A novel prediction model for survival in individual patients with cardiac resynchronization therapy with a defibrillator: Analysis of the new Japan cardiac device treatment registry database
Hisashi Yokoshiki, Akihiko Shimizu, Takeshi Mitsuhashi, Kohei Ishibashi, Tomoyuki Kabutoya, Yasuhiro Yoshiga, Yusuke Kondo, Taro Temma, Masahiko Takagi, Hiroshi Tada,Abstract
Background
Accurate prediction for survival in individualized patients with cardiac resynchronization therapy with a defibrillator (CRT‐D) is difficult.
Methods
We analyzed the New Japan cardiac device treatment registry (JCDTR) database to develop a survival prediction model for CRT‐D recipients.
Results
Four hundred and eighty‐two CRT‐D recipients, at the implantation year 2018–2021, with a QRS width ≥120 ms and left ventricular ejection fraction (LVEF) ≤35% at baseline, were analyzed. During an average follow‐up of 21 ± 10 months, death occurred in 66 of 482 CRT‐D patients (14%). A prediction model estimating annual survival probability was developed using Cox regression with internal validation. With seven explanation predictors (age >75 years, serum creatinine >1.4 mg/dL, blood hemoglobin <12 g/dL, heart rate ≥90/min, LVEF, prior NSVT, and QRS width <150 ms), the model distinguished patients with and without all‐cause death, with an optimism‐corrected C‐statistics of 0.766, 0.764, and 0.768, and calibration slope of 1.01, 1.00, and 1.00 at 1 year, 2 years, and 3 years. Additionally, we have devised the calculator of survival probability for individual CRT‐D recipients.
Conclusions
Using routine available variables, we have developed a survival prediction model for individual CRT‐D recipients.