Comparative Effectiveness of Cardiac Resynchronization Therapy Among Patients With Heart Failure and Atrial Fibrillation: Findings From the National Cardiovascular Data Registry's Implantable Cardioverter-Defibrillator Registry.

Autor:	Khazanie P; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.)., Greiner MA; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.)., Al-Khatib SM; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.)., Piccini JP; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.)., Turakhia MP; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.)., Varosy PD; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.)., Masoudi FA; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.)., Curtis LH; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.)., Hernandez AF; From the Duke Clinical Research Institute (P.K., M.A.G., S.M.A.-K., J.P.P., L.H.C., A.F.H.) and Department of Medicine (P.K., S.M.A.-K., J.P.P., L.H.C., A.F.H.), Duke University School of Medicine, Durham, NC; Veterans Affairs Eastern Colorado Healthcare System, Denver, CO (P.D.V.); University of Colorado Anschutz Medical Campus, Aurora, CO (F.A.M.); and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA and Stanford University School of Medicine, CA (M.P.T.). adrian.hernandez@duke.edu.
Jazyk:	angličtina
Zdroj:	Circulation. Heart failure [Circ Heart Fail] 2016 Jun; Vol. 9 (6).
DOI:	10.1161/CIRCHEARTFAILURE.115.002324
Abstrakt:	Background: Atrial fibrillation is common in patients with heart failure, but outcomes of patients with both conditions who receive cardiac resynchronization therapy with defibrillator (CRT-D) compared with an implantable cardioverter-defibrillator (ICD) alone are unclear. Methods and Results: Using the National Cardiovascular Data Registry's ICD Registry linked with Medicare claims, we identified 8951 patients with atrial fibrillation who were eligible for CRT-D and underwent first-time device implantation for primary prevention between April 2006 and December 2009. We used Cox proportional hazards models and inverse probability-weighted estimates to compare outcomes with CRT-D versus ICD alone. Cumulative incidence of mortality (744 [33%] for ICD; 1893 [32%] for CRT-D) and readmission (1788 [76%] for ICD; 4611 [76%] for CRT-D) within 3 years and complications within 90 days were similar between groups. After inverse weighting for the probability of receiving CRT-D, risks of mortality (hazard ratio, 0.83; 95% confidence interval, 0.75-0.92), all-cause readmission (hazard ratio, 0.86; 95% confidence interval, 0.80-0.92), and heart failure readmission (hazard ratio, 0.68; 95% confidence interval, 0.62-0.76) were lower with CRT-D compared with ICD alone. There was no significant difference in the 90-day complication rate (hazard ratio, 0.88; 95% confidence interval, 0.60-1.29). We observed hospital-level variation in the use of CRT-D among patients with atrial fibrillation. Conclusions: Among eligible patients with heart failure and atrial fibrillation, CRT-D was associated with lower risks of mortality, all-cause readmission, and heart failure readmission, as well as with a similar risk of complications compared with ICD alone. (© 2016 American Heart Association, Inc.)
Databáze:	MEDLINE
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