PMID- 25687979
OWN - NLM
STAT- MEDLINE
DCOM- 20160309
LR  - 20181202
IS  - 1572-8595 (Electronic)
IS  - 1383-875X (Linking)
VI  - 43
IP  - 1
DP  - 2015 Jun
TI  - Comparison of pharmacological treatment alone versus treatment combined with 
      cardiac resynchronization therapy in patients over 75 years.
PG  - 13-20
LID - 10.1007/s10840-015-9979-2 [doi]
AB  - BACKGROUND: The role of cardiac resynchronization therapy (CRT) in patients aged 
      >/=75 years is not well established. METHODS: We identified 607 patients aged 
      >/=75 years with left ventricular ejection fraction (LVEF) of </=35 %, of whom 78 met 
      the guidelines for indication of CRT. Based on the decision of the patients or 
      attending cardiologists, 34 patients received a CRT defibrillator (CRT-D). 
      RESULTS: The age of patients with a CRT indication was 80 +/- 4 years, and 73 % 
      were males. As compared with patients on medical therapy, CRT-D patients were 
      younger (79 +/- 3 vs. 83 +/- 4, P < 0.001), had lower LVEF (23 +/- 7 vs. 27 +/- 7 %, 
      P = 0.008) and higher rate of decompensated heart failure episodes (77 vs. 55 %, 
      P = 0.04), were more frequently New York Heart Association (NYHA) class III-IV 
      (53 vs. 25 %, P = 0.01), and were more likely to be on beta-blockers (88 vs. 
      66 %, P = 0.023), anticoagulants (61 vs. 32 % P = 0.02), and anti-aldosterone 
      drugs (82 vs. 50 %, P = 0.003). After a median follow-up of 26 months, seven 
      patients in the CRT-D group (21 %) and 20 non-CRT patients (46 %) died (hazard 
      ratio (HR) 0.16 [95 % confidence interval (CI) 0.06-0.46]). The end point of 
      mortality or hospitalization was not reduced because of a similar rate of 
      hospitalizations for heart failure of CRT-D patients. Four CRT-D patients (12 %) 
      had received appropriate device therapy, and one had been inappropriately 
      discharged. During follow-up, 44 % of CRT-D patients improved their LVEF by 
      >40 %. CONCLUSION: CRT-D is potentially of benefit in terms of mortality in our 
      population; this effect persists after correction for use of beta-blockers. In 
      patients >/=75 years, CRT indications should be similar to those accepted for 
      younger subjects.
FAU - de la Cruz, Elena
AU  - de la Cruz E
AD  - Hospital Universitario Fundacion Jimenez Diaz - idcsalud, Universidad Autonoma de 
      Madrid, Madrid, Spain.
FAU - Cortes, Marcelino
AU  - Cortes M
FAU - Farre, Jeronimo
AU  - Farre J
FAU - Palfy, Julia
AU  - Palfy J
FAU - Avila, Paloma
AU  - Avila P
FAU - Hernandez, Ignacio
AU  - Hernandez I
FAU - Romero, Angelica
AU  - Romero A
FAU - Benezet, Juan
AU  - Benezet J
FAU - Franco, Juan Antonio
AU  - Franco JA
FAU - Navas, Miguel Angel
AU  - Navas MA
FAU - Hernandez, Jose Joel
AU  - Hernandez JJ
FAU - Briongos, Sem
AU  - Briongos S
FAU - Rubio, Jose M
AU  - Rubio JM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20150217
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
RN  - 0 (Cardiotonic Agents)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Resynchronization Therapy/*mortality/*statistics & numerical data
MH  - Cardiotonic Agents/*therapeutic use
MH  - Combined Modality Therapy/mortality/statistics & numerical data
MH  - Female
MH  - Heart Failure/*mortality/*prevention & control
MH  - Hospital Mortality
MH  - Humans
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Prevalence
MH  - Retrospective Studies
MH  - Spain/epidemiology
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2015/02/18 06:00
MHDA- 2016/03/10 06:00
CRDT- 2015/02/18 06:00
PHST- 2014/11/03 00:00 [received]
PHST- 2015/01/23 00:00 [accepted]
PHST- 2015/02/18 06:00 [entrez]
PHST- 2015/02/18 06:00 [pubmed]
PHST- 2016/03/10 06:00 [medline]
AID - 10.1007/s10840-015-9979-2 [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2015 Jun;43(1):13-20. doi: 
      10.1007/s10840-015-9979-2. Epub 2015 Feb 17.