Effectiveness of cardiac resynchronization therapy by the frequency of revascularization procedures in ischemic cardiomyopathy patients

Husaini, Mustafa; Biton, Yitschak; Stair, Brad; Moss, Arthur J.; Solomon, Scott D.; McNitt, Scott; Polonsky, Bronislava; Zaręba, Wojciech; Barsheshet, Alon; Kutyifa, Valentina

doi:10.5603/cj.a2016.0032

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…However, the clinical application of them has to be questioned, as they were present in only 24% and 7% of patients, respectively. In addition, a sub-analysis from MADIT-CRT showed that a history of PCI, independent of frequency or timing before enrolment, did not influence mortality [12]. Finally, there is no intuitive explanation for these two identified predictors and, due to the low number of patients with these comorbidities, a type I error especially for PVD cannot be excluded.…”

Section: Discussionmentioning

confidence: 96%

Predictors for early mortality and arrhythmic events in patients with cardiac resynchronization therapy with defibrillator: A two center cohort study

et al. 2020

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Background: Guidelines of heart failure therapy include cardiac resynchronization as standard of care in patients with severely depressed left ventricular function and wide QRS complex. It has been shown that patients benefit regarding mortality and morbidity. However, early mortality precludes longterm benefits from the device. The aim of the study was to identify predictors for early occurrence of both death and first-ever implantable cardioverter-defibrillator (ICD) therapy using a large combined database of patients with cardiac resynchronization therapy with defibrillator (CRT-D). Methods: From two registries (tertiary care centers) 904 patients were identified, no single patient was excluded. Early death was defined as death occurring within the 3 years after implantation whereas early ICD therapy as such occurring within the first year. 33 baseline parameters were compared using uni-and multivariate analysis with the Cox model and binary logistic regression. Results: The population was predominantly male (77%), with mean age of 63 ± 11 years and primary prevention indication in 80%. Mean follow-up was 55 ± 38 months. 256 (28%) patients had ICD therapies whereof the first-ever event occurred early in 52%. 270 (30%) patients died after 41 ± ± 31 months, mostly from advancing heart failure (41%), 141 (52%) patients of them early. Independent predictors for early ICD therapy were secondary prevention and renal failure. Independent predictors for early mortality were a history of percutaneous coronary intervention and of peripheral vascular disease. Conclusions: Predictors for early mortality after CRT-D implantation were a history of percutaneous coronary intervention and peripheral vascular disease, present in only a minority of patients, thus limiting their use in clinical practice.

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Section: Discussionmentioning

confidence: 96%

Predictors for early mortality and arrhythmic events in patients with cardiac resynchronization therapy with defibrillator: A two center cohort study

et al. 2020

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“…Response to CRT has been shown to have effects on clinical outcomes including rate of ventricular arrhythmia and overall prognosis [29,35]. Nevertheless, there is data that demonstrated no difference in left ventricular reverse remodeling irrespective of revascularization [36]. It is also well known that ischemic cardiomyopathy has a lower rate of CRT response, compared to non-ischemic cardiomyopathy [37].…”

Section: Discussionmentioning

confidence: 99%

The effect of revascularization on mortality and risk of ventricular arrhythmia in patients with ischemic cardiomyopathy

Alkharaza

Alharbi

Elsokkari

et al. 2020

BMC Cardiovasc Disord

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Background There is clear evidence that patients with prior myocardial infarction and a reduced ejection fraction benefit from implantation of a cardioverter-defibrillator (ICD). It is unclear whether this benefit is altered by whether or not revascularization is performed prior to ICD implantation. Methods This was a retrospective cohort study following patients who underwent ICD implantation from 2002 to 2014. Patients with ischemic cardiomyopathy and either primary or secondary prevention ICDs were selected for inclusion. Using the electronic medical record, cardiac catheterization data, revascularization status (percutaneous coronary intervention or coronary bypass surgery) were recorded. The outcomes were mortality and ventricular arrhythmia. Results There were 606 patients included in the analysis. The mean age was 66.3 ± 10.1 years, 11.9% were women, and the mean LVEF was 30.5 ± 12.0, 58.9% had a primary indication for ICD, 82.0% of the cohort had undergone coronary catheterization prior to ICD implantation. In the overall cohort, there were fewer mortality and ventricular arrhythmia events in patients who had undergone prior revascularization. In patients who had an ICD for secondary prevention, revascularization was associated with a decrease in mortality (HR 0.46, 95% CI (0.24, 0.85) p = 0.015), and a trend towards fewer ventricular arrhythmia (HR 0.62, 95% CI (0.38, 1.00) p = 0.051). There was no association between death or ventricular arrhythmia with revascularization in patients with primary prevention ICDs. Conclusion Revascularization may be beneficial in preventing recurrent ventricular arrhythmia, and should be considered as adjunctive therapy to ICD implantation to improve cardiovascular outcomes.

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“…So far most of the studies that have been done are in relation to comparison of effectiveness of CABG versus PCI, effect of PCI on Survival, effectiveness of cardiac resynchronization therapy by the frequency of revascularization procedures in ischemic cardiomyopathy patients, [ 20 – 22 ] or have studied one of the effectiveness indicators in their studies. [ 23 , 24 ] To our knowledge, this systematic review will be the first to evaluate existing research on the effectiveness of revascularization interventions compared with medical therapy in patients with ischemic cardiomyopathy.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of revascularization interventions compared with medical therapy in patients with ischemic cardiomyopathy

et al. 2018

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Effectiveness of cardiac resynchronization therapy by the frequency of revascularization procedures in ischemic cardiomyopathy patients

Cited by 3 publications

References 18 publications

Predictors for early mortality and arrhythmic events in patients with cardiac resynchronization therapy with defibrillator: A two center cohort study

Predictors for early mortality and arrhythmic events in patients with cardiac resynchronization therapy with defibrillator: A two center cohort study

The effect of revascularization on mortality and risk of ventricular arrhythmia in patients with ischemic cardiomyopathy

Effectiveness of revascularization interventions compared with medical therapy in patients with ischemic cardiomyopathy

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