Heart failure & cardiomyopathies
Improved prognosis after cardiac resynchronization therapy over a decade
Authors' conclusion
From the perspective of an entire public health system, survival has improved and HF hospitalizations have decreased after CRT implantation over the past decade. This prognostic improvement has occurred despite an increasing comorbidity burden.
Study context
- Population
- Patients with heart failure (HF) undergoing cardiac resynchronization therapy (CRT)-defibrillation or CRT-pacing implantation, England, 2010 to 2019
- Participants
- 64,698 consecutive patients
- Exposure
- CRT implantation in 2018-2019 vs 2010-2011
- Outcome
- Clinical outcomes after CRT:
- Total mortality
- Total mortality
- HF hospitalization
Methodological detailsnational database, consecutive patients
- National database
- Consecutive patients
Main finding
As reported in the abstract
Total mortality and total mortality or HF hospitalisation, 2018-2019 vs 2010-2011 · 2 years
2018-2019 vs 2010-2011Hazard ratio (95% CI)
Total mortality
0.72(0.69–0.76)
Total mortality or HF hospitalisation
0.59(0.57–0.62)
After correction for age, race, sex, device type, comorbidities or the CCI
0.81(0.77–0.85)
- Total mortality at 30 days decreased (1.43-1.09%)
- P < 0.001
- Total mortality at 1 year decreased (9.51-8.13%)
- P < 0.001
Observational data: associations, not effects.
Further findings
Comorbidity burden, 2010-2011 to 2018-2019
- Hypertension
- 59.6-73.4%
- Diabetes
- 26.5-30.8%
- CKD
- 8.62-22.5%
- CCI ≥ 3
- 20.0% to 25.1%
- Increase in CRT implantations
- 76%
- All P < 0.001
Original publication
Improved prognosis after cardiac resynchronization therapy over a decade. Europace. Published 2 June 2023. doi:10.
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