{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:32:27Z","timestamp":1787959947859,"version":"build-2784847793"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T00:00:00Z","timestamp":1486425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100006279","name":"St. Jude Medical","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006279","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005035","name":"Biotronik","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005035","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Cardiac resynchronization therapy (CRT) improves outcomes in heart failure (HF) but may be underutilized. The reasons are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We linked the Swedish Heart Failure Registry to national registries with ICD-10 (International Classification of Diseases-10th Revision) co-morbidity diagnoses and demographic and socio-economic data. In patients with EF \u226439% and NYHA II\u2013IV, we assessed prevalence of CRT indication and CRT use. In those with CRT indication, we assessed the association between 37 potential baseline covariates and CRT non-use using multivariable generalized estimating equation (GEE) models. Of 12 807 patients (mean age 71\u2009\u00b1\u200912\u2009years, 28% female), 841 (7%) had CRT, 3094 (24%) had an indication for but non-use of CRT, and 8872 (69%) had no indication. Important variables independently associated with CRT non-use were: HF duration &amp;lt;6\u2009months [risk ratio (RR) 1.21, 95% confidence interval (CI) 1.17\u20131.24]; non-cardiology planned follow-up (RR 1.14, 95% CI 1.09\u20131.18); age &amp;gt;75\u2009years (RR 1.13, 95% CI 1.09\u20131.18); non-cardiology care at baseline (RR 1.10, 95% CI 1.07\u20131.14); small-town non-university centre (RR 1.08, 95% CI 1.05\u20131.12); female sex (RR 1.07 95% CI 1.03\u20131.10) (all P &amp;lt; 0.05); as was absence of AF, living alone; psychiatric diagnosis; smoking; and non-use of HF drugs. Education, income, cancer, or HF characteristics were not independently associated with CRT non-use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this population-wide HF registry, CRT was underutilized. Non-use was associated mostly with demographic and organizational, but not clinical or socio-economic factors. This calls for programmes to raise awareness of CRT indications and improve access and referrals to cardiology specialists.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.781","type":"journal-article","created":{"date-parts":[[2017,2,8]],"date-time":"2017-02-08T00:00:37Z","timestamp":1486512037000},"page":"1270-1279","source":"Crossref","is-referenced-by-count":100,"title":["Association Between Demographic, Organizational, Clinical, and Socio-Economic Characteristics and Underutilization of Cardiac Resynchronization Therapy: Results from the Swedish Heart Failure Registry"],"prefix":"10.1093","volume":"19","author":[{"given":"Lars H.","family":"Lund","sequence":"first","affiliation":[{"name":"Karolinska Institutet, Department of Medicine , Stockholm ,","place":["Sweden"]},{"name":"Karolinska University Hospital, Department of Cardiology , Stockholm 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