Cardiac-resynchronization therapy for the prevention of heart-failure events
| Title: | Cardiac-resynchronization therapy for the prevention of heart-failure events |
|---|---|
| Authors: | Moss AJ; Hall WJ; Cannom DS; Klein H; Brown MW; Daubert JP; Estes NA 3rd; Foster E; Greenberg H; Higgins SL; Pfeffer MA; Solomon SD; Wilber D; Zareba W; Desai P; Wiggins S; Greer G; Beau S; Curnis A; Katz A; Cook J; McPherson C; Rozmus G; Switzer D; Stone J; Ludmer P; Colavita P; Tomassoni G; Crevey B; Nair G; Saliba W; Corbisiero R; Gilliam F; Hranitzky P; Rashtian M; Giudici M; Thomsen P; Cannom D; Clyne C; Pena E; Lessmeier T; Schuger C; Vogt J; Kacet S; Almendral J; Quesada A; Kautzner J; Padeletti L; Delnoy P; Goel S; Berger R; Pitschner H; Martin D; Kfoury A; Klein S; Levin V; Schalij M; Chow T; Chung E; Greenberg Y; Lemke B; Singh J; Rea R; Gold M; Guttigoli A; Adler A; Singer I; Shinn T; Guarnieri T; Casey C; Naccarelli G; Gornick C; Thibault B; Ackerman S; Turk K; Hunter N; Jentzer J; Bartlett T; Glascock D; Tamirisa K; Goldberger J; Coman J; Sandler D; Malik R; Nair L; O'Neill P; Sharma A; Brodine W; Kargul W; Higgins S; Porter M; Merkely B; Onufer J; Eldar M; Gottipaty V; Pires L; Wilson D; Arshad A; Fischer A; Mollerus M; Dixon M; Clair W; Wang P; Cox M; Viskin S; Greenspon A; Thakur R; Link M; Goette A; Duru F; Parker J; Stambler B; Meine M; Badhwar N; Olgin J; Knight B; Attari M; Berenbom L; Shorofsky S; Pelosi F; Mounsey J; Sanders W Jr; Barrington W; Daubert J; Huang D; Saxon L; DiMarco J; Merillat J; Bajaj R; Margolis D; Ewald G; Morgan J; Finta B; Haines D; Oakes D; Pearson T; Richeson F; Pomerantz R; Goldstein R; Haigney M; Krone R; Dwyer E Jr; Kukin M; Lichstein E; Solomon S; Beck C; McNitt S; Zhang H; Bausch J; Wang H; Brown M; Andrews M; Barber D; Buermann R; Cermak P; Kremer K; Moll J; Oberer A; Palmmontalbano L; Perkins E; Pyykkonen K; Ramsell D; Moss A; Pfeffer M; Zareba W. |
| Contributors: | Moss Aj; Hall Wj; Cannom D; Klein H; Brown Mw; Daubert Jp; Estes NA 3rd; Foster E; Greenberg H; Higgins Sl; Pfeffer Ma; Solomon Sd; Wilber D; Zareba W; Desai P; Wiggins S; Greer G; Beau S; Curnis A; Katz A; Cook J; Mcpherson C; Rozmus G; Switzer D; Stone J; Ludmer P; Colavita P; Tomassoni G; Crevey B; Nair G; Saliba W; Corbisiero R; Gilliam F; Hranitzky P; Rashtian M; Giudici M; Thomsen P; Clyne C; Pena E; Lessmeier T; Schuger C; Vogt J; Kacet S; Almendral J; Quesada A; Kautzner J; Padeletti L; Delnoy P; Goel S; Berger R; Pitschner H; Martin D; Kfoury A; Klein S; Levin V; Schalij M; Chow T; Chung E; Greenberg Y; Lemke B; Singh J; Rea R; Gold M; Guttigoli A; Adler A; Singer I; Shinn T; Guarnieri T; Casey C; Naccarelli G; Gornick C; Thibault B; Ackerman S; Turk K; Hunter N; Jentzer J; Bartlett T; Glascock D; Tamirisa K; Goldberger J; Coman J; Sandler D; Malik R; Nair L; O'Neill P; Sharma A; Brodine W; Kargul W; Higgins S; Porter M; Merkely B; Onufer J; Eldar M; Gottipaty V; Pires L; Wilson D; Arshad A; Fischer A |
| Publication Year: | 2009 |
| Collection: | Università degli Studi di Brescia: OPENBS - Open Archive UniBS |
| Description: | BACKGROUND: This trial was designed to determine whether cardiac-resynchronization therapy (CRT) with biventricular pacing would reduce the risk of death or heart-failure events in patients with mild cardiac symptoms, a reduced ejection fraction, and a wide QRS complex. METHODS: During a 4.5-year period, we enrolled and followed 1820 patients with ischemic or nonischemic cardiomyopathy, an ejection fraction of 30% or less, a QRS duration of 130 msec or more, and New York Heart Association class I or II symptoms. Patients were randomly assigned in a 3:2 ratio to receive CRT plus an implantable cardioverter-defibrillator (ICD) (1089 patients) or an ICD alone (731 patients). The primary end point was death from any cause or a nonfatal heart-failure event (whichever came first). Heart-failure events were diagnosed by physicians who were aware of the treatment assignments, but they were adjudicated by a committee that was unaware of assignments. RESULTS: During an average follow-up of 2.4 years, the primary end point occurred in 187 of 1089 patients in the CRT-ICD group (17.2%) and 185 of 731 patients in the ICD-only group (25.3%) (hazard ratio in the CRT-ICD group, 0.66; 95% confidence interval [CI], 0.52 to 0.84; P = 0.001). The benefit did not differ significantly between patients with ischemic cardiomyopathy and those with nonischemic cardiomyopathy. The superiority of CRT was driven by a 41% reduction in the risk of heart-failure events, a finding that was evident primarily in a prespecified subgroup of patients with a QRS duration of 150 msec or more. CRT was associated with a significant reduction in left ventricular volumes and improvement in the ejection fraction. There was no significant difference between the two groups in the overall risk of death, with a 3% annual mortality rate in each treatment group. Serious adverse events were infrequent in the two groups. CONCLUSIONS: CRT combined with ICD decreased the risk of heart-failure events in relatively asymptomatic patients with a low ejection fraction and ... |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/19723701; info:eu-repo/semantics/altIdentifier/wos/WOS:000270300000007; volume:361; issue:14; firstpage:1329; lastpage:1338; journal:NEW ENGLAND JOURNAL OF MEDICINE; http://hdl.handle.net/11379/161191 |
| DOI: | 10.1056/NEJMoa0906431 |
| Availability: | http://hdl.handle.net/11379/161191; https://doi.org/10.1056/NEJMoa0906431 |
| Accession Number: | edsbas.3B67A0A9 |
| Database: | BASE |