Comparison of the usefulness of cardiac resynchronization therapy in three age-groups (<65, 65-74 and 6575 Years) (from the InSync/InSync ICD Italian Registry)

Chronic heart failure is one of the most important geriatric syndromes, associated with disability, increased hospital admissions, and high mortality. The aim of this study was to evaluate the existence of age-related differences in clinical effectiveness and outcomes of cardiac resynchronization therapy (CRT), alone or in combination with an implantable cardioverter-defibrillator (CRT-D), in a large, real-world registry. A total of 1,787 patients admitted for CRT or CRT-D to the 117 centers participating in the InSync/InSync ICD Italian Registry from 1999 to 2005 were evaluated. Patients were divided into 3 age groups: <65 years (n = 571), 65 to 74 years (n = 740), and 6575 years (n = 476). The left ventricular ejection fraction did not differ in the 3 groups (26 \ub1 8% vs 26 \ub1 7% vs 27 \ub1 8%, p = 0.123). Atrial fibrillation prevalence demonstrated an age-related increase. The use of recommended medical therapy for chronic heart failure decreased with age, as well as CRT-D implantation (p <0.001). The percentage of echocardiographic responders to CRT was similar in the 3 groups, and New York Heart Association class significantly improved independent of age. During the follow-up period (19 \ub1 13 months), all-cause mortality was higher in patients aged 6575 years than in those aged