Effects of cardiac resynchronization therapy with pacemaker and cardiac resynchronization therapy with defibrillator on the outcomes of patients with heart failure: a meta - analysis
10.3760/cma.j.issn.1671-0282.2011.12.022
- VernacularTitle:心脏再同步治疗起搏器与心脏再同步治疗除颤器对心力衰竭患者预后影响的荟萃分析
- Author:
Buchun ZHANG
;
Weijing LIU
;
Lei HOU
;
Hailing LI
;
Weiming LI
;
Yawei XU
- Publication Type:Journal Article
- Keywords:
Cardiac resynchronization;
Pacemaker;
Defibrillators;
Implantable;
Heart failure;
Mortality;
Sudden death;
Meta-analysis
- From:
Chinese Journal of Emergency Medicine
2011;20(12):1316-1320
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of cardiac resynchronization therapy with pacemaker (CRT- P) and cardiac resynchronization therapy with defibrillator (CRT -D) on the outcomes of patients with heart failure.Methods MEDLINE,Cochrane Controlled Trials Register,EMBASE and Chinese Wan Fang,CNKI database were searched to collect data from randomized controlled trials and cohort trials of CRT - P versus CRT - D for the treatment of heart failure from January 1,1990 through September 30,2011.Meta - analysis of data including all causes leading to mortality and mortality of sudden cardiac arrest and heart failure was carried out by using the RevMan 5.0 package.Results A total of 3 404 patients were collected from seven studies.Pooled analysis demonstrated CRT - D significantly reduced mortalities of all causes in comparison with CRT - P [ odds ratio (OR) =0.61,95％ confidence interval (CI) =0.47 ～0.79,P =0.0001 ].Sub - group analysis showed that an increased benefit was seen after extended follow -up period ( after 1 year,OR =0.56,95 ％ CI =0.41 ～ 0.77,P =0.0004),but not after relatively short follow - up period ( within one year,OR =0.76,95 ％ CI =0.54 ～ 1.06,P =0.11 ).Mortalities of sudden cardiac arrest ( OR =0.20,95％ CI =0.07 ～ 0.59,P =0.003) and heart failure ( OR =0.72,95％ CI =0.54 ～ 0.96,P =0.02) of patients treated with CRT - D were lower than those of patients treated with CRT- P.Conclusions This study suggests that CRT - D is superior over CRT - P in respect of better outcome of patients with heart failure.
