COMPANION
Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure
Patient / Population Intervention / Exposition Vergleich Endpunkt
In 1,520 patients with NYHA III-IV heart failure and QRS ≥ 120 ms, cardiac resynchronisation therapy (with or without a defibrillator) reduced all-cause death or hospitalisation compared with optimal medical therapy alone.
N
1.520
Design
Randomised (1:2:2) three-arm trial
Endpunkt
Composite of death from or hospitalisation for any cause
Relevanz
2
Ergebnisvs optimal medical therapy, CRT-P reduced the primary endpoint (HR 0.81; P=0.014) and CRT-D reduced it (HR 0.80; P=0.01); CRT-D also cut all-cause mortality (HR 0.64; P=0.003).
Bristow MR, et al. N Engl J Med. 2004;350(21):2140-2150. 10.1056/NEJMoa032423
Diskussion & Kritik
Only CRT-D reached significance for mortality (CRT-P borderline), and 1:2:2 allocation left the medical arm smaller. First trial to show CRT reduces morbidity/mortality in advanced HF, launching device-based therapy for wide-QRS HFrEF.