Utilization of cardiac resynchronization therapy in eligible patients hospitalized for heart failure and its association with patient outcomes

Randolph, Tiffany C.; Hellkamp, Anne S.; Zeitler, Emily P.; Fonarow, Gregg C.; Hernandez, Adrian F.; Thomas, Kevin L.; Peterson, Eric D.; Yancy, Clyde W.; Al‐Khatib, Sana M.

doi:10.1016/j.ahj.2017.04.001

Cited by 31 publications

(30 citation statements)

References 43 publications

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“…15 Briefly, the score has four subscales: A = patient's readiness for transplant, B = social support system, C = psychosocial stability, and D = substance abuse and lifestyle. Total scores can be categorized as excellent candidate (0-6), good candidate (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), minimally acceptable candidate (21-39), high-risk candidate (40-68), and poor candidate (≥69). Patients with missing SIPAT scores were excluded from this analysis (N = 15).…”

Section: Psychosocial Covariatesmentioning

confidence: 99%

“…The proportion of patients considered minimally acceptable or worse did not differ by sex (men 14.4% vs women 10.3%, P = .2). Total SIPAT scores were higher for men than women (11 [6][7][8][9][10][11][12][13][14][15][16][17] were ineligible for advanced HF therapies (Table 3).…”

Section: Psychosocial Characteristics Of Patients Considered Ineligmentioning

confidence: 99%

“…8 Similarly, though the number of LVAD implants continues to grow, the proportion of women recipients has declined compared to the mid-1990s. 9 Since most large HF databases show that women represent at least 30%-40% of patients with HF with reduced ejection fraction (HFrEF), 10,11 there is a suggestion that women may be underrepresented as candidates for advanced HF therapies. However, there are little published data that explain why this might be.…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in eligibility for advanced heart failure therapies

Steinberg

Nayak

O'Connell

et al. 2020

Clinical Transplantation

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Objectives:We investigated sex-based differences in eligibility for and outcomes after receipt of advanced heart failure (HF) therapies.Background: Although women are more likely to die from HF than men, registry data suggest that women are less likely to receive heart transplant (HT) or left ventricular assist device (LVAD) for largely unknown reasons. Methods:We performed a single-center retrospective cohort study of patients evaluated for advanced HF therapies from 2012 to 2016. Logistic regression was used to determine the association of sex with eligibility for HT/LVAD. Competing risks and Kaplan-Meier analysis were used to examine survival. Results:Of 569 patients (31% women) evaluated, 223 (39.2%) were listed for HT and 81 (14.2%) received destination (DT) LVAD. Women were less likely to be listed for HT (adjusted odds ratio [OR] 0.36, 95% confidence interval [CI] 0.21-0.61; P < .0001), based on allosensitization (P < .0001) and obesity (P = .02). Women were more likely to receive DT LVAD (adjusted OR 2.29, 95% CI 1.23-4.29; P = .01). Survival was similar between men and women regardless of whether they received HT and DT LVAD or were ineligible for therapy. Conclusion:Women are less likely to be HT candidates, but more likely to receive DT LVAD. K E Y W O R D Sdisparities, heart failure, heart transplant, left ventricular assist device, women

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Section: Psychosocial Covariatesmentioning

confidence: 99%

Section: Psychosocial Characteristics Of Patients Considered Ineligmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sex differences in eligibility for advanced heart failure therapies

Steinberg

Nayak

O'Connell

et al. 2020

Clinical Transplantation

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“…Because we derived the patient population from electronic medical data, based on physician's coding, some patients may not have been included if the diagnosis was not charted or a preexisting device was not recognized. For example, a limitation of using ICD9 code v45.02 is that we are unable to discern the proportion of people with cardiac resynchronization devices, which may affect findings in a diverse patient population . This cross‐sectional analysis of the electronic medical record was unable to exhaustively explore the potential factors that could influence ICD implantation, such as marital status, provider referral rates, or patient refusal rates .…”

Section: Discussionmentioning

confidence: 99%

“…For example, a limitation of using ICD9 code v45.02 is that we are unable to discern the proportion of people with cardiac resynchronization devices, which may affect findings in a diverse patient population. 42 This cross-sectional analysis of the electronic medical record was unable to exhaustively explore the potential factors that could influence ICD implantation, such as marital status, provider referral rates, or patient refusal rates. 43 Our method of data collection also limited our ability to include patients outside the health system.…”

Section: Limitationsmentioning

confidence: 99%

Persistent sex disparities in implantable cardioverter‐defibrillator therapy

Johnson

Adhikari

Althouse

et al. 2018

Pacing Clinical Electrophis

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Physical Training and Cardiac Rehabilitation in Heart Failure Patients

Gregorio¹

2018

Advances in Experimental Medicine and Biology

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Regardless of advances in medical and interventional treatment of cardiovascular disease (CVD), a limited number of patients attend a cardiac rehabilitation (CR) programme on a regular basis. Due to modern therapies more individuals will be surviving an acute cardiovascular event, but the expected burden of chronic heart failure will be increasing worldwide.However, both in high- and low-income countries, secondary prevention after an acute myocardial infarction or stroke has been implemented in less than a half of eligible patients.Combined interventions are still needed to reduce decompensations, hospitalizations and mortality in heart failure patients from any origin. In addition to medical treatments, regular exercise has been demonstrated to improve metabolic and hemodynamic conditions in both asymptomatic risk factor carriers and cardiac patients. Risk factor control and exercise should gather together for an effective management of patients.Exercise-based training is a core component of primary and secondary prevention. It should involve healthy carriers of cardiovascular risk factors, and patients with cardiomyopathy as well. The supposed attenuated effect of CR in the era of advanced revascularization and structural interventions is due to the heterogeneity of training models and physical training in the literature. Moreover, lifestyle modification, psycho-social challenges and patient's compliance are potential confounders.In this chapter the most recent evidences about training modalities and potential benefit of CR in heart failure patients are discussed.

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Utilization of cardiac resynchronization therapy in eligible patients hospitalized for heart failure and its association with patient outcomes

Cited by 31 publications

References 43 publications

Sex differences in eligibility for advanced heart failure therapies

Sex differences in eligibility for advanced heart failure therapies

Persistent sex disparities in implantable cardioverter‐defibrillator therapy

Physical Training and Cardiac Rehabilitation in Heart Failure Patients

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