Abstract 13344: Is Cardiac Resynchronization Therapy Use Improving Among Racial/Ethnic Minorities? An Analysis of 107,096 Patients from the NCDR-ICD Registry
Background: Despite the evidence from randomized clinical trials and practice guidelines, studies have suggested that cardiac resynchronization therapy with defibrillation (CRT-D) is under-utilized in potentially eligible patients. Whether use of this therapy is improving among racial/ethnic minorities in the United States is unknown.
Methods: We queried the National Cardiovascular Data Registry's Implantable Cardioverter Defibrillator (ICD) Registry for patients eligible for CRT-D (those with NYHA class III or IV symptoms, left ventricular ejection fraction ≤35%, and native QRS width ≥120 msec on optimal medical therapy) who received CRT-D between April 1, 2006 and March 31, 2010. Optimal medical therapy was defined as treatment with a beta-blocker and an ACE-I or an ARB. We determined the rate of CRT-D implantation in eligible patients during this timeframe. We created annual cohorts of CRT-D eligible patients and determined trends in CRT-D implantation from 2006 to 2010 for the overall cohort, as well as according to race/ethnicity.
Results: We identified 107,096 patients eligible for a CRT-D. Of these, 87,692 (81.88%) received CRT-D. In the overall study population, the use of CRT-D in eligible patients increased from 80.35% in the first year to 84.02% in the fourth year (p <0.0001). The increase in CRT-D rates was significant among racial/ethnic subgroups (Table).
Conclusions: CRT-D use among potentially eligible patients appears to be improving in the overall population and in racial minorities. Future efforts should continue to promote evidence-based practice and address persistent racial disparities in CRT-D use.
- © 2011 by American Heart Association, Inc.