Clinical outcomes of cardiac resynchronization therapy with and without a defibrillator in elderly patients with heart failure
Bibliographic record
Abstract
Abstract Background Evidence regarding the incremental benefit of cardiac resynchronization therapy (CRT) with a defibrillator (CRT‐D) versus without (CRT‐P) in elderly patients with heart failure is limited. We compared mortality and cardiac hospitalisation between CRT‐D and CRT‐P in the elderly. Methods A retrospective chart review identified all consecutive patients with age ≥75 with CRT implantation over the last 10 years at a Canadian tertiary care cardiac centre. Kaplan‐Meier survival analyses and cumulative incidence curves were used to compare mortality and time to first cardiac hospitalisation, respectively, with CRT‐D versus CRT‐P over a 3 year period. Analyses were also repeated with propensity score matching based on age, sex, primary versus secondary prevention, date of implant, and Charlson Comorbidity Index. Results One hundred and seventy CRT patients were identified. A total of 128 received CRT‐D while 42 received CRT‐P. Median age was 79 (IQR 77‐81), and the majority were male (83%). CRT‐P patients had a higher burden of comorbidities (Charlson score 7, IQR 6‐8) than CRT‐D patients (Charlson score 5, IQR 5‐7; P < 0.001). There was no significant difference in survival between the two groups in an unmatched comparison (P = 0.69) and with a propensity score‐matched cohort (P = 0.91). Secondary prevention CRT‐D patients had a higher risk of hospitalisation compared to primary prevention CRT‐D patients; however, there was no significant difference in hospitalisation between the CRT‐D and CRT‐P groups. Conclusion This study suggests there is no significant difference in mortality or cardiac hospitalisation between CRT‐D and CRT‐P in elderly patients with heart failure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".