PMID- 27388610
OWN - NLM
STAT- MEDLINE
DCOM- 20170103
LR  - 20181113
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 15
DP  - 2016 Jul 7
TI  - Effect of obesity on the effectiveness of cardiac resynchronization to reduce the 
      risk of first and recurrent ventricular tachyarrhythmia events.
PG  - 93
LID - 10.1186/s12933-016-0401-x [doi]
LID - 93
AB  - BACKGROUND: Obesity is associated with multiple adverse cardiovascular conditions 
      and may increase the risk of ventricular tachyarrhythmias (VT/VF). There is 
      limited data on the association between obesity and risk of VT/VF requiring 
      appropriate implantable cardioverter-defibrillator (ICD) therapies and the 
      effectiveness of cardiac resynchronization therapy (CRT) to reduce risk for 
      VT/VF. The multicenter automatic defibrillator implantation trial with cardiac 
      resynchronization therapy (MADIT-CRT) was design to investigate effectiveness of 
      CRT therapy to reduce cardiovascular outcome for patients with heart failure (HF) 
      and reduced ejection fraction. METHODS AND RESULTS: We identified patients 
      enrolled in the MADIT CRT trial as obese (n = 433) and non-obese (n = 845) and 
      analyzed their risk for appropriate device therapy for VT/VF, repeated VT/VF 
      events, fast VT/VF, as well as events after first VT/VF episodes. Obesity was 
      defined as body mass index (BMI) >/=30 kg/m(2). Among ICD patients, the risk of 
      first appropriate ICD therapy for VT/VF at 3 years was similar between obese and 
      non-obese patients (23 vs. 21 %, p = 0.76). CRT-D treatment reduced the risk of 
      first appropriate ICD therapy both in non-obese ([HR]; 0.58 [CI]: 0.42-0.79; p < 
      0.001) and obese patients (HR 0.75, 95 % CI 0.5-1.38; p = 0.179) (interaction p 
      value 0.323). Similarly, a significant reduction in the risk of fast VT/VF was 
      observed in non-obese patients ([HR]; 0.49 [CI]: 0.33-0.73; p < 0.001) and obese 
      ([HR]; 0.49 [CI]: 0.29-0.81; p < 0.01), (interaction p value 0.984). CONCLUSION: 
      Obese and non-obese patients with mild heart failure have a similar risk of 
      ventricular tachyarrhythmias. Obesity in mild heart failure did not diminish the 
      clinical benefit of cardiac resynchronization therapy to reduce risk for 
      appropriate ICD therapy. Clinical trial registration 
      http://clinicaltrials.gov/ct2/show/NCT00180271.
FAU - Szepietowska, Barbara
AU  - Szepietowska B
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA. 
      barbara_szepietowska@URMC.Rochester.edu.
FAU - Polonsky, Bronislava
AU  - Polonsky B
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA.
FAU - Sherazi, Saadia
AU  - Sherazi S
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA.
FAU - Biton, Yitschak
AU  - Biton Y
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA.
FAU - Kutyifa, Valentina
AU  - Kutyifa V
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA.
FAU - McNitt, Scott
AU  - McNitt S
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA.
FAU - Aktas, Mehmet
AU  - Aktas M
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA.
FAU - Moss, Arthur J
AU  - Moss AJ
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA.
FAU - Zareba, Wojciech
AU  - Zareba W
AD  - Heart Research Follow-up Program, Cardiology Division, University of Rochester 
      Medical Center, 265 Crittenden Blvd., PO Box 653, Rochester, NY, 14642, USA.
LA  - eng
SI  - CRiS/NCT00180271
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20160707
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arrhythmias, Cardiac/*therapy
MH  - *Cardiac Resynchronization Therapy
MH  - *Defibrillators, Implantable
MH  - Female
MH  - Heart Failure/physiopathology/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity/*complications/physiopathology
MH  - Recurrence
MH  - Risk Factors
MH  - Tachycardia, Ventricular/*physiopathology
MH  - Treatment Outcome
PMC - PMC4936234
OTO - NOTNLM
OT  - Cardiac resynchronization therapy
OT  - Heart failure
OT  - Implantable cardioverter defibrillator
OT  - Obesity
OT  - Ventricular tachyarrhythmias
EDAT- 2016/07/09 06:00
MHDA- 2017/01/04 06:00
PMCR- 2016/07/07
CRDT- 2016/07/09 06:00
PHST- 2016/04/15 00:00 [received]
PHST- 2016/05/24 00:00 [accepted]
PHST- 2016/07/09 06:00 [entrez]
PHST- 2016/07/09 06:00 [pubmed]
PHST- 2017/01/04 06:00 [medline]
PHST- 2016/07/07 00:00 [pmc-release]
AID - 10.1186/s12933-016-0401-x [pii]
AID - 401 [pii]
AID - 10.1186/s12933-016-0401-x [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2016 Jul 7;15:93. doi: 10.1186/s12933-016-0401-x.