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| Item Type: | Article |
|---|---|
| Title: | The effect of weight Loss on clinical outcomes in patients implanted with a cardiac resynchronization therapy device - A MADIT-CRT sub-study |
| Creators Name: | Aktas, M.K., Zareba, W., Huang, D.T., McNitt, S., Polonsky, S., Chen, L., Stockburger, M., Merkely, B., Moss, A.J. and Kutyifa, V. |
| Abstract: | BACKGROUND: There is no data regarding the effect of weight loss on clinical outcomes in patients undergoing cardiac resynchronization therapy. This study was designed to evaluate the effect of weight loss on clinical outcomes in patients implanted with a cardiac resynchronization therapy with defibrillator (CRT-D). METHODS: The risk of heart failure (HF) or death, and death alone was compared between patients with and without weight loss of 2 kilograms (kg) or more at 1-year in the CRT-D arm of Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT). RESULTS: Weight loss was observed in 170 of 994 (17%) patients implanted with a CRT-D. Multivariate analysis showed a significant increase in the risk of HF or death among patients with weight loss compared to those without weight loss (HR=1.82, 95% CI: 1.26 - 2.63, p=0.001). Weight loss was associated with a 79% increase in the risk of all-cause mortality (HR=1.79, 95% CI: 1.16 - 3.34, p=0.01). When analyzed in a continuous fashion, each kg of weight loss was associated with a 4% increase in the risk of HF or death (p=0.03). In left bundle branch block (LBBB) patients with a CRT-D, weight loss was associated with an especially high risk of HF/Death (HR=2.23, 95% CI: 1.36 - 3.65, p=0.002), and death alone (HR=2.33, 95% CI: 1.07 - 5.06, p=0.03, interaction p-value=0.26). CONCLUSIONS: In patients with mild symptoms of heart failure receiving CRT-D, weight loss observed at 1 year is associated with adverse clinical outcomes, especially in those with a LBBB ECG pattern. |
| Keywords: | Weight Loss, Cardiac Resynchronization Therapy, Left Bundle Branch Block |
| Source: | Journal of Cardiac Failure |
| ISSN: | 1071-9164 |
| Publisher: | Churchill Livingstone Inc Medical Publishers |
| Volume: | 20 |
| Number: | 3 |
| Page Range: | 183-189 |
| Date: | March 2013 |
| Official Publication: | https://doi.org/10.1016/j.cardfail.2013.12.012 |
| PubMed: | View item in PubMed |
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