| Cardiac resynchronization therapy reduces the risk of cardiac events in patients with diabetes enrolled in the multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy (MADIT-CRT). | |
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MedLine Citation:
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PMID: 21350054 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Data are limited regarding whether the presence of diabetes mellitus (DM) influences the benefit of cardiac resynchronization with defibrillator therapy (CRT-D) in heart failure (HF) patients. METHODS AND RESULTS: The effect of CRT-D was evaluated in 1817 patients who were enrolled in the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT). Patients were minimally symptomatic (New York Heart Association class I or II), with ejection fraction ≤0.30 and QRS ≥130 ms. We used Cox regression to determine hazard ratio (HR) of CRT-D versus implantable cardioverter-defibrillator (ICD) therapy for the risk of HF event or death, whichever came first (MADIT-CRT primary end point), in DM (n=552) and non-DM (n=1265) patients. Compared with the non-DM patients, those with DM had more coronary risk factors. During an average follow-up of 2.4 years, DM patients had significantly more primary end point events than non-DM patients (26.6% versus 18%, P<0.001). CRT-D was associated with a significant reduction in risk of primary end point in both DM (HR=0.56, P<0.001) and non-DM patients (HR=0.67, P=0.003). Compared with non-DM patients, CRT-D:ICD HRs in DM patients were lower in the total population, and in subgroups with ischemic cardiomyopathy (0.63 versus 0.64), nonischemic cardiomyopathy (0.39 versus 0.73), and left bundle-branch block (0.36 versus 0.50). There were no significant differences in ventricular remodeling, arrhythmia events, or device-related complications between DM and non-DM patients. CONCLUSIONS: Patients with diabetes, left ventricular dysfunction, mildly symptomatic HF, and wide QRS complex derive similar benefit from CRT-D compared with patients without diabetes. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00180271. |
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Authors:
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David T Martin; Scott McNitt; Richard W Nesto; Martin K Rutter; Arthur J Moss |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2011-02-24 |
Journal Detail:
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Title: Circulation. Heart failure Volume: 4 ISSN: 1941-3297 ISO Abbreviation: Circ Heart Fail Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-05-18 Completed Date: 2011-07-14 Revised Date: 2011-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101479941 Medline TA: Circ Heart Fail Country: United States |
Other Details:
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Languages: eng Pagination: 332-8 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Medicine, Lahey Clinic Medical Center, Burlington, MA 01805, USA. david.t.martin@lahey.org |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00180271 |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Resynchronization Therapy* Defibrillators, Implantable* Diabetes Mellitus* Female Heart Block / therapy* Heart Failure / therapy* Humans Male Proportional Hazards Models Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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