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- Title
The impact of gender on survival amongst patients with implantable cardioverter defibrillators for primary prevention against sudden cardiac death.
- Authors
Henyan, N. N.; White, C. M.; Gillespie, E. L.; Smith, K.; Coleman, C. I.; Kluger, J.
- Abstract
Background. Implantable cardioverter defibrillators (ICDs) are a life-saving therapy for many patients with cardiovascular disease at increased risk of fatal dysrhythmias. As men comprise the majority of the study population (67–92%) in clinical trials, the benefit to women is unknown. We performed a meta-analysis of primary prevention trials to evaluate the impact of ICDs in men and women on death from any cause. Methods. Included trials met the following criteria: (i) randomized controlled trials versus standard of care, (ii) ICD used as primary prevention in a well-described protocol and (iii) data provided on risk of death from any cause for both male and female patients. Results. Five clinical trials were included in this meta-analysis. The risk of death from any cause was significantly reduced by 26% in male patients who received ICD therapy compared to control, hazard ratio (HR) 0.74 (95% CI 0.60–0.91) but not amongst female patients, HR 0.81 (95% CI 0.60–1.09). As the COMPANION trial evaluated the combination of biventricular pacemaker with ICD therapy we conducted a separate analysis without the inclusion of this study. Male patients receiving ICD therapy demonstrated a similar 24% reduction in risk of death from any cause, HR 0.76 (95% CI 0.58–0.99) whilst female patients demonstrated a reduction of only 12%, HR 0.88 (95% CI 0.63–1.22). Conclusions. Unlike their male counterparts, females did not significantly benefit from ICD therapy and without concurrent biventricular pacing, appear only to achieve a nonsignificant 12% reduction in risk of death.
- Subjects
IMPLANTABLE cardioverter-defibrillators; CARDIAC arrest; MYOCARDIAL infarction; META-analysis; VENTRICULAR tachycardia; ELECTROPHYSIOLOGY; ARRHYTHMIA
- Publication
Journal of Internal Medicine, 2006, Vol 260, Issue 5, p467
- ISSN
0954-6820
- Publication type
Article
- DOI
10.1111/j.1365-2796.2006.01713.x