Cardiac Resynchronization in Different Age Groups: A MADIT-CRT Long-Term Follow-Up Substudy

Sabu Thomas, Arthur J. Moss, Wojciech Zareba, Scott McNitt, Alon Barsheshet, Helmut Klein, Ilan Goldenberg, David T. Huang, Yitschak Biton, Valentina Kutyifa

Research output: Contribution to journalArticlepeer-review

Abstract

Background Cardiac resynchronization with defibrillators (CRT-D) reduces heart failure and mortality compared with defibrillators alone. Whether this applies to all ages is unclear. Methods and Results We assessed the association of age on heart failure and death as a post hoc analysis of the MADIT-CRT follow-up study, in which 1,281 patients with class I/II heart failure (HF) were randomized to CRT-D or implantable cardioverter-defibrillators alone. Different age groups (<60, 60-74, and ≥75 years) were evaluated over 7 years for mortality and HF events. Among the 3 age groups, there were 399, 651, and 231 patients, respectively. We compared events with the use of a multivariate regression model. CRT-D compared with defibrillators alone significantly reduced the composite of HF or death across all age groups: <60 years: relative risk reduction (RRR) = 36%; 60-74 years: RRR = 61%; ≥75 years: RRR = 56%. CRT-D significantly reduced HF in all age groups: <60 years: RRR = 49%; 60-74 years: RRR = 62%; ≥75 years: RRR = 74%. CRT-D was associated with significant mortality reduction only in the 60-74 year age group: RRR = 59%. Conclusions CRT-D reduced HF events and the composite of mortality or HF events during long-term follow-up in all age groups. CRT-D reduced mortality only in the 60-74 year age group.

Original languageEnglish
Pages (from-to)143-149
Number of pages7
JournalJournal of Cardiac Failure
Volume22
Issue number2
DOIs
StatePublished - 1 Feb 2016

Keywords

  • Heart failure
  • biventricular pacing
  • geriatric cardiology
  • hospitalizations

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