Abstract:
BACKGROUND:When used in appropriately selected heart failure (HF) patients, cardiac resynchronization therapy (CRT) reduces mortality and hospitalization. It is not understood whether CRT implantation during hospitalization for HF is associated with similar benefits. HYPOTHESIS:Timing of CRT implantation relative to hospitalization for HF is associated with clinical outcomes. METHODS:This analysis included patients eligible for CRT and discharged alive between January 2005 and December 2012 from 388 hospitals in Get With The Guidelines-HF. Participants were linked with Centers for Medicare and Medicaid Services data to evaluate outcomes of all-cause mortality and HF re-hospitalization based on CRT status (present on admission, placed during hospitalization, and prescribed at discharge; reference = no CRT). RESULTS:Of 15 619 CRT-eligible HF patients, 2408 (15%) had CRT on admission, 1269 (8%) underwent CRT implantation during hospitalization and 643 (4%) had CRT prescribed at discharge. Compared with patients without CRT, mortality was lower in those who received CRT implantation during HF hospitalization (adjusted hazard ratio [HR] 0.63; P < 0.0001) and those prescribed CRT at discharge (adjusted HR 0.78; P = 0.048). A reduction in HF re-hospitalization was observed in patients with CRT implanted during hospitalization (adjusted HR 0.64; P < 0.0001), but not in those who were prescribed CRT at discharge (adjusted HR 1.02; P = 0.77). CONCLUSION:CRT implantation during HF hospitalization was associated with lower rates of mortality and HF re-hospitalization. These data suggest that a CRT utilization strategy that does not delay implantation to the post-discharge period may be appropriate. Randomized data are needed to definitively identify optimal timing of CRT implantation.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Goldstein SA,Mentz RJ,Hellkamp AS,Randolph TC,Fonarow GC,Hernandez A,Yancy CW,Al-Khatib SMdoi
10.1002/clc.23135subject
Has Abstractpub_date
2019-02-01 00:00:00pages
256-263issue
2eissn
0160-9289issn
1932-8737journal_volume
42pub_type
杂志文章,多中心研究abstract:BACKGROUND:In patients with acute decompensated heart failure (ADHF), both natriuretic peptides and renal impairment predict adverse outcomes. Our aim was to evaluate the complementary prognosis role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and the newly developed Chronic Kidney Disease Epidemiology Col...
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journal_title:Clinical cardiology
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doi:10.1002/clc.4960210608
更新日期:1998-06-01 00:00:00
abstract::Several studies have investigated the role of physical fitness in atrial fibrillation (AF), but the results remain controversial. We aimed to estimate the association between physical fitness and risk of AF. We comprehensively retrieved data from the Cochrane Library, PubMed, and Embase databases until February 29, 20...
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abstract::Various types of pulmonary venous return abnormalities have been described in the literature. This report presents a case in which a 4-h-old neonate presented with cyanotic heart disease and respiratory distress. This neonate was subsequently shown to have complete absence of the pulmonary veins (CAPV), a previously u...
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:1989-11-01 00:00:00
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更新日期:2014-09-01 00:00:00
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doi:10.1002/clc.4960050707
更新日期:1982-07-01 00:00:00
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更新日期:2009-10-01 00:00:00
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abstract::Lithium has been used for the treatment of bipolar disorder for more than 6 decades. Reports of cardiac side effects resulting in both benign electrocardiographic (ECG) changes and near fatal arrhythmias have been reported in the literature. A systematic literature search was conducted on 2 electronic databases-PubMed...
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