Tuesday, August 12, 2008

DCRI researchers find younger, white patients more likely to undergo cardiac resynchronization
By Kelly Winget, DCRI Communications

Cardiac resynchronization therapy (CRT) could possibly benefit between a third and half of patients who are hospitalized for heart failure. A recent study led by DCRI researchers found that many patients who would benefit from the therapy don't receive it, and that race, age and geography appear to be a factor in who does receive the therapy.

The study, led by the DCRI's Jonathan Piccini, MD, found that black patients, older and sicker patients, and patients in the Northeast parts of the U.S. were the least likely to receive CRT. Even though younger, white patients were much more likely to receive the therapy, black patients have twice the risk of suffering from heart failure as white patients.

Researchers did not find a significant difference between the number of male and female patients who received CVT.

Studies have shown that when CRT is used as part of optimal medical treatment it can significantly lower a patient's risk of repeat hospitalizations or untimely death.

The study results were scheduled to appear in the August 12 issue of Circulation.

Patients who undergo cardiac resynchronization have a specialized pacemaker implanted in the upper region of their chest. The pacemaker runs leads into the heart to ensure the two ventricles in the heart pump in tandem, instead of separately. The American College of Cardiology/American Heart Association recommends using CRT with patients who have left ventricular ejection fractions of 35 percent or less, which indicates how much blood leaves the ventricle with every heartbeat.

But the DCRI-led study found that approximately 10 percent of the time, patients who had ejection fractions of greater than 35 percent received CRT.

For the study, researchers examined records of close to 34,000 patients who were admitted to 228 hospitals between January 2005 and September 2007. The hospitals were part of the American College of Cardiology/American Heart Association's “Get with the Guidelines” program. Researchers noted which patients arrived at the hospital with CRT in place, and which patients had it when they were released from the hospital.

Piccini noted that the use of the therapy was highly varied across the country, and the DCRI's Adrian Hernandez, MD, the study's senior author, notes that the trends need to be watched closely, as the findings of this study were concerning.

The DCRI's Eric Peterson, MD, was also involved in this study.