Heart failure & cardiomyopathies
Effectiveness of adding a defibrillator with cardiac resynchronization therapy in heart failure according to the modified Model for End-stage Liver Disease-Albumin score
Authors' conclusion
Our findings suggest that CRT-D is associated with an excess risk of composite clinical endpoints in HF patients with higher MELD-Albumin score.
Study context
- Population
- HF patients with CRT with pacemaker (CRT-P) or CRT-D implantation, 2010–2022
- Participants
- 752 patients
- Exposure
- CRT-D vs CRT-P, by MELD-Albumin score
- CRT-Pn = 291reference
- Outcome
- Composite of:
- All-cause mortality
- Worsening HF
- Follow-up
- Median 880 days
Methodological detailsconsecutive patients, multivariable-adjusted Cox regression
- Consecutive patients
- Multivariable-adjusted Cox regression
Main finding
As reported in the abstract
Primary endpoint by MELD-Albumin score
Each group vs CRT-PHazard ratio (CI)P value
CRT-Dassociation of MELD-Albumin score with primary endpoint within CRT-D
1.16(1.09–1.24)
P < 0.001CRT-Passociation of MELD-Albumin score with primary endpoint within CRT-P
1.03(0.95–1.12)
P = 0.49CRT-DMELD-Albumin ≥ 12
1.99(1.10–3.58)
P = 0.02CRT-DMELD-Albumin < 12
1.19(0.83–1.70)
P = 0.35- Patients reaching the primary endpoint
- 205
- Optimal MELD-Albumin cut-off
- 12
Observational data: associations, not effects.
Original publication
Effectiveness of adding a defibrillator with cardiac resynchronization therapy in heart failure according to the modified Model for End-stage Liver Disease-Albumin score. Europace. Published 4 August 2023. doi:10.
Summarised from the published abstract; every number is checked against it