Abstract 4854: Cardiac Resynchronisation Therapy in Elderly Patients: Effects on Quality of Life. A Secondary Analysis from CARE-HF
In elderly patients, controlled data on the clinical efficacy and safety of cardiac resynchronization therapy (CRT) are very scarce. The CARE-HF study was the first multi-center randomised trial to demonstrate that CRT by atrio-biventricular pacing improves symptoms and the quality of life while reducing all-cause mortality and major morbidity in NYHA Class III-IV HF patients with wide QRS. This post-hoc analysis reports data on quality of life in the sub-population of patients aged ≥70 yrs.302 pts, mean age 75.1 yrs, were randomized to CRT (N=157) or medical treatment (MT:N=145) and followed for a mean of 28.9 months. There were no significant differences between the two groups in baseline characteristics including HF pharmacological treatment. Overall, 91.7% pts received ACE-I or ARB and 64.8% a Beta-blocker. HF was of ischemic etiology in 51% pts and mean QRS width was 165 ms.Three measures of quality of life were assessed: the Minnesota Living with Heart Failure (MLWHF) score at baseline (B), 3-month and 18-month f/u, the Euro Quality of life (EuroQal) score at B, 3-month, 18-month and end f/u, and number of quality adjusted life year (QALY) gained at end f/u.
Conclusion : In elderly patients with heart failure and wide QRS, CRT results in a highly significant and sustained improvement in quality of life and increases survival with a good quality of life