PhD Scientific Days 2022

Clinical Medicine VII. (Poster discussion will take place in the Aula during the Coffee Break)

The benefits of adding a defibrillator to cardiac resynchronization therapy - Systematic review and meta-analysis

Előadó neve

Dr. Veres, Boglárka

Előadó munkahelye

Heart and Vascular Center Semmelweis University

Előadó telefonszáma

06703304485

Előadó e-mail címe

boglarka.sara.veres@gmail.com

Az előadás címe

The benefits of adding a defibrillator to cardiac resynchronization therapy - Systematic review and meta-analysis

Szerző(k) neve és munkahelye

B. Veres1, WR. Schwertner1, M. Engh2, R. Masszi1, L. Kuthi1, A. Behon1, ED. Merkel1, I. Osztheimer1, P. Fehervari2, S. Ghare2, E. Zima1, P. Hegyi2, A. Kosztin1, B. Merkely1
1 Semmelweis University Heart and Vascular Center, Budapest
2 Semmelweis University Translational Medicine Center, Budapest

Bemutatás módja

Poszter

Szekció

Clinical Medicine VII. (Poster discussion will take place in the Aula during the Coffee Break)

Language of the presentation

Hungarian

Preferred session

Clinical Medicine

Összefoglaló szövege

Background: There is an long-standing debate whether cardiac resynchronisation therapy-defibrillation (CRT-D) is preferred over CRT-pacemaker (CRT-P). No randomised controlled trials have been designed to compare these treatments. However, several observational studies have been performed so far providing controversial results.

Methods: PubMed, CENTRAL and Embase until October 2021 were screened for studies comparing CRT-P and CRT-D, focusing on all-cause mortality, cardiovascular mortality, sudden cardiac death. Conference abstracts were excluded. Odds ratio with 95% confidence interval (CI) was calculated, data from the selected studies were pooled.Results were summarized by Forest plots.

Results: Altogether 20 observational retrospective studies (69 124 patients) were included (CRT-P: 37 461, CRT-D: 31 663). CRT-D was superior to CRT-P regarding all-cause mortality in multivariate analysis (aHR:0.79; 95% CI:0.69-0.88; p <0.01). Based on propensity matched studies (25 040 patients; 12 520 CRT-P, 12 520 CRT-D) CRT-D showed significantly better survival compared to CRT-P (HR:0.83; 95% CI:0.79-0.87; p<0.001). Three studies (47 846 patients, CRT-P: 27 344, CRT-D: 20 502) compared cardiovascular mortality between CRT-D and CRT-P. Univariate analysis showed a significantly lower rate of cardiovascular mortality in patients implanted with a CRT-D device compared to patients with a CRT-P device (HR:0.61; 95% CI:0.50-0.73; p=0.002). Five studies (6 434 patients. CRT-P:3 475, CRT-D:2 959) were analyzed for sudden cardiac death, CRT-D was superior in univariate analysis (HR:0.33; 95% CI:0.28-0.89; p=0.03).

Conclusion: Our meta-analysis demonstrated that patients with CRT-D had a lower risk of all-cause mortality compared to CRT-P based on those studies that used multivariate analysis and propensity score matching. Univariate analysis showed a significantly lower rate of cardiovascular- and sudden cardiac death in patients implanted with a CRT-D device compared to patients with a CRT-P. However, due to the heterogeneity of the articles coming from the selection bias of patients for CRT-D/CRT-P implantation, this question requires further analysis.

University and Doctoral School

Semmelweis University, Doctoral School of Theoretical and Translational Medicine

Supervisor

Dr. Annamaria Kosztin, Prof. Dr. Béla Merkely

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

5969

Start

13:45

End

13:50

Authors (legacy)

B. Veres1, WR. Schwertner1, M. Engh2, R. Masszi1, L. Kuthi1, A. Behon1, ED. Merkel1, I. Osztheimer1, P. Fehervari2, S. Ghare2, E. Zima1, P. Hegyi2, A. Kosztin1, B. Merkely1
1 Semmelweis University Heart and Vascular Center, Budapest
2 Semmelweis University Translational Medicine Center, Budapest