Evidence map›Paper›PMID 39082424›Full record

SynthesisJournal of the American Heart Association2024

Outcomes of Cardiac Resynchronization Therapy by New York Heart Association Class: A Patient-Level Meta-Analysis.

Nishkala Shivakumar, Daniel J Friedman, Marat Fudim, William T Abraham, John G F Cleland, Anne B Curtis, Michael R Gold, Valentina Kutyifa, Cecilia Linde, James Young and 5 more

Abstract readMeta-Analysis
In one paragraph

Synthesis in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Nishkala ShivakumarDepartment of Medicine Duke University School of Medicine Durham NC USA.ORCID 0000-0001-5014-4895
Daniel J FriedmanDivision of Cardiology, Department of Medicine Duke University School of Medicine Durham NC USA.ORCID 0000-0001-5791-1954
Marat FudimDivision of Cardiology, Department of Medicine Duke University School of Medicine Durham NC USA.ORCID 0000-0002-8671-7007
William T AbrahamDivision of Cardiovascular Medicine The Ohio State University Columbus OH USA.ORCID 0000-0003-4805-1037
John G F ClelandNational Heart and Lung Institute, Royal Brompton & Harefield Hospitals Imperial College London United Kingdom.ORCID 0000-0002-1471-7016
Anne B CurtisDepartment of Medicine University at Buffalo Buffalo NY USA.ORCID 0000-0002-9115-8051
Michael R GoldDepartment of Medicine Medical University of South Carolina Charleston SC USA.ORCID 0000-0002-4579-0216
Valentina KutyifaDivision of Cardiology, Department of Medicine University of Rochester Medical Center Rochester NY USA.ORCID 0000-0002-0016-289X
Cecilia LindeKarolinska Institutet and Department of Cardiology Karolinska University Stockholm Sweden.ORCID 0000-0002-9039-6023
James YoungCleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland OH USA.ORCID 0000-0003-2785-1617
Anthony TangDepartment of Medicine Western University Ontario Canada.ORCID 0000-0003-3056-3114
Antonio Olivas-MartinezDepartment of Biostatistics University of Washington Seattle WA USA.
Lurdes Y T InoueDepartment of Biostatistics University of Washington Seattle WA USA.
Gillian D SandersDuke Clinical Research Institute Duke University School of Medicine Durham NC USA.
Sana M Al-KhatibDivision of Cardiology, Department of Medicine Duke University School of Medicine Durham NC USA.ORCID 0000-0002-3561-0146

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

backgroundData on the benefits of cardiac resynchronization therapy (CRT) in patients with severe heart failure symptoms are limited. We investigated the relative effects of CRT in patients with ambulatory New York Heart Association (NYHA) IV versus III functional class at the time of device implantation. METHODS AND

resultsIn this meta-analysis, we pooled patient-level data from the MIRACLE (Multicenter InSync Randomized Clinical Evaluation), MIRACLE-ICD (Multicenter InSync Implantable Cardioversion Defibrillation Randomized Clinical Evaluation), and COMPANION (Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure) trials. Outcomes evaluated were time to the composite end point of the first heart failure hospitalization or all-cause mortality, and time to all-cause mortality alone. The association between CRT and outcomes was evaluated using a Bayesian hierarchical Weibull survival regression model. We assessed if this association differed between NYHA III and IV groups by adding an interaction term between CRT and NYHA class as a random effect. A sensitivity analysis was performed by including data from RAFT (Resynchronization-Defibrillation for Ambulatory Heart Failure). Our pooled analysis included 2309 patients. Overall, CRT was associated with a longer time to heart failure hospitalization or all-cause mortality (adjusted hazard ratio [aHR], 0.79 [95% credible interval [CI], 0.64-0.99]; posterior probability or

conclusionsOverall, there was no significant difference in the association of CRT with either outcome for patients in NYHA functional class III compared with functional class IV.

Indexed as

Cardiac Resynchronization TherapyHeart FailureAgedBayes TheoremElectric CountershockFemaleHospitalizationHumansMaleMiddle AgedRandomized Controlled Trials as TopicRisk FactorsSeverity of Illness IndexTime FactorsTreatment Outcomecardiac resynchronization therapyheart failurehospitalizationproportional hazards model

Identifiers

PMID39082424
PMCPMC11964027

What OpenQuestion holds

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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.