Heart failure & cardiomyopathiesMeta-analysis
Cardiac Resynchronization Therapy in Ischemic Versus Nonischemic Cardiomyopathy
- Individual patient-data meta-analysis of randomised trials
- Bayesian hierarchical Weibull survival regression
Authors' conclusion
Although CRT led to greater increases in left ventricular ejection fraction and reductions in ventricular dimensions for patients with NICM compared with those with ICM, CRT significantly increased the time to HFH or all-cause death independently of the etiology of cardiomyopathy.
Study context
- Population
- Patients in 7 clinical trials of cardiac resynchronization therapy (CRT)
- Participants
- 6,252 patients · 7 clinical trials
- Comparison
- CRT vs no CRT, by etiology
- Ischemic cardiomyopathy (ICM)n = 3,704reference
- Outcome
- Time to all-cause death or HF hospitalization (heart failure hospitalization (HFH))
Pooled result
As reported in the abstract
HFH or all-cause death
Estimate (95% CrI)P value
CRT vs no CRTCrI
HR 0.67(0.56–0.82)
P < 0.001NICM vs ICMCrI; no difference by etiology
HR ratio 1.06(0.87–1.29)
P = 0.57Further pooled results
| Outcome | Estimate | P value | |
|---|---|---|---|
| All-cause death — CRT vs no CRT · CrI | HR 0.71 (95% CrI 0.55–0.93) | P = 0.019 | |
| All-cause death — NICM vs ICM · CrI; no difference by etiology | HR ratio 1.06 (95% CrI 0.80–1.43) | P = 0.70 | |
| 0.512Ratio (log scale) |
Echocardiographic response (LVEF, LV end-diastolic and end-systolic diameter)
- CRT improvements in LVEF, LV end-diastolic and end-systolic diameter larger in nonischemic cardiomyopathy (NICM)
- echo data available for 2,430 (39%) patients
Original publication
Cardiac Resynchronization Therapy in Ischemic Versus Nonischemic Cardiomyopathy. JACC Heart Fail. Published 9 October 2024. doi:10.1016/j.jchf.2024.08.010
Summarised from the published abstract; every number is checked against it