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Impact of Current Versus Previous Cardiac Resynchronization Therapy Guidelines on the Proportion of Patients With Heart Failure Eligible for Therapy.

Publication ,  Journal Article
Lyons, KJ; Ezekowitz, JA; Liang, L; Heidenreich, PA; Yancy, CW; DeVore, AD; Hernandez, AF; Fonarow, GC
Published in: JACC Heart Fail
May 2017

OBJECTIVES: This study sought to ascertain the impact of heart failure (HF) guideline change on the number of patients eligible to undergo cardiac resynchronization therapy (CRT). BACKGROUND: The 2013 HF guideline of the American College of Cardiology Foundation and American Heart Association (ACCF/AHA) narrowed the recommendations for CRT. The impact of this guideline change on the number of eligible patients for CRT has not been described. METHODS: Using data from Get With The Guidelines-Heart Failure between 2012 and 2015, this study evaluated the proportion of hospitalized patients with HF who were eligible for CRT on the basis of historical and current guideline recommendations. The authors identified 25,102 hospitalizations for HF that included patients with a left ventricular ejection fraction (LVEF) ≤35% from 283 hospitals. Patients with a medical, system-related, or patient-related reason for not undergoing CRT were excluded. RESULTS: Overall, 49.1% (n = 12,336) of patients with HF, an LVEF ≤35%, and no documented contraindication were eligible for CRT on the basis of historical guidelines, and 33.1% (n = 8,299) of patients were eligible for CRT on the basis of current guidelines, a 16.1% absolute reduction in eligibility (p < 0.0001). Patients eligible for CRT on the basis of current guidelines were more likely to have CRT with an implantable cardioverter-defibrillator or CRT with pacing only placed or prescribed at discharge (57.8% vs. 54.9%; p < 0.0001) compared with patients eligible for CRT on the basis of historical guidelines. CONCLUSIONS: In this population of patients with HF, an LVEF ≤35%, and no documented contraindication for CRT, the current ACCF/AHA HF guidelines reduce the proportion of patients eligible for CRT by approximately 15%.

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Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

May 2017

Volume

5

Issue

5

Start / End Page

388 / 392

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Stroke Volume
  • Societies, Medical
  • Sex Factors
  • Practice Guidelines as Topic
  • Patient Selection
  • Middle Aged
 

Citation

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Lyons, K. J., Ezekowitz, J. A., Liang, L., Heidenreich, P. A., Yancy, C. W., DeVore, A. D., … Fonarow, G. C. (2017). Impact of Current Versus Previous Cardiac Resynchronization Therapy Guidelines on the Proportion of Patients With Heart Failure Eligible for Therapy. JACC Heart Fail, 5(5), 388–392. https://doi.org/10.1016/j.jchf.2017.02.018
Lyons, Kristin J., Justin A. Ezekowitz, Li Liang, Paul A. Heidenreich, Clyde W. Yancy, Adam D. DeVore, Adrian F. Hernandez, and Gregg C. Fonarow. “Impact of Current Versus Previous Cardiac Resynchronization Therapy Guidelines on the Proportion of Patients With Heart Failure Eligible for Therapy.JACC Heart Fail 5, no. 5 (May 2017): 388–92. https://doi.org/10.1016/j.jchf.2017.02.018.
Lyons KJ, Ezekowitz JA, Liang L, Heidenreich PA, Yancy CW, DeVore AD, et al. Impact of Current Versus Previous Cardiac Resynchronization Therapy Guidelines on the Proportion of Patients With Heart Failure Eligible for Therapy. JACC Heart Fail. 2017 May;5(5):388–92.
Lyons, Kristin J., et al. “Impact of Current Versus Previous Cardiac Resynchronization Therapy Guidelines on the Proportion of Patients With Heart Failure Eligible for Therapy.JACC Heart Fail, vol. 5, no. 5, May 2017, pp. 388–92. Pubmed, doi:10.1016/j.jchf.2017.02.018.
Lyons KJ, Ezekowitz JA, Liang L, Heidenreich PA, Yancy CW, DeVore AD, Hernandez AF, Fonarow GC. Impact of Current Versus Previous Cardiac Resynchronization Therapy Guidelines on the Proportion of Patients With Heart Failure Eligible for Therapy. JACC Heart Fail. 2017 May;5(5):388–392.
Journal cover image

Published In

JACC Heart Fail

DOI

EISSN

2213-1787

Publication Date

May 2017

Volume

5

Issue

5

Start / End Page

388 / 392

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Survival Analysis
  • Stroke Volume
  • Societies, Medical
  • Sex Factors
  • Practice Guidelines as Topic
  • Patient Selection
  • Middle Aged