Evidence map›Paper›PMID 37984672›Full record

SynthesisAmerican heart journal2024

Benefit of cardiac resynchronization therapy among older patients: A patient-level meta-analysis.

Emily P Zeitler, Frederik Dalgaard, William T Abraham, John G F Cleland, Anne B Curtis, Daniel J Friedman, Michael R Gold, Valentina Kutyifa, Cecilia Linde, Anthony S Tang and 4 more

Open access · greenAbstract readMeta-Analysis
In one paragraph

Synthesis in American heart journal, 2024. 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
0.9field-weighted citation impact, top 22% of its field
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, 4 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
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

14 authors at 10 institutions in 5 countries.

Emily P ZeitlerDartmouth Health and The Dartmouth Institute, Lebanon, NH. Electronic address: emily.p.zeitler@hitchcock.org.
Frederik DalgaardDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Nykøbing Falster Sygehus, Nykøbing and Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen, Denmark.
William T AbrahamDivision of Cardiovascular Medicine, The Ohio State University, Columbus, OH.
John G F ClelandNational Heart and Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, London, United Kingdom; British Heart Foundation Centre of Research Excellence, School of Cardiovascular and Metabolic Health, University of Glasgow, United Kingdom.
Anne B CurtisDepartment of Medicine, University at Buffalo, NY.
Daniel J FriedmanDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
Michael R GoldMedical University of South Carolina, Charleston, SC.
Valentina KutyifaDivision of Cardiology, Department of Medicine, University of Rochester Medical Center, NY.
Cecilia LindeKarolinska Institutet and Department of Cardiology, Karolinska University, Stockholm, Sweden.
Anthony S TangDepartment of Medicine, Western University, Ontario, Canada.
Antonio Olivas-MartinezDepartment of Biostatistics, University of Washington, Seattle, WA.
Lurdes Y T InoueDepartment of Biostatistics, University of Washington, Seattle, WA.
Gillian D SandersDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Population Health Sciences, Duke-Margolis Center for Health Policy, Duke University School of Medicine, Durham, NC.
Sana M Al-KhatibDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
Duke University · USUniversity of Washington · USDartmouth Institute for Health Policy and Clinical Practice · USHarefield Hospital · GBKarolinska University Hospital · SEMedical University of South Carolina · USThe Ohio State University · USUniversity at Buffalo, State University of New York · USUniversity of Rochester Medical Center · USWestern University · CA

Funding

Power of Bayesian Methods, RCTs, and Decision Models to Inform CRT UncertaintiesR01HL131754 · NHLBI · DUKE UNIVERSITY · PI SCHMIDLER, GILLIAN SANDERS · 2017 to 2020
$2.7M
NHLBI NIH HHS R01 HL131754
6 · The paper itself

Abstract

backgroundCardiac resynchronization therapy (CRT) reduces heart failure hospitalizations (HFH) and mortality for guideline-indicated patients with heart failure (HF). Most patients with HF are aged ≥70 years but such patients are often under-represented in randomized trials.

methodsPatient-level data were combined from 8 randomized trials published 2002-2013 comparing CRT to no CRT (n = 6,369). The effect of CRT was estimated using an adjusted Bayesian survival model. Using age as a categorical (<70 vs ≥70 years) or continuous variable, the interaction between age and CRT on the composite end point of HFH or all-cause mortality or all-cause mortality alone was assessed.

resultsThe median age was 67 years with 2436 (38%) being 70+; 1,554 (24%) were women; 2,586 (41%) had nonischemic cardiomyopathy and median QRS duration was 160 ms. Overall, CRT was associated with a delay in time to the composite end point (adjusted hazard ratio [aHR] 0.75, 95% credible interval [CI] 0.66-0.85, P = .002) and all-cause mortality alone (aHR of 0.80, 95% CI 0.69-0.96, P = .017). When age was treated as a categorical variable, there was no interaction between age and the effect of CRT for either end point (P > .1). When age was treated as a continuous variable, older patients appeared to obtain greater benefit with CRT for the composite end point (P for interaction = .027) with a similar but nonsignificant trend for mortality (P for interaction = .35).

conclusionReductions in HFH and mortality with CRT are as great or greater in appropriately indicated older patients. Age should not be a limiting factor for the provision of CRT.

Indexed as

Cardiac Resynchronization TherapyDefibrillators, ImplantableHeart FailureAgedBayes TheoremFemaleHumansMaleProportional Hazards ModelsTreatment Outcome

Identifiers

PMID37984672
PMCPMC10842211
OpenAlexW4388807371

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.