Heart failure & cardiomyopathies
Immediate Pharmacotherapy Intensification After Cardiac Resynchronization Therapy: Incidence, Characteristics, and Impact
Main finding · All-cause death or first HF hospitalizationResult — go to the resultHazard ratio 0.51 95% CI 0.27–0.97Authors' conclusion
In patients with LBBB morphology and QRS ≥ 120 ms, IPI was associated with a significantly better prognosis and fewer HF hospitalizations after CRT implantation than others.
Study context
- Population
- Cardiac resynchronization therapy (CRT) recipients with left bundle branch block (LBBB), QRS ≥120 ms, LVEF ≤35%, NYHA II–IV heart failure (HF), HF hospitalization within the previous year, on guideline-directed medical therapy
- Participants
- 194 recipients
- Exposure
- Immediate pharmacotherapy intensification (IPI) vs no IPI after CRT implantation
- IPIn = 105
- Outcome
- All-cause death or first hospitalization for HF
- Follow-up
- Median 29 months
Methodological detailsmulticentre
- Multicentre
Main finding
All-cause death or first HF hospitalization
Hazard ratio
0.51
95% CI 0.27–0.97
P = 0.043
IPI vs Without IPI
HR 0.51 (95% CI 0.27–0.97); P = 0.043
As reported in the abstract
- Patients reaching primary endpoint (overall)
- 70 (36%)
Observational data: associations, not effects.
Secondary outcomes
QRS duration (baseline)
P = 0.004
eGFR (baseline)
P = 0.022
All-cause death · median follow-up 29 months
- Deaths (overall)
- 42 (22%)
- Significantly better outcome with IPI than without IPI
Volumetric responder ratio · 6 months
- Not significantly different between IPI and without IPI
Mortality · 6 months
- Reduced with IPI
Original publication
Immediate Pharmacotherapy Intensification After Cardiac Resynchronization Therapy: Incidence, Characteristics, and Impact. ESC Heart Fail. Published 11 March 2024. doi:10.
Summarised from the published abstract; every number is checked against it