Clinical Impact of Digitalis Therapy in a Large Multicenter Cohort of CRT-Recipients
(1) Introduction: Digitalis use in patients with severe heart failure is controversial. We assessed the effects of digitalis therapy on mortality in a large, observational study in recipients of cardiac resynchronization therapy (CRT). (2) Methods: Consecutive patients receiving a CRT-defibrillator...
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2024
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| Sorozat: | JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
11 No. 6 |
| Tárgyszavak: | |
| doi: | 10.3390/jcdd11060173 |
| mtmt: | 34900574 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/32548 |
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| 024 | 7 | |a 10.3390/jcdd11060173 |2 doi | |
| 024 | 7 | |a 34900574 |2 mtmt | |
| 040 | |a SZTE Publicatio Repozitórium |b hun | ||
| 041 | |a eng | ||
| 100 | 1 | |a Erath Julia W. | |
| 245 | 1 | 0 | |a Clinical Impact of Digitalis Therapy in a Large Multicenter Cohort of CRT-Recipients |h [elektronikus dokumentum] / |c Erath Julia W. |
| 260 | |c 2024 | ||
| 300 | |a 12 | ||
| 490 | 0 | |a JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE |v 11 No. 6 | |
| 520 | 3 | |a (1) Introduction: Digitalis use in patients with severe heart failure is controversial. We assessed the effects of digitalis therapy on mortality in a large, observational study in recipients of cardiac resynchronization therapy (CRT). (2) Methods: Consecutive patients receiving a CRT-defibrillator in three European tertiary referral centers were enrolled and followed-up for a mean 37 months ± 28 months. Digitalis use was assessed at the time of CRT implantation. A multivariate Cox-regression model and propensity score matching were used to determine all-cause mortality as the primary endpoint. CRT-response (defined as improvement of ≥1 NYHA class), echocardiographic improvement (defined as improvement of LVEF of ≥ 5%) and incidence of ICD shocks and rehospitalization were assessed as secondary endpoints in a subgroup of patients. (3) Results: The study comprised 552 CRT-recipients with standard indications, including 219 patients (40%) treated with digitalis. Compared to patients without digitalis, they had more often atrial fibrillation, poorer LVEF and a higher NYHA class (all p ≤ 0.002). Crude analysis of all-cause mortality demonstrated a similar relative risk of death for patients with and without digitalis (HR = 1.14; 95% CI 0.88–1.5; p = 0.40). After adjustment for independent predictors of mortality, digitalis therapy did not alter the risk for death (adjusted HR = 1.04; 95% CI 0.75–1.45; p = 0.82). Furthermore, in comparison to 286 propensity-score-matched patients, mortality was not affected by digitalis intake (propensity-adjusted HR = 1.11; 95% CI 0.72–1.70; p = 0.64). A CRT-response was predominant in digitalis non-users, concerning both improvement of HF symptoms and LVEF (NYHA p < 0.01; LVEF p < 0.01), while patients on digitalis had more often ventricular tachyarrhythmias requiring ICD shock (p = 0.01); although, rehospitalization for cardiac reasons was significantly lower among digitalis users compared to digitalis non-users (HR = 0.58; 95% C. I. 0.40–0.85; p = 0.01). (4) Conclusions: Digitalis therapy had no effect on mortality, but was associated with a reduced response to CRT and increased susceptibility to ventricular arrhythmias requiring ICD shock treatment. Although, digitalis administration positively altered the likelihood for cardiac rehospitalization during follow-up. | |
| 650 | 4 | |a Klinikai orvostan | |
| 700 | 0 | 1 | |a Vigh Nikolett |e aut |
| 700 | 0 | 1 | |a Muk Balázs |e aut |
| 700 | 0 | 1 | |a Israel Carsten W. |e aut |
| 700 | 0 | 1 | |a Keck Sarah |e aut |
| 700 | 0 | 1 | |a Pilecky David |e aut |
| 700 | 0 | 1 | |a Duray Gábor Z. |e aut |
| 700 | 0 | 1 | |a Vámos Máté |e aut |
| 856 | 4 | 0 | |u http://publicatio.bibl.u-szeged.hu/32548/1/Erath.pdf |z Dokumentum-elérés |