Mortality in African-Americans Following Cardiac Resynchronization Therapy: A Single Center Experience

Area of Science:

• Cardiology
• Medical Devices
• Clinical Outcomes Research

Background:

• Cardiac resynchronization therapy (CRT) is proven to improve outcomes in heart failure patients.
• Limited representation of African-Americans in CRT trials raises questions about applicability to this demographic.
• This study addresses the need to understand CRT outcomes specifically in African-American populations.

Purpose of the Study:

• To describe baseline characteristics of African-American patients receiving CRT.
• To determine the outcomes of CRT in African-American patients.
• To compare CRT outcomes in African-Americans to those reported in major clinical trials.

Main Methods:

• Evaluation of 131 African-American patients with heart failure (NYHA class II-IV) undergoing CRT.
• Identification of predictors for all-cause mortality.
• Utilized Kaplan-Meier survival estimates and Cox proportional hazards models.

Main Results:

• Mean age of participants was 65 ± 12 years.
• Over 6 years, African-American mortality was 23%, comparable to 29% in the MADIT-CRT trial.
• Increased mortality linked to older age, ischemic cardiomyopathy, and absence of ACE inhibitor/ARB or beta-blocker therapy.

Conclusions:

• African-American patients achieve similar survival benefits from CRT as Caucasian patients.
• Findings suggest CRT is effective across diverse populations.
• Optimal medical therapy, including ACE inhibitors/ARBs and beta-blockers, is crucial for CRT success.