Baroreflex activation therapy for the treatment of heart failure with reduced ejection fraction in patients with and without coronary artery disease
| Autor: | Vijay Swarup, Michael R. Zile, Rolf Wachter, Didier Klug, Fred A. Weaver, William C. Little, Seth J. Wilks, Marcel Halbach, William T. Abraham, Jochen Müller-Ehmsen, Hannes Reuter, Anique Ducharme, Michele Senni, Christian Butter, Jill E. Schafer |
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| Přispěvatelé: | Halbach, M, Abraham, W, Butter, C, Ducharme, A, Klug, D, Little, W, Reuter, H, Schafer, J, Senni, M, Swarup, V, Wachter, R, Weaver, F, Wilks, S, Zile, M, Müller-Ehmsen, J |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty animal structures Cardiomyopathy Subgroup analysis Electric Stimulation Therapy Heart failure Baroreflex activation therapy 030204 cardiovascular system & hematology Baroreflex Coronary artery disease law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Natriuretic Peptide Brain medicine Humans Device cardiovascular diseases 030212 general & internal medicine Retrospective Studies Ejection fraction business.industry Stroke Volume medicine.disease Peptide Fragments Treatment Outcome Cohort Cardiology Female Cardiology and Cardiovascular Medicine business Biomarkers |
| Popis: | In a randomized trial, baroreflex activation therapy (BAT) improved exercise capacity, quality of life and NT-proBNP in patients with heart failure with reduced ejection fraction (HFrEF). In view of different mechanisms underlying HFrEF, we performed a post-hoc subgroup analysis of efficacy and safety of BAT in patients with and without coronary artery disease (CAD).Patients with left ventricular ejection fraction35% and NYHA Class III were randomized 1:1 to guideline-directed medical and device therapy alone or plus BAT. Patients with a history of CAD, prior myocardial infarction or coronary artery bypass graft were assigned to the CAD group with all others assigned to the no-CAD group. Of 71 BAT treated patients, 52 had CAD and 19 had no CAD. In the control group, 49 of 69 patients had CAD and 20 had no CAD. The system- or procedure-related major adverse neurological or cardiovascular event rate was 3.8% in the CAD group vs. 0% in the no-CAD group (p = 1.0). In the whole cohort, NYHA Class, Minnesota Living with Heart Failure score, 6-minute hall walk distance and NTproBNP were improved in BAT treated patients compared with controls. Statistical analyses revealed no interaction between the presence of CAD and effect of BAT (all p 0.05).No major differences were found in BAT efficacy or safety between patients with and without CAD, indicating that BAT improves exercise capacity, quality of life and NTproBNP in patients with ischemic and non-ischemic cardiomyopathy. CLINICALTRIALS.NCT01471860 and NCT01720160. |
| Databáze: | OpenAIRE |
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