Heart failure & cardiomyopathiesCohort study
Age-stratified comparison of prognosis in cardiac resynchronization therapy with or without prophylactic defibrillator for nonischemic cardiomyopathy—a nationwide cohort study
- Retrospective cohort study
- nationwide
- registry-based
- propensity-score matched
Authors' conclusion
In this nationwide registry-based study, patients with CRT-D had better 5-year survival compared to patients with CRT-P. The interaction between age and mortality reduction was not consistent, but patients with CRT-D aged <60 years had the largest absolute mortality reduction.
Study context
- Population
- Patients with nonischemic cardiomyopathy implanted with CRT with pacemaker (CRT-P) or primary preventive cardiac resynchronization therapy with defibrillator (CRT-D) in Sweden, 2005–2020matched cohort n = 2414
- Participants
- 4,027 patients
- Exposure
- CRT-D vs CRT-P
- CRT-Dn = 1,693
- CRT-Pn = 2,334reference
- Outcome
- All-cause mortality
- Follow-up
- 5 years
Main finding
As reported in the abstract
Estimate
0.72
CI 0.61–0.85
P < 0.001
- Crude 5-year mortality, CRT-P vs CRT-D
- 635 (27%) vs. 246 (15%), P < 0.001
Observational data: associations, not effects.
Further findings
5-year mortality, matched cohort
- 5-year mortality, CRT-P vs CRT-D (overall 21%)
- 24 vs. 16%, P < 0.001
- matched cohort (n = 2414)
CV mortality (share of deaths)
- Similar between groups
- 62 vs. 64%, P = 0.64
Death from HF (share of deaths)
- More common in the CRT-D group
- 46 vs. 36%, P = 0.007
Mortality by age group (subgroups)
- CRT-P associated with higher mortality in age groups <60 years and 70-79 years
- No difference in age groups 60-69 years or 80-89 years
Original publication
Age-stratified comparison of prognosis in cardiac resynchronization therapy with or without prophylactic defibrillator for nonischemic cardiomyopathy—a nationwide cohort study. Europace. Published 1 July 2023. doi:10.1093/europace/euad187
Summarised from the published abstract; every number is checked against it