PO-02-022 IS CRT ASSOCIATED WITH IMPROVED OUTCOMES IN PATIENTS WITH AMBULATORY NYHA CLASS IV SYMPTOMS COMPARED WITH PATIENTS WITH NYHA CLASS III SYMPTOMS?

Numerous trials have explored the role of CRT in heart failure (HF) patients across a range symptom severity. However, data on benefits with severe HF symptoms, i.e. NYHA class IV, are limited as such were not well represented prior clinical trials. Accordingly, more evidence is needed outcomes IV symptoms. To examine relative benefit ambulatory vs III functional status at time implantation. In this meta-analysis, we pooled patient-level from MIRACLE, MIRACLE-ICD, and COMPANION that enrolled LVEF≤35%, QRS ≥120ms, or Outcomes evaluated to combined endpoint all-cause mortality/HF hospitalization (HFH) mortality alone. The association between was using Bayesian Hierarchical Weibull survival regression model. Whether differs groups assessed by adding an interaction (III IV) random effect. Of 2311 data, 2008 (87%) had symptoms (1398 610 without CRT), 303 (13%) (204 99 CRT). Overall, associated lower risk death HFH (adjusted hazard ratio [aHR] 0.79, 95%CI 0.64 – 0.99, p = 0.044) but (aHR 0.78, 95% CI 0.59 1.03, 0.83). There no associations differed (ratio aHR 0.72, 0.30 1.27, 0.23 for death/HFH 0.70, 0.35 1.34, 0.27 alone). there significant difference either outcome those status. number small, limiting power analysis. This finding supports need further studies patients.Tabled 1Adjusted* overall symptomsEstimate95% Credible IntervalPosterior ProbabilityTime HFHaHR overall0.790.64-0.990.044By groupaHR III0.820.66-1.040.10aHR IV0.590.26-1.040.067Ratio (IV / III)0.720.30-1.270.23Time mortalityaHR overall0.780.59-1.030.083By III0.870.62-1.200.40aHR IV0.610.31-1.090.088Ratio III)0.700.35-1.340.27aHR, adjusted ratio. Note: different 1 indicates group group. *Adjusted ICD, age, sex, class, EF, duration, LBBB, atrial fibrillation, diabetes, hypertension, ischemic etiology, use beta blockers, ACE/ARB Open table new tab