Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT

Jonathan Buber, Helmut Klein, Arthur J. Moss, Scott McNitt, Michael Eldar, Luigi Padeletti, Juergen Vogt, Mathias Meine, Mary W. Brown, Alon Barsheshet, Wojciech Zareba, Ilan Goldenberg

Research output: Contribution to journalArticle

Abstract

Aims We aimed to evaluate within the MADIT-CRT database whether different enrollment characteristics between US and non-US centres affected the clinical course of study patients. Methods and results We evaluated differences in baseline characteristics, procedure-associated complications, clinical as well as echocardiographic response to cardiac resynchronization therapy with a defibrillator (CRT-D), between patients enrolled in 87 US centres (n= 1271) and 23 non-US centres (n= 549) in MADIT-CRT. Non-US patients displayed significant differences in baseline characteristics from US patients, including a higher frequency of left bundle branch block, a more advanced heart failure (HF) functional class >3 months prior to enrolment, and larger baseline cardiac volumes. Procedure-related complications occurred at a significantly higher frequency among patients enrolled in non-US centres (17) than among those enrolled in US centres (10; P <0.001). During follow-up, CRT-D was associated with 42 (P = 0.003) and 38 (P <0.001) reductions in the risk of HF or death in the two respective groups (P for the difference = 0.80), and with similar reductions in cardiac volumes (all P > 0.10). Subgroup analysis showed a more pronounced effect of CRT-D among women in the US group, including a significant 71 (P = 0.02) reduction in the risk of death, whereas CRT-D therapy was associated with a significant clinical benefit in men only in the non-US group. Conclusion Patients enrolled in US and non-US centres in MADIT-CRT displayed significant differences in baseline clinical and echocardiographic characteristics and in the frequency of procedure-related complications, but experienced an overall similar clinical and echocardiographic response to CRT-D.

Original languageEnglish
Pages (from-to)2697-2704
Number of pages8
JournalEuropean Heart Journal
Volume32
Issue number21
DOIs
Publication statusPublished - Nov 2011

Fingerprint

Cardiac Resynchronization Therapy
Defibrillators
Cardiac Volume
Bundle-Branch Block
Risk Reduction Behavior
Heart Failure
Databases
Therapeutics

Keywords

  • Cardiac resynchronization therapy
  • Complications
  • Death
  • Heart failure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Buber, J., Klein, H., Moss, A. J., McNitt, S., Eldar, M., Padeletti, L., ... Goldenberg, I. (2011). Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT. European Heart Journal, 32(21), 2697-2704. https://doi.org/10.1093/eurheartj/ehr149

Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT. / Buber, Jonathan; Klein, Helmut; Moss, Arthur J.; McNitt, Scott; Eldar, Michael; Padeletti, Luigi; Vogt, Juergen; Meine, Mathias; Brown, Mary W.; Barsheshet, Alon; Zareba, Wojciech; Goldenberg, Ilan.

In: European Heart Journal, Vol. 32, No. 21, 11.2011, p. 2697-2704.

Research output: Contribution to journalArticle

Buber, J, Klein, H, Moss, AJ, McNitt, S, Eldar, M, Padeletti, L, Vogt, J, Meine, M, Brown, MW, Barsheshet, A, Zareba, W & Goldenberg, I 2011, 'Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT', European Heart Journal, vol. 32, no. 21, pp. 2697-2704. https://doi.org/10.1093/eurheartj/ehr149
Buber, Jonathan ; Klein, Helmut ; Moss, Arthur J. ; McNitt, Scott ; Eldar, Michael ; Padeletti, Luigi ; Vogt, Juergen ; Meine, Mathias ; Brown, Mary W. ; Barsheshet, Alon ; Zareba, Wojciech ; Goldenberg, Ilan. / Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT. In: European Heart Journal. 2011 ; Vol. 32, No. 21. pp. 2697-2704.
@article{198c1c312376493bb3cdec46654cfdee,
title = "Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT",
abstract = "Aims We aimed to evaluate within the MADIT-CRT database whether different enrollment characteristics between US and non-US centres affected the clinical course of study patients. Methods and results We evaluated differences in baseline characteristics, procedure-associated complications, clinical as well as echocardiographic response to cardiac resynchronization therapy with a defibrillator (CRT-D), between patients enrolled in 87 US centres (n= 1271) and 23 non-US centres (n= 549) in MADIT-CRT. Non-US patients displayed significant differences in baseline characteristics from US patients, including a higher frequency of left bundle branch block, a more advanced heart failure (HF) functional class >3 months prior to enrolment, and larger baseline cardiac volumes. Procedure-related complications occurred at a significantly higher frequency among patients enrolled in non-US centres (17) than among those enrolled in US centres (10; P <0.001). During follow-up, CRT-D was associated with 42 (P = 0.003) and 38 (P <0.001) reductions in the risk of HF or death in the two respective groups (P for the difference = 0.80), and with similar reductions in cardiac volumes (all P > 0.10). Subgroup analysis showed a more pronounced effect of CRT-D among women in the US group, including a significant 71 (P = 0.02) reduction in the risk of death, whereas CRT-D therapy was associated with a significant clinical benefit in men only in the non-US group. Conclusion Patients enrolled in US and non-US centres in MADIT-CRT displayed significant differences in baseline clinical and echocardiographic characteristics and in the frequency of procedure-related complications, but experienced an overall similar clinical and echocardiographic response to CRT-D.",
keywords = "Cardiac resynchronization therapy, Complications, Death, Heart failure",
author = "Jonathan Buber and Helmut Klein and Moss, {Arthur J.} and Scott McNitt and Michael Eldar and Luigi Padeletti and Juergen Vogt and Mathias Meine and Brown, {Mary W.} and Alon Barsheshet and Wojciech Zareba and Ilan Goldenberg",
year = "2011",
month = "11",
doi = "10.1093/eurheartj/ehr149",
language = "English",
volume = "32",
pages = "2697--2704",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",
number = "21",

}

TY - JOUR

T1 - Clinical course and outcome of patients enrolled in US and non-US centres in MADIT-CRT

AU - Buber, Jonathan

AU - Klein, Helmut

AU - Moss, Arthur J.

AU - McNitt, Scott

AU - Eldar, Michael

AU - Padeletti, Luigi

AU - Vogt, Juergen

AU - Meine, Mathias

AU - Brown, Mary W.

AU - Barsheshet, Alon

AU - Zareba, Wojciech

AU - Goldenberg, Ilan

PY - 2011/11

Y1 - 2011/11

N2 - Aims We aimed to evaluate within the MADIT-CRT database whether different enrollment characteristics between US and non-US centres affected the clinical course of study patients. Methods and results We evaluated differences in baseline characteristics, procedure-associated complications, clinical as well as echocardiographic response to cardiac resynchronization therapy with a defibrillator (CRT-D), between patients enrolled in 87 US centres (n= 1271) and 23 non-US centres (n= 549) in MADIT-CRT. Non-US patients displayed significant differences in baseline characteristics from US patients, including a higher frequency of left bundle branch block, a more advanced heart failure (HF) functional class >3 months prior to enrolment, and larger baseline cardiac volumes. Procedure-related complications occurred at a significantly higher frequency among patients enrolled in non-US centres (17) than among those enrolled in US centres (10; P <0.001). During follow-up, CRT-D was associated with 42 (P = 0.003) and 38 (P <0.001) reductions in the risk of HF or death in the two respective groups (P for the difference = 0.80), and with similar reductions in cardiac volumes (all P > 0.10). Subgroup analysis showed a more pronounced effect of CRT-D among women in the US group, including a significant 71 (P = 0.02) reduction in the risk of death, whereas CRT-D therapy was associated with a significant clinical benefit in men only in the non-US group. Conclusion Patients enrolled in US and non-US centres in MADIT-CRT displayed significant differences in baseline clinical and echocardiographic characteristics and in the frequency of procedure-related complications, but experienced an overall similar clinical and echocardiographic response to CRT-D.

AB - Aims We aimed to evaluate within the MADIT-CRT database whether different enrollment characteristics between US and non-US centres affected the clinical course of study patients. Methods and results We evaluated differences in baseline characteristics, procedure-associated complications, clinical as well as echocardiographic response to cardiac resynchronization therapy with a defibrillator (CRT-D), between patients enrolled in 87 US centres (n= 1271) and 23 non-US centres (n= 549) in MADIT-CRT. Non-US patients displayed significant differences in baseline characteristics from US patients, including a higher frequency of left bundle branch block, a more advanced heart failure (HF) functional class >3 months prior to enrolment, and larger baseline cardiac volumes. Procedure-related complications occurred at a significantly higher frequency among patients enrolled in non-US centres (17) than among those enrolled in US centres (10; P <0.001). During follow-up, CRT-D was associated with 42 (P = 0.003) and 38 (P <0.001) reductions in the risk of HF or death in the two respective groups (P for the difference = 0.80), and with similar reductions in cardiac volumes (all P > 0.10). Subgroup analysis showed a more pronounced effect of CRT-D among women in the US group, including a significant 71 (P = 0.02) reduction in the risk of death, whereas CRT-D therapy was associated with a significant clinical benefit in men only in the non-US group. Conclusion Patients enrolled in US and non-US centres in MADIT-CRT displayed significant differences in baseline clinical and echocardiographic characteristics and in the frequency of procedure-related complications, but experienced an overall similar clinical and echocardiographic response to CRT-D.

KW - Cardiac resynchronization therapy

KW - Complications

KW - Death

KW - Heart failure

UR - http://www.scopus.com/inward/record.url?scp=80755172643&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80755172643&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehr149

DO - 10.1093/eurheartj/ehr149

M3 - Article

C2 - 21642283

AN - SCOPUS:80755172643

VL - 32

SP - 2697

EP - 2704

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 21

ER -