| Gender differences in clinical outcome and primary prevention defibrillator benefit in patients with severe left ventricular dysfunction: a systematic review and meta-analysis. | |
| | |
MedLine Citation:
|
PMID: 20380893 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Women are underrepresented in primary prevention implantable cardioverter-defibrillator (ICD) trials, and data on the benefit of ICD therapy in this subgroup are controversial. OBJECTIVE: The purpose of this study was to better evaluate the benefit of prophylactic ICD in women by performing a meta-analysis of primary prevention ICD trials that assessed gender differences on the end-points of total mortality, appropriate ICD intervention, and survival benefit of ICD compared with placebo. METHODS: PubMed, CENTRAL, and other databases were searched in October 2009. Studies were included only if they examined gender differences in the specified end-points, providing the hazard ratio (HR) obtained in multiple Cox regression analyses, and adjusted for all confounding variables. RESULTS: We retrieved five studies (MADIT-II, MUSTT, SCD-HeFT, DEFINITE, COMPANION) that enrolled 7,229 patients (22% women) with dilated cardiomyopathy (74% ischemic). Compared to men, women had no significant difference in overall mortality (HR 0.96, 95% confidence interval [CI] 0.67-1.39, P = .84) but experienced significantly less appropriate ICD interventions (HR 0.63, 95% CI 0.49-0.82, P < or =.001). The benefit of ICD on mortality was significantly higher in men (HR 0.67, 95% CI 0.58-0.78, P <.001) but did not reach statistical significance in women (HR 0.78, 95% CI 0.57-1.05, P = .1). CONCLUSION: Women enrolled in primary prevention ICD trials have the same mortality compared to men while experiencing significantly less appropriate ICD interventions, thus suggesting a smaller impact of sudden cardiac death on overall mortality in women with dilated cardiomyopathy. These findings may explain the smaller ICD survival benefit among women. |
| | |
Authors:
|
Pasquale Santangeli; Gemma Pelargonio; Antonio Dello Russo; Michela Casella; Caterina Bisceglia; Stefano Bartoletti; Pietro Santarelli; Luigi Di Biase; Andrea Natale |
Related Documents
:
|
12558713 - Cognitive impairment and mortality in older mexican americans. 2069433 - Mortality among petrochemical science and engineering employees. 19135903 - Quitting by gradual smoking reduction using nicotine gum: a randomized controlled trial. |
Publication Detail:
|
Type: Journal Article; Meta-Analysis; Review Date: 2010-04-07 |
Journal Detail:
|
Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 7 ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2010 Jul |
Date Detail:
|
Created Date: 2010-07-15 Completed Date: 2010-11-22 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
|
Languages: eng Pagination: 876-82 Citation Subset: IM |
Copyright Information:
|
Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy. pasquale.santangeli@libero.it |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Arrhythmias, Cardiac / mortality Cardiomyopathy, Dilated / epidemiology, mortality, therapy* Death, Sudden, Cardiac / epidemiology Defibrillators, Implantable* Female Heart Failure / epidemiology, physiopathology, therapy* Humans Male Middle Aged Primary Prevention Sex Factors Treatment Outcome Ventricular Dysfunction, Left / epidemiology, therapy* |
| Comments/Corrections | |
Comment In:
|
Heart Rhythm. 2010 Jul;7(7):883-4
[PMID:
20423732
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: (13)C-labelling studies indicate compartmentalized synthesis of triacylglycerols in C6 rat glioma ce...
Next Document: Cytosolic calcium accumulation and delayed repolarization associated with ventricular arrhythmias in...