{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T23:35:34Z","timestamp":1769124934247,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T00:00:00Z","timestamp":1540857600000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008497","name":"Boston Scientific Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiac resynchronization therapy (CRT) is highly beneficial in patients with heart failure (HF) and left bundle branch block (LBBB); however, up to 30% of patients in this selected group are nonresponders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>We hypothesized that clinical and echocardiographic variables can be used to develop a simple mortality risk stratification score in CRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Best\u2010subsets proportional\u2010hazards regression analysis was used to develop a simple clinical risk score for all\u2010cause mortality in 756 patients with LBBB allocated to the CRT with defibrillator (CRT\u2010D) group enrolled in the multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy. The score was used to assess the mortality risk within the CRT\u2010D group and the associations with mortality reduction with CRT\u2010D vs implantable cardioverter defibrillator (ICD) in each risk category.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four clinical variables comprised the risk score: age\u2009\u2265\u200965, creatinine \u2265 1.4 mg\/dL, history of coronary artery bypass graft, and left ventricular ejection fraction (LVEF) &lt; 26%. Every 1 point increase in the score was associated with 2\u2010fold increased mortality within the CRT\u2010D arm (<jats:italic>P<\/jats:italic> &lt; 0.001). CRT\u2010D was associated with mortality reduction as compared with ICD only in patients with moderate risk: score 0 (HR\u2009= 0.80, <jats:italic>P<\/jats:italic> = 0.615), score 1 (HR\u2009= 0.54, <jats:italic>P<\/jats:italic> = 0.019), score 2 (HR\u2009= 0.54, <jats:italic>P<\/jats:italic> = 0.016), score 3\u20104 risk factors (HR\u2009= 1.08, <jats:italic>P<\/jats:italic> = 0.811); however, the device by score interaction was not significant (<jats:italic>P<\/jats:italic> = 0.306). The score was also significantly predictive of left ventricular reverse remodeling (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Four clinical variables can be used for improved mortality risk stratification in mild HF patients with LBBB implanted with CRT\u2010D.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23058","type":"journal-article","created":{"date-parts":[[2018,8,24]],"date-time":"2018-08-24T02:48:31Z","timestamp":1535078911000},"page":"1358-1366","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of long\u2010term mortality with cardiac resynchronization therapy in mild heart failure patients with left bundle branch block"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5844-8551","authenticated-orcid":false,"given":"Yitschak","family":"Biton","sequence":"first","affiliation":[{"name":"Cardiology Division University of Rochester Medical Center  Rochester New York"},{"name":"Cardiac Arrhythmia Service Massachusetts General Hospital and Harvard Medical School  Boston Massachusetts"},{"name":"Hadassah Ein Kerem Medical Center Hebrew University, Hadassah Medical School  Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Costa","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Rochester Medical Center  Rochester New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Zareba","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Rochester Medical Center  Rochester New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayson R.","family":"Baman","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Rochester Medical Center  Rochester New York"},{"name":"Department of Medicine, Feinberg School of Medicine Northwestern University  Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilan","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Rochester Medical Center  Rochester New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"McNitt","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Rochester Medical Center  Rochester New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Harvard Medical School  Boston 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