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Impact of Etiology on the Outcomes in Heart Failure Patients Treated with Cardiac Resynchronization Therapy: A Meta-Analysis

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  • Yanmei Chen
  • Chongyang Duan
  • Feng Liu
  • Shuxin Shen
  • Pingyan Chen
  • Jianping Bin

Abstract

Background: Cardiac resynchronization therapy (CRT) has been extensively demonstrated to benefit heart failure patients, but the role of underlying heart failure etiology in the outcomes was not consistently proven. This meta-analysis aimed to determine whether efficacy and effectiveness of CRT is affected by underlying heart failure etiology. Methods and Results: Searches of MEDLINE, EMBASE and Cochrane databases were conducted to identify RCTs and observational studies that reported clinical and functional outcomes of CRT in ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM) patients. Efficacy of CRT was assessed in 7 randomized controlled trials (RCTs) with 7072 patients and effectiveness of CRT was evaluated in 14 observational studies with 3463 patients In the pooled analysis of RCTs, we found that CRT decreased mortality or heart failure hospitalization by 29% in ICM patients (95% confidence interval [CI], 21% to 35%), and by 28% (95% CI, 18% to 37%) in NICM patients. No significant difference was observed between the 2 etiology groups (P = 0.55). In the pooled analysis of observational studies, however, we found that ICM patients had a 54% greater risk for mortality or HF hospitalization than NICM patients (relative risk: 1.54; 95% CI: 1.30–1.83; P

Suggested Citation

  • Yanmei Chen & Chongyang Duan & Feng Liu & Shuxin Shen & Pingyan Chen & Jianping Bin, 2014. "Impact of Etiology on the Outcomes in Heart Failure Patients Treated with Cardiac Resynchronization Therapy: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-10, April.
    • Handle: RePEc:plo:pone00:0094614
    DOI: 10.1371/journal.pone.0094614
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    Cited by:

    1. Fa-Hui Yin & Chun-Lei Fan & Ya-Ya Guo & Hai Zhu & Zhi-Lu Wang, 2017. "The impact of gender difference on clinical and echocardiographic outcomes in patients with heart failure after cardiac resynchronization therapy: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-14, April.

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