PMID- 23252710
OWN - NLM
STAT- MEDLINE
DCOM- 20140106
LR  - 20220331
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 36
IP  - 6
DP  - 2013 Jun
TI  - Outcomes of cardiac resynchronization therapy in the elderly.
PG  - 664-72
LID - 10.1111/pace.12048 [doi]
AB  - BACKGROUND: Octogenarians (>80 years) have been underrepresented in clinical 
      trials of cardiac resynchronization therapy (CRT). OBJECTIVE: To determine the 
      benefit of CRT with or without a defibrillator in older elderly patients. 
      METHODS: We retrospectively studied consecutive patients who received CRT at our 
      institution from 2002 through 2008. New York Heart Association (NYHA) class and 
      echocardiographic parameters were assessed before and after CRT. Thirty-day 
      complications after device implant were collected. Survival data were obtained 
      from the national death and location database. Data were compared between those 
      80 years and younger and those older than 80 years. RESULTS: Of 728 patients 
      identified, 90 (12.4%) were older than 80 years. After CRT, older and younger 
      patients had similar improvements in NHYA class (P = 0.41), ejection fraction (P 
      = 0.48), and mitral valve regurgitation (MR) severity (P = 0.42). In the older 
      patients, defibrillator implantation was associated with comparable improvement 
      in NYHA class, ejection fraction, and MR grade severity (P > 0.05), as in those 
      without a defibrillator. Overall survival was worse in octogenarians than in the 
      younger patients by Kaplan-Meier estimates (P = 0.001). Multivariate analysis 
      showed similar survival between the younger and older subjects (hazard ratio, 
      1.23; 95% confidence interval, 0.83-1.84; P = 0.31). The observed complication 
      rate in all study subjects was 12.2%, with no difference between the two age 
      groups. CONCLUSION: Octogenarian patients who received CRT with or without a 
      defibrillator for advanced heart failure had similar clinical benefits as younger 
      patients. CRT should not be withheld from octogenarians meeting current selection 
      guidelines.
CI  - (c)2012, The Authors. Journal compilation (c)2012 Wiley Periodicals, Inc.
FAU - Killu, Ammar M
AU  - Killu AM
AD  - Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, 
      USA.
FAU - Wu, Jia-Hui
AU  - Wu JH
FAU - Friedman, Paul A
AU  - Friedman PA
FAU - Shen, Win-Kuang
AU  - Shen WK
FAU - Webster, Tracy L
AU  - Webster TL
FAU - Brooke, Kelly L
AU  - Brooke KL
FAU - Hodge, David O
AU  - Hodge DO
FAU - Wiste, Heather J
AU  - Wiste HJ
FAU - Cha, Yong-Mei
AU  - Cha YM
LA  - eng
PT  - Journal Article
DEP - 20121218
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Resynchronization Therapy/*mortality/*statistics & numerical data
MH  - Female
MH  - Heart Failure/diagnosis/*mortality/*prevention & control
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Minnesota/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2012/12/21 06:00
MHDA- 2014/01/07 06:00
CRDT- 2012/12/21 06:00
PHST- 2012/02/22 00:00 [received]
PHST- 2012/09/21 00:00 [revised]
PHST- 2012/09/22 00:00 [accepted]
PHST- 2012/12/21 06:00 [entrez]
PHST- 2012/12/21 06:00 [pubmed]
PHST- 2014/01/07 06:00 [medline]
AID - 10.1111/pace.12048 [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2013 Jun;36(6):664-72. doi: 10.1111/pace.12048. Epub 
      2012 Dec 18.