PMID- 19152106
OWN - NLM
STAT- MEDLINE
DCOM- 20090916
LR  - 20211020
IS  - 1572-8595 (Electronic)
IS  - 1383-875X (Linking)
VI  - 25
IP  - 2
DP  - 2009 Aug
TI  - Benefit of cardiac resynchronization in elderly patients: results from the 
      Multicenter InSync Randomized Clinical Evaluation (MIRACLE) and Multicenter 
      InSync ICD Randomized Clinical Evaluation (MIRACLE-ICD) trials.
PG  - 91-6
LID - 10.1007/s10840-008-9330-2 [doi]
AB  - PURPOSE: Heart failure (HF) affects five million patients each year with both 
      prevalence and incidence increasing with age. At least 20% of hospital admissions 
      in patients > age 65 are due to HF. Cardiac resynchronization therapy (CRT) has 
      been shown to improve HF symptoms and decrease mortality. However, little data 
      are available which specifically address the effects of CRT in the elderly (>65). 
      METHODS: We performed an analysis of the NYHA III/IV 839 patients randomized in 
      the MIRACLE (n = 470) and MIRACLE-ICD (n = 369) trials. Both included patients 
      with moderate to severe HF, ejection fraction (EF) <or=35%, and QRS duration 
      >or=130 msec. Patients were grouped by age <65, 65-75, and >75 years. For each 
      group, patients with CRT activated (ON) were compared with patients with CRT 
      inactivated (OFF) for end points at 6 months, including New York Heart 
      Association (NYHA) functional class and EF. RESULTS: Of the 839 patients, 368 
      were <65, 297 were 65-75, and 174 were >75 years old. Compared with controls, 
      patients from all three age groups, whose CRT was activated, had statistically 
      significant improvements in NYHA class (-0.84 for age <65, -0.78 for age 65-75, 
      and -0.78 for age >75). All age groups with CRT ON also had statistically 
      significant improvements in left ventricular EF (5.23%, 2.98%, and 4.03% 
      respectively). There were no between group differences by age in LVEF 
      improvement. CONCLUSIONS: In elderly patients enrolled in the MIRACLE and 
      MIRACLE-ICD trials, CRT resulted in significant improvements in NYHA class and 
      LVEF, regardless of age. These data suggest that the full age range of patients 
      with appropriate indications for implantation can benefit from CRT.
FAU - Kron, Jordana
AU  - Kron J
AD  - Division of Cardiology, Virginia Commonwealth University, Richmond, VA, USA.
FAU - Aranda, Juan M Jr
AU  - Aranda JM Jr
FAU - Miles, William M
AU  - Miles WM
FAU - Burkart, Thomas A
AU  - Burkart TA
FAU - Woo, Gregory W
AU  - Woo GW
FAU - Saxonhouse, Sherry J
AU  - Saxonhouse SJ
FAU - Sears, Samuel F Jr
AU  - Sears SF Jr
FAU - Conti, Jamie B
AU  - Conti JB
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20090119
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
SB  - IM
MH  - Adult
MH  - Age Distribution
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Pacing, Artificial
MH  - Comorbidity
MH  - Female
MH  - Heart Failure/*epidemiology/*prevention & control
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Risk Assessment
MH  - Risk Factors
MH  - Sex Distribution
MH  - Treatment Outcome
MH  - United States/epidemiology
MH  - Ventricular Dysfunction, Left/*epidemiology/*prevention & control
EDAT- 2009/01/20 09:00
MHDA- 2009/09/17 06:00
CRDT- 2009/01/20 09:00
PHST- 2008/08/20 00:00 [received]
PHST- 2008/09/29 00:00 [accepted]
PHST- 2009/01/20 09:00 [entrez]
PHST- 2009/01/20 09:00 [pubmed]
PHST- 2009/09/17 06:00 [medline]
AID - 10.1007/s10840-008-9330-2 [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2009 Aug;25(2):91-6. doi: 
      10.1007/s10840-008-9330-2. Epub 2009 Jan 19.