PMID- 26277764
OWN - NLM
STAT- MEDLINE
DCOM- 20160621
LR  - 20220321
IS  - 2213-1787 (Electronic)
IS  - 2213-1779 (Linking)
VI  - 3
IP  - 9
DP  - 2015 Sep
TI  - Long-Term Extrapolation of Clinical Benefits Among Patients With Mild Heart 
      Failure Receiving Cardiac Resynchronization Therapy: Analysis of the 5-Year 
      Follow-Up From the REVERSE Study.
PG  - 691-700
LID - S2213-1779(15)00344-3 [pii]
LID - 10.1016/j.jchf.2015.05.005 [doi]
AB  - OBJECTIVES: This study sought to assess the lifelong extrapolated patient 
      outcomes with cardiac resynchronization therapy (CRT) in mild heart failure (HF), 
      beyond the follow-up of randomized clinical trials (RCTs). BACKGROUND: RCTs have 
      demonstrated short-term survival and HF hospitalization benefits of CRT in mild 
      HF. We used data from the 5-year follow-up of the REVERSE (REsynchronization 
      reVErses Remodeling in Systolic left vEntricular dysfunction) study to 
      extrapolate survival and HF hospitalizations. We compared CRT-ON versus CRT-OFF 
      and CRT defibrillators (CRT-D) versus CRT pacemakers (CRT-P). METHODS: 
      Multivariate regression models were used to estimate treatment-specific all-cause 
      mortality, disease progression, and HF-related hospitalization rates. 
      Rank-preserving structural failure time (RPSFT) models were used to adjust for 
      protocol-mandated crossover in the survival analysis. RESULTS: CRT-ON was 
      predicted to increase survival by 22.8% (CRT-ON 52.5% vs. CRT-OFF 29.7%; hazard 
      ratio [HR]: 0.45; p = 0.21), leading to an expected survival of 9.76 years 
      (CRT-ON) versus 7.5 years (CRT-OFF). CRT-D showed a significant improvement in 
      survival compared with CRT-P (HR: 0.47; 95% confidence interval [CI]: 0.25 to 
      0.88; p = 0.02) and were predicted to offer 2.77 additional life-years. New York 
      Heart Association (NYHA) functional class II patients had a 30.6% higher HF 
      hospitalization risk than class I (I vs. II incident rate ratio [IRR]: 0.69; 95% 
      CI: 0.57 to 0.85; p < 0.001) and 3 times lower rate compared with class III (III 
      vs. II IRR: 2.98; 95% CI: 2.29 to 3.87; p < 0.001). CONCLUSIONS: RPSFT estimates 
      yielded results demonstrating clinically important long-term benefit of CRT in 
      mild HF. CRT was predicted to reduce mortality, with CRT-D prolonging life more 
      than CRT-P. NYHA functional class I/II patients were shown to have a 
      significantly reduced risk of HF hospitalization compared with class III, leading 
      to CRT reducing HF hospitalization rates.
CI  - Copyright (c) 2015 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Gold, Michael R
AU  - Gold MR
AD  - Division of Cardiology, Medical University of South Carolina, Charleston, South 
      Carolina. Electronic address: goldmr@musc.edu.
FAU - Padhiar, Amie
AU  - Padhiar A
AD  - Health Economics and Epidemiology, ICON/Oxford Outcomes, Oxford, United Kingdom.
FAU - Mealing, Stuart
AU  - Mealing S
AD  - Health Economics and Epidemiology, ICON/Oxford Outcomes, Oxford, United Kingdom.
FAU - Sidhu, Manpreet K
AU  - Sidhu MK
AD  - Health Economics and Epidemiology, ICON/Oxford Outcomes, Morristown, New Jersey.
FAU - Tsintzos, Stelios I
AU  - Tsintzos SI
AD  - Global Economics, Reimbursement and Evidence, Medtronic Global CRHF Headquarters, 
      Mounds View, Minnesota.
FAU - Abraham, William T
AU  - Abraham WT
AD  - Division of Cardiovascular Medicine, Ohio State University, Columbus, Ohio.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20150812
PL  - United States
TA  - JACC Heart Fail
JT  - JACC. Heart failure
JID - 101598241
SB  - IM
CIN - JACC Heart Fail. 2015 Sep;3(9):701-2. PMID: 26277766
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Disease Progression
MH  - Double-Blind Method
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/diagnosis/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Remodeling/*physiology
OTO - NOTNLM
OT  - cardiac resynchronization therapy
OT  - health economics
OT  - health policy
OT  - heart failure
OT  - rank-preserving structural failure time
EDAT- 2015/08/19 06:00
MHDA- 2016/06/22 06:00
CRDT- 2015/08/17 06:00
PHST- 2015/02/10 00:00 [received]
PHST- 2015/04/30 00:00 [revised]
PHST- 2015/05/16 00:00 [accepted]
PHST- 2015/08/17 06:00 [entrez]
PHST- 2015/08/19 06:00 [pubmed]
PHST- 2016/06/22 06:00 [medline]
AID - S2213-1779(15)00344-3 [pii]
AID - 10.1016/j.jchf.2015.05.005 [doi]
PST - ppublish
SO  - JACC Heart Fail. 2015 Sep;3(9):691-700. doi: 10.1016/j.jchf.2015.05.005. Epub 
      2015 Aug 12.