Predictors of Recurring Hospitalizations for Heart Failure during Long-Term Follow-Up in MADIT-CRT

Abstract

Background There are limited data regarding predictors of recurrent hospitalization for heart failure (HHF) in mild heart failure (HF) patients during long-term follow-up. Objective We aimed to evaluate baseline risk factors for first and subsequent HHF among mild HF patients in MADIT-CRT. Methods Data regarding recurring HHF were prospectively collected for MADIT-CRT participants during long-term (7-year) follow-up. Multivariate regression analysis was used to identify predictors of recurring HHF, adjusting for treatment with cardiac resynchronization therapy with defibrillator (CRT-D). Results During long-term follow-up, 1442 patients had 0 HHF, 209 had 1 HHF, 90 had 2 HHF, and 77 had ≥3 HHFs. Predictors of first HHF included: atrial arrhythmia prior to enrollment, diabetes, prior coronary revascularization, glomerular filtration rate Conclusions Our data from the long-term follow-up of MADIT-CRT show that there are multiple baseline risk factors for first HHF following device implantation in mild HF patients, many of which do not predict subsequent HHF. These findings suggest a need to identify novel time-dependent risk factors for recurrent HHF.