Aim ― Meta-analysis of clinical trials comparing the efficacy of medical therapy (MT) and surgical treatment, including cardiac resynchronization therapy with and without cardioversion-defibrillation (CRT and CRT-D), circulatory support system (CSS) and heart transplantation (HT), in terms of decreasing overall mortality in patients with severe chronic heart failure (CHF). Material and Methods ― Meta-analysis included 39 clinical trials with a total number of 30,257 patients. Search was performed in MEDLINE, Medscape, Pubmed databases and on web resources, dedicated to clinical trials (National Institutes of Health, Clinical Center, ClinicalStudyResults.org, ClinicalTrials.gov). Results ― There was no significant overall mortality reduction in patients receiving MT when compared to control group: OR=0.97 (95% CI: 0.85-1.10), p=0.211. Treatment with CRT and CRT-D, as well as CSS implantation and HT reduced overall mortality: OR=0.67 (95% CI: 0.57–0.79), p < 0.001 for CRT/CRT-D and OR=0.46 (95% CI: 0.24–0.86), p = 0.018 for CSS/HT. Conclusion ― Superiority of surgical treatment over traditional MT in terms of overall mortality was observed in patients with severe CHF.
Olanna T. Kotsoeva Comparison of impact of medical therapy and surgical treatment on overall mortality in patients with severe chronic heart failure: a meta-analysis // Russian Open Medical Journal, Vol. 5, Issue 3, 2016, pp. 0-0