Evidence map›Paper›PMID 30141210›Full record

Trial reportClinical cardiology2018

Predictors of long-term mortality with cardiac resynchronization therapy in mild heart failure patients with left bundle branch block.

Yitschak Biton, Jason Costa, Wojciech Zareba, Jayson R Baman, Ilan Goldenberg, Scott McNitt, Scott D Solomon, Bronislava Polonsky, Valentina Kutyifa

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Clinical cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Review
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yitschak BitonCardiology Division, University of Rochester Medical Center, Rochester, New York.ORCID http://orcid.org/0000-0001-5844-8551
Jason CostaCardiology Division, University of Rochester Medical Center, Rochester, New York.
Wojciech ZarebaCardiology Division, University of Rochester Medical Center, Rochester, New York.
Jayson R BamanCardiology Division, University of Rochester Medical Center, Rochester, New York.
Ilan GoldenbergCardiology Division, University of Rochester Medical Center, Rochester, New York.
Scott McNittCardiology Division, University of Rochester Medical Center, Rochester, New York.
Scott D SolomonBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Bronislava PolonskyCardiology Division, University of Rochester Medical Center, Rochester, New York.
Valentina KutyifaCardiology Division, University of Rochester Medical Center, Rochester, New York.ORCID http://orcid.org/0000-0002-0016-289X

Funding

Boston Scientific CorporationUnrestricted grant to the University of Rochester
6 · The paper itself

Abstract

backgroundCardiac resynchronization therapy (CRT) is highly beneficial in patients with heart failure (HF) and left bundle branch block (LBBB); however, up to 30% of patients in this selected group are nonresponders. HYPOTHESIS: We hypothesized that clinical and echocardiographic variables can be used to develop a simple mortality risk stratification score in CRT.

methodsBest-subsets proportional-hazards regression analysis was used to develop a simple clinical risk score for all-cause mortality in 756 patients with LBBB allocated to the CRT with defibrillator (CRT-D) group enrolled in the multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy. The score was used to assess the mortality risk within the CRT-D group and the associations with mortality reduction with CRT-D vs implantable cardioverter defibrillator (ICD) in each risk category.

resultsFour clinical variables comprised the risk score: age ≥ 65, creatinine ≥ 1.4 mg/dL, history of coronary artery bypass graft, and left ventricular ejection fraction (LVEF) < 26%. Every 1 point increase in the score was associated with 2-fold increased mortality within the CRT-D arm (P < 0.001). CRT-D was associated with mortality reduction as compared with ICD only in patients with moderate risk: score 0 (HR = 0.80, P = 0.615), score 1 (HR = 0.54, P = 0.019), score 2 (HR = 0.54, P = 0.016), score 3-4 risk factors (HR = 1.08, P = 0.811); however, the device by score interaction was not significant (P = 0.306). The score was also significantly predictive of left ventricular reverse remodeling (P < 0.001).

conclusionsFour clinical variables can be used for improved mortality risk stratification in mild HF patients with LBBB implanted with CRT-D.

Indexed as

AgedBundle-Branch BlockCardiac Resynchronization TherapyEchocardiographyFemaleFollow-Up StudiesHeart FailureHeart VentriclesHumansKaplan-Meier EstimateMaleRisk AssessmentRisk FactorsSurvival RateTime FactorsTreatment Outcomecardiac resynchronization therapyheart failureleft bundle branch blockrisk factors

Identifiers

PMID30141210
PMCPMC6490024

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.