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CARE-HF: Early markers help predict long-term mortality
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Patients with heart failure with severe mitral regurgitation or elevated amino terminal pro-brain natriuretic peptides have higher mortality, a report suggested.
Researchers from the United Kingdom and other European countries enrolled 813 patients in the randomized, multicenter trial. Patients either received or did not receive cardiac resynchronization therapy along with pharmacologic treatment. The researchers followed patients for a median of 37.6 months. Multivariate analysis of results from the Cardiac Resynchronization in Heart Failure (CARE-HF) trial suggested that plasma concentration of amino terminal pro-brain natriuretic peptide (P<.0001) and severity of mitral regurgitation (P<.0001) were the strongest independent predictors of mortality at three months for both treatment arms. The adjusted hazard ratio for mortality at three months was 0.67 (95% CI, 0.49-0.91). One hundred and fifty-four patients not assigned to cardiac resynchronization therapy and 101 patients assigned to cardiac resynchronization therapy died during median follow-up.
“These data support the observation that patients who improve their cardiac function after receiving cardiac resynchronization therapy have a better prognosis, but at the same time, indicate that this is the mechanism of a relatively small proportion of the effect of cardiac resynchronization therapy on long-term mortality,” the researchers wrote.
For more information:
- J Am Coll Cardiol. 2008;52:438-445.