysis. A high HFRS was associated with a significantly increased risk of admission over the next 30 days with a relative risk for cardiovascular hospitalization (CVH) of 4.5 (95% CI 3.1-6.6, P < 0.001), of HF hospitalization of 6.3 (95% CI 3.9-10.2, P < 0.001) and of non-HF related CVH of 3.5 (95% CI 2.0-6.9, P < 0.001). The negative predictive value of low or medium HFRS for these admissions was ≥98%. A high HFRS was associated with an increased risk of HF symptoms. Of all the automatic remote monitoring alerts generated during the study, only 10% had a high HFRS.Conclusion:
The HFRS is able to risk-stratify CRT-D patients, which is potentially useful for managing automatic remote monitoring alerts, by focusing attention on the minority of high-risk patients. Clinical Trial Registration The trial was registered at www.clinicaltrials.gov under number NCT00885677.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Desfibriladores Implantáveis
/
Tecnologia de Sensoriamento Remoto
/
Terapia de Ressincronização Cardíaca
/
Insuficiência Cardíaca
/
Hospitalização
/
Monitorização Fisiológica
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Europace
Assunto da revista:
CARDIOLOGIA
/
FISIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Suíça