title: Cardiac Resynchronization in Different Age Groups: A MADIT-CRT Long-Term Follow-Up Substudy.
abstract: BACKGROUND
  Cardiac resynchronization with defibrillators (CRT-D) reduces heart failure and mortality compared with defibrillators alone. Whether this applies to all ages is unclear.
  
  
  RESULTS
  We assessed the association of age on heart failure and death as a post hoc analysis of the MADIT-CRT follow-up study, in which 1,281 patients with class I/II heart failure (HF) were randomized to CRT-D or implantable cardioverter-defibrillators alone. Different age groups (<60, 60-74, and ≥75 years) were evaluated over 7 years for mortality and HF events. Among the 3 age groups, there were 399, 651, and 231 patients, respectively. We compared events with the use of a multivariate regression model. CRT-D compared with defibrillators alone significantly reduced the composite of HF or death across all age groups: <60 years: relative risk reduction (RRR) = 36%; 60-74 years: RRR = 61%; ≥75 years: RRR = 56%. CRT-D significantly reduced HF in all age groups: <60 years: RRR = 49%; 60-74 years: RRR = 62%; ≥75 years: RRR = 74%. CRT-D was associated with significant mortality reduction only in the 60-74 year age group: RRR = 59%.
  
  
  CONCLUSIONS
  CRT-D reduced HF events and the composite of mortality or HF events during long-term follow-up in all age groups. CRT-D reduced mortality only in the 60-74 year age group.
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York. Electronic address: sabu_thomas@urmc.rochester.edu.
authors.forename: Sabu
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Moss
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zareba
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York.
authors.forename: Scott
authors.initials: S
authors.lastname: McNitt
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York; Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Barsheshet
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York.
authors.forename: Helmut
authors.initials: H
authors.lastname: Klein
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York; Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York.
authors.forename: David T
authors.initials: DT
authors.lastname: Huang
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York.
authors.forename: Yitschak
authors.initials: Y
authors.lastname: Biton
authors.affiliation: Heart Research Follow-Up Group, University of Rochester School of Medicine, Rochester, New York.
authors.forename: Valentina
authors.initials: V
authors.lastname: Kutyifa
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D058406:Cardiac Resynchronization Therapy / Q000706:statistics & numerical data*; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: Heart failure; biventricular pacing; geriatric cardiology; hospitalizations