The impact of age on clinical outcomes following cardiac resynchronisation therapy.
J Interv Card Electrophysiol
; 39(1): 95-102, 2014 Jan.
Article
en En
| MEDLINE
| ID: mdl-24293176
ABSTRACT
BACKGROUND:
Cardiac resynchronisation therapy (CRT) is an established treatment for selected patients with symptomatic left ventricular (LV) systolic dysfunction. Heart failure (HF) is primarily a disease of the elderly; however, these patients are underrepresented in CRT trials. Our aim was to evaluate the impact of age on clinical outcomes following CRT.METHODS:
A consecutive series of 177 patients was identified and divided into those aged ≤ 7 5 years (n = 131, mean ± SD 62.1 ± 11.2 years) and those aged >75 years (n = 46, mean ± SD 80.7 ± 4.1 years). The primary end point was a composite of all-cause mortality or HF hospitalisation.RESULTS:
During a median ± IQR follow up of 28.5 ± 33.7 months, the event rate for the primary end point was significantly higher in the elderly compared to younger patients (20.1 vs. 11.1 %, respectively, logrank p = 0.020). This was mainly driven by an excess mortality rate among those aged >75 years (10 vs. 4.7%, respectively, logrank p = 0.018) whereas HF hospitalisation rates were similar between groups (10 vs. 6.4%, respectively, logrank p = 0.301). After adjusting for comorbidities and ICD status, the difference in the composite end point rates was attenuated and no longer significant (HR 1.580, 95% CI 0.899-2.778; p = 0.112 for >75 vs. ≤ 75 years). Notably, both groups demonstrated similar response rates to CRT in terms of symptomatic improvement, reverse LV remodelling and neurohormonal activation.CONCLUSIONS:
CRT is equally effective in the elderly as in younger patients to reduce adverse clinical outcomes. For those who fulfil the prerequisite selection criteria, it should be considered as a valid therapeutic option.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Evaluación de Resultado en la Atención de Salud
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Terapia de Resincronización Cardíaca
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Insuficiencia Cardíaca
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Tiempo de Internación
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Interv Card Electrophysiol
Asunto de la revista:
CARDIOLOGIA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Reino Unido