{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T22:59:36Z","timestamp":1768777176676,"version":"3.49.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Data are limited regarding whether the presence of diabetes mellitus (DM) influences the benefit of cardiac resynchronization with defibrillator therapy (CRT-D) in heart failure (HF) patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              The effect of CRT-D was evaluated in 1817 patients who were enrolled in the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT). Patients were minimally symptomatic (New York Heart Association class I or II), with ejection fraction \u22640.30 and QRS \u2265130 ms. We used Cox regression to determine hazard ratio (HR) of CRT-D versus implantable cardioverter-defibrillator (ICD) therapy for the risk of HF event or death, whichever came first (MADIT-CRT primary end point), in DM (n=552) and non-DM (n=1265) patients. Compared with the non-DM patients, those with DM had more coronary risk factors. During an average follow-up of 2.4 years, DM patients had significantly more primary end point events than non-DM patients (26.6% versus 18%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). CRT-D was associated with a significant reduction in risk of primary end point in both DM (HR=0.56,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and non-DM patients (HR=0.67,\n              <jats:italic>P<\/jats:italic>\n              =0.003). Compared with non-DM patients, CRT-D:ICD HRs in DM patients were lower in the total population, and in subgroups with ischemic cardiomyopathy (0.63 versus 0.64), nonischemic cardiomyopathy (0.39 versus 0.73), and left bundle-branch block (0.36 versus 0.50). There were no significant differences in ventricular remodeling, arrhythmia events, or device-related complications between DM and non-DM patients.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Patients with diabetes, left ventricular dysfunction, mildly symptomatic HF, and wide QRS complex derive similar benefit from CRT-D compared with patients without diabetes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00180271.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.110.959510","type":"journal-article","created":{"date-parts":[[2011,2,25]],"date-time":"2011-02-25T03:39:44Z","timestamp":1298605184000},"page":"332-338","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Cardiac Resynchronization Therapy Reduces the Risk of Cardiac Events in Patients With Diabetes Enrolled in the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT)"],"prefix":"10.1161","volume":"4","author":[{"given":"David T.","family":"Martin","sequence":"first","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Lahey Clinic Medical Center, Burlington, MA (D.T.M., R.W.N.); the Department of Medicine, University of Rochester Medical Center, Rochester, NY (S.M., A.J.M.); The Cardiovascular Research Group, School of Biomedicine, University of Manchester, United Kingdom (M.K.R.); Manchester Diabetes Centre, NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"McNitt","sequence":"additional","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Lahey Clinic Medical Center, Burlington, MA (D.T.M., R.W.N.); the Department of Medicine, University of Rochester Medical Center, Rochester, NY (S.M., A.J.M.); The Cardiovascular Research Group, School of Biomedicine, University of Manchester, United Kingdom (M.K.R.); Manchester Diabetes Centre, NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard W.","family":"Nesto","sequence":"additional","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Lahey Clinic Medical Center, Burlington, MA (D.T.M., R.W.N.); the Department of Medicine, University of Rochester Medical Center, Rochester, NY (S.M., A.J.M.); The Cardiovascular Research Group, School of Biomedicine, University of Manchester, United Kingdom (M.K.R.); Manchester Diabetes Centre, NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin K.","family":"Rutter","sequence":"additional","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Lahey Clinic Medical Center, Burlington, MA (D.T.M., R.W.N.); the Department of Medicine, University of Rochester Medical Center, Rochester, NY (S.M., A.J.M.); The Cardiovascular Research Group, School of Biomedicine, University of Manchester, United Kingdom (M.K.R.); Manchester Diabetes Centre, NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur J.","family":"Moss","sequence":"additional","affiliation":[{"name":"From the Department of Cardiovascular Medicine, Lahey Clinic Medical Center, Burlington, MA (D.T.M., R.W.N.); the Department of Medicine, University of Rochester Medical Center, Rochester, NY (S.M., A.J.M.); The Cardiovascular Research Group, School of Biomedicine, University of Manchester, United Kingdom (M.K.R.); Manchester Diabetes Centre, NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, United..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612263352601"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(74)90089-7"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)89163-1"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi376"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(85)80335-1"},{"key":"e_1_3_3_12_2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","article-title":"Regression models and life-tables","volume":"34","author":"Cox D","year":"1972","unstructured":"Cox D. 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