1. Does the Age Affect the Outcomes of Cardiac Resynchronization Therapy in Elderly Patients?
- Author
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Salvatore Ivan Caico, S. Badolati, Giuseppe Ricciardi, Patrizia Pepi, Valerio Pergola, Giuseppe Stabile, Antonio De Simone, Lucio Addeo, Giuseppe Arena, Giuseppe Ammirati, Carmelo La Greca, Francesco Solimene, Antonio Rapacciuolo, A. Spotti, Antonio D'Onofrio, Domenico Pecora, Emanuele Bertaglia, Gavino Casu, Maurizio Malacrida, Massimiliano Marini, Teresa Strisciuglio, Strisciuglio, Teresa, Stabile, Giuseppe, Pecora, Domenico, Arena, Giuseppe, Ivan Caico, Salvatore, Marini, Massimiliano, Pepi, Patrizia, D'Onofrio, Antonio, De Simone, Antonio, Ricciardi, Giuseppe, Badolati, Sandra, Spotti, Alfredo, Casu, Gavino, Solimene, Francesco, La Greca, Carmelo, Ammirati, Giuseppe, Pergola, Valerio, Addeo, Lucio, Malacrida, Maurizio, Bertaglia, Emanuele, and Rapacciuolo, Antonio
- Subjects
medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Composite event ,Cardiac resynchronization therapy ,Pulmonary disease ,lcsh:Medicine ,cardiac resynchronization therapy ,heart failure ,030204 cardiovascular system & hematology ,clinical response ,Affect (psychology) ,outcomes ,elderly ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,In patient ,030212 general & internal medicine ,COPD ,business.industry ,lcsh:R ,General Medicine ,medicine.disease ,Heart failure ,cardiovascular system ,business ,Kidney disease - Abstract
Background: More and more heart failure (HF) patients aged ≥ 75 years undergo cardiac resynchronization therapy (CRT) device implantation, however the data regarding the outcomes and their predictors are scant. We investigated the mid- to long-term outcomes and their predictors in CRT patients aged ≥ 75 years. Methods: Patients in the Cardiac Resynchronization Therapy Modular (CRT MORE) Registry were divided into three age-groups: <, 65 (group A), 65–74 (group B) and ≥75 years (group C). Mortality, hospitalization, and composite event rate were evaluated at 1 year and during long-term follow-up. Results: Patients (n = 934) were distributed as follows: group A 242, group B 347, group C 345. On 12-month follow-up examination, 63% of patients ≥ 75 years displayed a positive clinical response. Mortality was significantly higher in patients ≥ 75 years than in the other two groups, although the rate of hospitalizations for HF worsening was similar to that of patients aged 65–74 (7 vs. 9.5%, respectively, p = 0.15). Independent predictors of death and of negative clinical response were age >, 80 years, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD). Over long-term follow-up (1020 days (IQR 680-1362)) mortality was higher in patients ≥ 75 years than in the other two groups. Hospitalization and composite event rates were similar in patients ≥ 75 years and those aged 65–74 (9 vs. 11.8%, p = 0.26, and 26.7 vs. 20.5%, p = 0.06). Conclusion: Positive clinical response and hospitalization rates do not differ between CRT recipients ≥ 75 years and those aged 65–74. However, age >, 80 years, COPD and CKD are predictors of worse outcomes.
- Published
- 2021