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- 幻灯介绍：
Cardiac Resynchronization Heart Failure Study
Presented at
American College of Cardiology
Scientific Sessions 2005
Presented by Dr. John G. Cleland
CARE-HF Study
Endpoints (mean 29.4 months):
Time to first event for the composite of hospitalization for
a major cardiovascular event or all-cause mortality
CARE-HF Study
Presented at ACC Scientific Sessions 2005
813 patients with patients with advanced heart failure (LVEF ≤ 35%, NYHA class III or IV), and cardiac dyssynchrony
despite standard pharmacological therapy.
Randomized
Control
Continued optimal pharmacological therapy
n=404
Cardiac Resynchronization Therapy (CRT)
Pharmacological therapy with CRT
n=409
Presented at ACC Scientific Sessions 2005
Baseline clinical characteristics were similar between the treatment groups, with 46% of patients having dilated cardiomyopathy and 38% with ischemic heart disease.
Mean LV ejection fraction was 25%.
Of the 409 patients randomized to the CRT device, 95% had a successful implantation.
The primary endpoint of all-cause mortality or hospitalization for a major cardiovascular event occurred less frequently in the CRT group than the medical therapy alone group (hazard ratio [HR] 0.63, 95% CI 0.51-0.77).
The major secondary endpoint of all-cause mortality was also lower in the CRT group (HR 0.64, 95% CI 0.48-0.85).
CRT
Control
Primary Endpoint
All-cause Mortality or Hospitalization for Major Cardiovascular Event
p<0.001
Secondary Endpoint
All-cause Mortality
p<0.001
CRT
Control
CARE-HF Study
Presented at ACC Scientific Sessions 2005
The composite of death or hospitalization for worsening heart failure was also lower in the CRT group (HR 0.54, p<0.001).
Patients in the CRT group had a lower NYHA class and a higher Euro Quality of Life score at 90 days.
Mean left ventricular ejection fraction was higher on average in the CRT group compared with the medical therapy alone group.
CARE-HF Study
NYHA Class at 90 days
p<0.001
Euro Quality of Life Score
at 90 days, p<0.001
Mean LVEF at 18 Months
p<0.001
6.9%
Among patients with advanced heart failure despite standard pharmacological therapy, treatment with cardiac resynchronization therapy was associated with a reduction in the primary endpoint of all-cause mortality and hospitalization for major cardiovascular events compared with standard pharmacological therapy.
Similar results were observed in the COMPANION trial, which showed a reduction in the composite endpoint of death or hospitalization through a mean 16 month follow-up in patients treated with CRT with or without an implantable defibrillator, but the reduction in mortality did not reach statistical significance (p=0.06).
Presented at ACC Scientific Sessions 2005
CARE-HF Study: Summary