Abstract 14974: Similar Risk Factors Associated With Cardiac and Non-Cardiac Mortality in MADIT-CRT Study
Purpose: To assess the causes of death and to reveal the factors that were associated with cardiac and non-cardiac mortality in MADIT-CRT study subjects.
Methods: In the MADIT-CRT study 1820 asymptomatic or mildly symptomatic patients with ischemic or nonischemic cardiomyopathy, EF ≤ 30% and QRS duration ≥ 130 msec were randomly assigned in a 3:2 ratio to receive a CRT-D or an ICD. The causes of death were determined by an expert committee.
The association of various factors with cardiac and non-cardiac mortality was evaluated in the Cox multivariate hazards model.
Results: During up to 4 years follow-up 169 (9.4%) patients died with known causes, of which 108 (63.9%) were cardiac and 61 (36.1%) non-cardiac. Patients (n=22, 1.2%) whose cause of death was unknown were excluded from the present analysis. Of the cardiac deaths 63 (58.3%) were evaluated to be due to pump failure, 28 (25.9%) due to arrhythmic causes and 17 (15.7%) due to unspecified cardiac causes. Of the 61 non-cardiac deaths, 19 (31.1%) were due to malignant diseases and 42 (68.9%) due to miscellaneous causes. The factors which retained their statistically significant association with cardiac or non-cardiac mortality after adjustments in the Cox multivariate regression analysis are shown in the Table.
Conclusion: In MADIT-CRT 2/3 of the deaths were cardiac and 1/3 non-cardiac. Many of the same risk factors were associated with cardiac and non-cardiac mortality. CRT-D reduced the risk for cardiac death in LBBB but increased the risk for non-cardiac death in non-LBBB.
- © 2013 by American Heart Association, Inc.