Trends in Readmissions Rates and Mortality After CRT-P vs. CRT-D in Patients With Non-Ischemic Cardiomyopathy
Document Type
Conference Proceeding
Publication Date
5-2024
Publication Title
Heart Rhythm
Abstract
Background: Cardiac Resynchronizing Therapy (CRT) has been widely used in patients with Heart Failure (HF) and Cardiomyopathy (CM). Patients with severely impaired LV function with HF symptoms and prolonged QRS duration with LBBB have been shown to benefit from CRT. Based on the DANISH trial, the data for the benefit of primary prevention for sudden cardiac death for Non-ischemic cardiomyopathy (NICM) is not as robust, especially in patients receiving CRT Objective: We aimed to examine the trends in readmission rates and mortality after CRT-P vs. CRT-D in patients with NICM Methods: The National Readmission Database (NRD) from 2016-2020 was inquired to identify patients with NICM who underwent CRTD or CRTP using appropriate ICD-10 codes. The primary outcome was Heart Failure (HF) readmission at six months. Secondary outcomes were all-cause readmissions and mortality readmissions at six months. Cox proportional hazard regression was used to generate hazard ratios Results: Out of 12,200 patients with NICM who had CRT, 8,801 patients had CRT-D placed, while 3,399 patients received CRT-P. On propensity-matched outcomes comparing CRTD vs CRTP groups, there was no statistical difference in the primary endpoint - HF readmission [Hazard Ratio (HR) 5 1.08 (0.98-1.19); p50.1]. Secondary outcomes showed no statistical difference in all-cause readmissions [HR 5 1.04 (0.87-1.12); p50.23] and readmission mortality [HR 5 0.83 (0.58-1.19); p50.32] among patients receiving CRTD vs CRTP at six months follow-up. Conclusion: We report that CRT-D does not confer additional benefits for all-cause and mortality readmissions at six months when compared to CRT-P. Adequately powered randomized studies with long-term follow-up and contemporary GDMT are needed to substantiate the clinical benefit of CRT-D over CRT-P in NICM patients.
Volume
21
Issue
5S
First Page
S94
Recommended Citation
Sheth A, Patel H, Patel B, Pandya K, Thakkar S, Munshi RF, et al. [Mehta N]. Trends in readmissions rates and mortality after CRT-P vs CRT-D in patients with non-ischemic cardiomyopathy. Heart Rhythm. 2024 May;21(5S):S94. doi:10.1016/j.hrthm.2024.03.449
DOI
10.1016/j.hrthm.2024.03.449
Comments
Heart Rhythm Society Annual Meeting, May 16-19, 2024, Boston, MA