Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT.
Eur Heart J
; 32(21): 2697-704, 2011 Nov.
Article
em En
| MEDLINE
| ID: mdl-21642283
ABSTRACT
AIMS:
We aimed to evaluate within the MADIT-CRT database whether different enrollment characteristics between US and non-US centres affected the clinical course of study patients. METHODS ANDRESULTS:
We evaluated differences in baseline characteristics, procedure-associated complications, clinical as well as echocardiographic response to cardiac resynchronization therapy with a defibrillator (CRT-D), between patients enrolled in 87 US centres (n = 1271) and 23 non-US centres (n = 549) in MADIT-CRT. Non-US patients displayed significant differences in baseline characteristics from US patients, including a higher frequency of left bundle branch block, a more advanced heart failure (HF) functional class >3 months prior to enrollment, and larger baseline cardiac volumes. Procedure-related complications occurred at a significantly higher frequency among patients enrolled in non-US centres (17%) than among those enrolled in US centres (10%; P < 0.001). During follow-up, CRT-D was associated with 42% (P = 0.003) and 38% (P < 0.001) reductions in the risk of HF or death in the two respective groups (P for the difference = 0.80), and with similar reductions in cardiac volumes (all P > 0.10). Subgroup analysis showed a more pronounced effect of CRT-D among women in the US group, including a significant 71% (P = 0.02) reduction in the risk of death, whereas CRT-D therapy was associated with a significant clinical benefit in men only in the non-US group.CONCLUSION:
Patients enrolled in US and non-US centres in MADIT-CRT displayed significant differences in baseline clinical and echocardiographic characteristics and in the frequency of procedure-related complications, but experienced an overall similar clinical and echocardiographic response to CRT-D.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Admissão do Paciente
/
Desfibriladores Implantáveis
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Unidades de Cuidados Coronarianos
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Terapia de Ressincronização Cardíaca
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Insuficiência Cardíaca
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
País como assunto:
America do norte
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Asia
/
Europa
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article