Impact of Etiology on the Outcomes in Heart Failure Patients Treated with Cardiac Resynchronization Therapy: A Meta-Analysis

<div><p>Background</p><p>Cardiac resynchronization therapy (CRT) has been extensively demonstrated to benefit heart failure patients, but the role of underlying heart failure etiology in the outcomes was not consistently proven. This meta-analysis aimed to determine whether efficacy and effectiveness of CRT is affected by underlying heart failure etiology.</p><p>Methods and Results</p><p>Searches of MEDLINE, EMBASE and Cochrane databases were conducted to identify RCTs and observational studies that reported clinical and functional outcomes of CRT in ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM) patients. Efficacy of CRT was assessed in 7 randomized controlled trials (RCTs) with 7072 patients and effectiveness of CRT was evaluated in 14 observational studies with 3463 patients In the pooled analysis of RCTs, we found that CRT decreased mortality or heart failure hospitalization by 29% in ICM patients (95% confidence interval [CI], 21% to 35%), and by 28% (95% CI, 18% to 37%) in NICM patients. No significant difference was observed between the 2 etiology groups (P = 0.55). In the pooled analysis of observational studies, however, we found that ICM patients had a 54% greater risk for mortality or HF hospitalization than NICM patients (relative risk: 1.54; 95% CI: 1.30–1.83; P<0.001). Both RCTs and observational studies demonstrated that NICM patients had greater echocardiographic improvements in the left ventricular ejection fraction and end-systolic volume, as compared with ICM patients (both P<0.001).</p><p>Conclusion</p><p>CRT might reduce mortality or heart failure hospitalization in both ICM and NICM patients similarly. The improvement of the left ventricular function and remodeling is greater in NICM patients.</p></div

Characteristics of Observational Studies Included in the Meta-analysis.

<p>ICM, ischemic cardiomyopathy; NICM, non-ischemic cardiomyopathy; other abbreviations as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0094614#pone-0094614-t001" target="_blank">Table 1</a>.</p

Forest Plots Showing the Impact of HF Etiology on Mortality or HF Hospitalization.

<p>(A): data from RCTs; (B): data from observational studies. COMPANION trial was 3 arms design; CI, confidence interval; HF, heart failure; ICD, implantable cardioverter-defibrillator; ICM, ischemic cardiomyopathy; MT, medical therapy; NICM, non-ischemic cardiomyopathy; PCS, prospective cohort studies; RCS, retrospective cohort studies; RR, relative risk; and other abbreviations as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0094614#pone-0094614-g001" target="_blank">Figure 1</a>.</p

Pooled Analyses of Secondary Outcomes (the Change from Baseline) in NICM Group versus ICM Group.

<p>WMD in change of Left Ventricular Ejection Fraction (A), SMD in change of Left Ventricular End-systolic Volume (B), WMD in change of 6-Min Walking Distance (C), and WMD in change of Quality of Life (D). WMD, weighted mean difference; SMD, standardized mean difference; and other abbreviations as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0094614#pone-0094614-g002" target="_blank">Figure 2</a>.</p

Leave-One-Out Analyses of Primary Outcomes.

<p>(A): data from RCTs; (B): data from observational studies. The RR and CIs for each row was presented as the overall effect size if that study were excluded. Abbreviations as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0094614#pone-0094614-g002" target="_blank">Figure 2</a>.</p

Additional file 1 of Risks of digestive diseases in long COVID: evidence from a population-based cohort study

Additional file 1: Figure S1. Directed Acyclic Graphs (DAG) for covariate selection. Figure S2. Flow chart of eligible participants’ selection. Figure S3. Distribution of follow-up time in the contemporary cohort (A) and the historical cohort (B). Figure S4. Hazard ratio of digestive outcomes in COVID-19 group and the contemporary comparison by severity of COVID-19. Table S1. Respiratory support treatments definition. Table S2. Outcome ascertainment. Table S3. The numbers (percentages) of participants with missing covariates. Table S4. Baseline characteristics of COVID-19 group and contemporary comparisons before weighting. Table S5. Hazard ratio of digestive outcomes in COVID-19 group and the contemporary comparison at different follow-up times. Table S6. Baseline characteristics of COVID-19, contemporary comparisons by severity of COVID-19 before weighting. Table S7. Baseline characteristics of COVID-19, contemporary comparisons by severity of COVID-19 after weighting. Table S8. Baseline characteristics of COVID-19 group and contemporary comparisons by status of SARS-CoV reinfection before weighting. Table S9. Baseline characteristics of COVID-19 group and contemporary comparisons by severity of SARS-CoV reinfection after weighting. Table S10. Hazard ratio of digestive outcomes in the reinfected group, single SARS-CoV-2 infection group, and non-infected comparisons. Table S11. Hazard ratio of digestive outcomes in reinfected group and single SARS-CoV-2 infection group in head-to-head comparison. Table S12. Baseline characteristics of COVID-19 group and contemporary comparisons in the sensitive analysis restricting to the period before vaccination was available before weighting. Table S13. Baseline characteristics of COVID-19 group and contemporary comparisons in the sensitive analysis restricting to the period before vaccination was available after weighting. Table S14. Hazard ratio of digestive outcomes in COVID-19 group and contemporary and historical comparisons in subgroups in the sensitive analysis restricting to the period before vaccination was available. Table S15. Hazard ratio of digestive outcomes in COVID-19 group compared to the contemporary and historical comparisons by pooling estimates across all five imputed datasets. Table S16. Hazard ratio of digestive outcomes compared with contemporary and historical comparisons in subgroups. Table S17. Hazard ratio of digestive outcomes in COVID-19 group, the contemporary and historical comparison by sex. Table S18. Baseline characteristics of COVID-19 group and historical comparisons before weighting. Table S19. Baseline characteristics of COVID-19 group and historical comparisons after weighting. Table S20. Baseline characteristics of COVID-19 group and historical comparisons by severity of COVID-19 before weighting. Table S21. Baseline characteristics of COVID-19 group and historical comparisons by severity of COVID-19 after weighting. Table S22. Baseline characteristics of COVID-19 group and historical comparisons in the sensitive analysis restricting to the period before vaccination was available before weighting. Table S23. Baseline characteristics of COVID-19 group and historical comparisons in the sensitive analysis restricting to the period before vaccination was available after weighting. Table S24. Hazard ratio of digestive outcomes in COVID-19 group and the historical comparison by severity of COVID-19

Additional file 1 of Model containing sarcopenia and visceral adiposity can better predict the prognosis of hepatocellular carcinoma: a multicenter study

Additional file 1