Heart failure & cardiomyopathiesCohort study
Long-Term Outcome After Upgrade to Cardiac Resynchronization Therapy: A Propensity Score-Matched Analysis
- Retrospective cohort study
- international
- multicentre
- registry
- propensity-score matched
Authors' conclusion
In this retrospective analysis, the outcome of patients who underwent upgrades to CRT differed significantly from patients who underwent de novo CRT implantation, particularly for upgrades from ICD.
Study context
- Population
- Patients with chronic HF undergoing de novo or upgrade cardiac resynchronization therapy (CRT) implantation
- Participants
- 2,275 patients · 488 matched pairs
- Exposure
- Upgrade to CRT vs de novo CRT implantation
- Upgraden = 605
- Outcome
- Composite of:
- All-cause mortality
- Heart transplantation
- Ventricular assist device implantation
- Follow-up
- Mean 3.6 ± 2.7 years
Main finding
As reported in the abstract
All-cause mortality, heart transplantation or ventricular assist device implantation
Multivariable hazard ratio
1.35
95% CI 1.08–1.70
By group
Upgrade
10.8%/year
incidence rate
De novo
7.1%/year
incidence rate
Upgrade vs De novo
multivariable HR 1.35 (95% CI 1.08–1.70)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate | |
|---|---|---|
| Primary composite, by device upgraded from (subgroup) — Upgrade vs De novo · upgrade from pacemaker · after PSM | multivariable HR 1.33 (95% CI 1.03–1.70) | |
| Primary composite, by device upgraded from (subgroup) — Upgrade vs De novo · upgrade from ICD · after PSM | multivariable HR 1.40 (95% CI 1.01–1.95) | |
| First HF admission · after PSM (277 pairs) | HR 1.74 (95% CI 1.26–2.41) | |
| 0.512Ratio (log scale) |
Original publication
Long-Term Outcome After Upgrade to Cardiac Resynchronization Therapy: A Propensity Score-Matched Analysis. Eur J Heart Fail. Published 9 November 2023. doi:10.1002/ejhf.3073
Summarised from the published abstract; every number is checked against it