Cardiac resynchronization therapy in the real world: comparison with the COMPANION study.
BACKGROUND
Several clinical trials have confirmed that cardiac resynchronization therapy (CRT) improves outcomes in well defined patient populations. It is uncertain, however, whether outcomes are similar in real-world clinical settings. This study compared outcomes after CRT with defibrillator (CRT-D) in a large real-world private-practice cardiology setting with those in the COMPANION multicenter trial.


RESULTS
A total of 429 consecutive patients who received CRT-D for standard indications (group 1) were retrospectively compared with the 595 patients (group 3) in the COMPANION CRT-D cohort regarding survival and survival free of cardiovascular (CV) hospitalization. A subgroup of the group 1 patients who met the COMPANION entrance criteria (group 2) was also compared with the COMPANION cohort (group 3) both with and without propensity-matching statistical analysis. Survival and survival free of CV hospitalization was better in group 1 than in group 3. Survival in group 2 with and without propensity matching was similar to group 3. However, survival free of CV hospitalization was better in the real-world patients (group 2) even after adjustment for differences in baseline characteristics.


CONCLUSIONS
Survival and CV hospitalization outcomes in a real-world clinical setting are as good as, or better than, those demonstrated in the COMPANION research trial.
St Paul Heart Clinic, St Paul, Minnesota, USA. Alan.Bank@allina.com
Alan J
AJ
Bank
Kevin V
KV
Burns
Ryan M
RM
Gage
Daniel B
DB
Vatterott
Stuart W
SW
Adler
Mariam
M
Sajady
Deanna
D
Rohde
Joshua S
JS
Parah
Inder
I
Anand
Patrick
P
Yong
Milan
M
Seth
Spencer H
SH
Kubo
D000368:Aged; D002304:Cardiac Pacing, Artificial; D058406:Cardiac Resynchronization Therapy; D015331:Cohort Studies; D016208:Databases, Factual; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008910:Minnesota; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014922:Wisconsin