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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/23236

Title: Mode of Death in Octogenarians Treated With Cardiac Resynchronization Therapy
Authors: Martens, Pieter
Verbrugge, Frederik H.
Nijst, Petra
Dupont, Matthias
Mullens, Wilfried
Issue Date: 2016
Citation: JOURNAL OF CARDIAC FAILURE, 22(12), p. 970-977
Abstract: Background: Cardiac resynchronization therapy (CRT) improves morbidity and mortality in heart failure with reduced ejection fraction (HFrEF) and electrical dyssynchrony. CRT patients in clinical practice are older compared with clinical trials. Objective: To investigate clinical response, reverse remodeling, outcome, and mode of death in octogenarians receiving CRT. Methods: Baseline characteristics, change in New York Heart Association (NYHA) functional class, reverse ventricular remodeling, heart failure readmissions, all-cause mortality, and mode of death were evaluated in CRT patients with comparison between octogenarians and nonoctogenarians. In addition, annual mortality rates of octogenarians undergoing CRT were compared with age-matched control subjects from the general population with the use of national actuarial tables. Results: A total of 686 patients, including 178 octogenarians (26%), were followed for 38 +/- 22 months. Octogenarians exhibited a similar change in NYHA functional class (P = .640), left ventricular ejection fraction increase (P = .796), and decrease in end-diastolic (P = .441) and end-systolic (P = .312) diameter compared with their younger counterparts undergoing CRT. Octogenarians had a higher all-cause mortality risk (P < .001), but heart failure readmission risk did not differ (hazard ratio 0.916, 95% confidence interval 0.638-1.313; P = .632). A higher proportion of noncardiac deaths was observed in octogenarians (74%) versus younger patients (50%; P = .022), with worsening heart failure rather than malignant tachyarrhythmia being the main cardiac cause of death. Compared with an age-matched sample from the general population, octogenarians receiving CRT had an equivalent annual mortality rate (log-rank test: P = .444). Conclusions: Octogenarians retain the ability to mount a significant symptomatic and ventricular remodeling response after CRT, resulting in survival similar to the general age-matched population.
Notes: [Martens, Pieter; Verbrugge, Frederik H.; Nijst, Petra; Dupont, Mdmatthias; Mullens, Wilfried] Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. [Martens, Pieter; Nijst, Petra] Hasselt Univ, Doctoral Sch Med & Life Sci, Diepenbeek, Belgium. [Mullens, Wilfried] Hasselt Univ, Fac Med & Life Sci, Biomed Res Inst, Diepenbeek, Belgium.
URI: http://hdl.handle.net/1942/23236
DOI: 10.1016/j.cardfail.2016.09.023
ISI #: 000389565400005
ISSN: 1071-9164
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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