Impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy: a meta-analysis.
BACKGROUND: Cardiac resynchronization therapy (CRT) has been extensively demonstrated to benefit heart failure patients, but the role of underlying heart failure etiology in the outcomes was not consistently proven. This meta-analysis aimed to determine whether efficacy and effectiveness of CRT is a...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3986107?pdf=render |
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| author | Yanmei Chen Chongyang Duan Feng Liu Shuxin Shen Pingyan Chen Jianping Bin |
| author_facet | Yanmei Chen Chongyang Duan Feng Liu Shuxin Shen Pingyan Chen Jianping Bin |
| author_sort | Yanmei Chen |
| collection | DOAJ |
| description | BACKGROUND: Cardiac resynchronization therapy (CRT) has been extensively demonstrated to benefit heart failure patients, but the role of underlying heart failure etiology in the outcomes was not consistently proven. This meta-analysis aimed to determine whether efficacy and effectiveness of CRT is affected by underlying heart failure etiology. METHODS AND RESULTS: Searches of MEDLINE, EMBASE and Cochrane databases were conducted to identify RCTs and observational studies that reported clinical and functional outcomes of CRT in ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM) patients. Efficacy of CRT was assessed in 7 randomized controlled trials (RCTs) with 7072 patients and effectiveness of CRT was evaluated in 14 observational studies with 3463 patients In the pooled analysis of RCTs, we found that CRT decreased mortality or heart failure hospitalization by 29% in ICM patients (95% confidence interval [CI], 21% to 35%), and by 28% (95% CI, 18% to 37%) in NICM patients. No significant difference was observed between the 2 etiology groups (P = 0.55). In the pooled analysis of observational studies, however, we found that ICM patients had a 54% greater risk for mortality or HF hospitalization than NICM patients (relative risk: 1.54; 95% CI: 1.30-1.83; P<0.001). Both RCTs and observational studies demonstrated that NICM patients had greater echocardiographic improvements in the left ventricular ejection fraction and end-systolic volume, as compared with ICM patients (both P<0.001). CONCLUSION: CRT might reduce mortality or heart failure hospitalization in both ICM and NICM patients similarly. The improvement of the left ventricular function and remodeling is greater in NICM patients. |
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| id | doaj.art-082985e6e3c14dfc9ce48fa7c613eca7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T04:08:36Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-082985e6e3c14dfc9ce48fa7c613eca72022-12-21T23:17:45ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9461410.1371/journal.pone.0094614Impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy: a meta-analysis.Yanmei ChenChongyang DuanFeng LiuShuxin ShenPingyan ChenJianping BinBACKGROUND: Cardiac resynchronization therapy (CRT) has been extensively demonstrated to benefit heart failure patients, but the role of underlying heart failure etiology in the outcomes was not consistently proven. This meta-analysis aimed to determine whether efficacy and effectiveness of CRT is affected by underlying heart failure etiology. METHODS AND RESULTS: Searches of MEDLINE, EMBASE and Cochrane databases were conducted to identify RCTs and observational studies that reported clinical and functional outcomes of CRT in ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM) patients. Efficacy of CRT was assessed in 7 randomized controlled trials (RCTs) with 7072 patients and effectiveness of CRT was evaluated in 14 observational studies with 3463 patients In the pooled analysis of RCTs, we found that CRT decreased mortality or heart failure hospitalization by 29% in ICM patients (95% confidence interval [CI], 21% to 35%), and by 28% (95% CI, 18% to 37%) in NICM patients. No significant difference was observed between the 2 etiology groups (P = 0.55). In the pooled analysis of observational studies, however, we found that ICM patients had a 54% greater risk for mortality or HF hospitalization than NICM patients (relative risk: 1.54; 95% CI: 1.30-1.83; P<0.001). Both RCTs and observational studies demonstrated that NICM patients had greater echocardiographic improvements in the left ventricular ejection fraction and end-systolic volume, as compared with ICM patients (both P<0.001). CONCLUSION: CRT might reduce mortality or heart failure hospitalization in both ICM and NICM patients similarly. The improvement of the left ventricular function and remodeling is greater in NICM patients.http://europepmc.org/articles/PMC3986107?pdf=render |
| spellingShingle | Yanmei Chen Chongyang Duan Feng Liu Shuxin Shen Pingyan Chen Jianping Bin Impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy: a meta-analysis. PLoS ONE |
| title | Impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy: a meta-analysis. |
| title_full | Impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy: a meta-analysis. |
| title_fullStr | Impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy: a meta-analysis. |
| title_full_unstemmed | Impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy: a meta-analysis. |
| title_short | Impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy: a meta-analysis. |
| title_sort | impact of etiology on the outcomes in heart failure patients treated with cardiac resynchronization therapy a meta analysis |
| url | http://europepmc.org/articles/PMC3986107?pdf=render |
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