Trends in use of implantable cardioverter-defibrillator therapy: have the previously observed sex disparities changed over time?

    Authors

    Keywords

    women, implantable cardioverter defibrillator, sex differences

    DOI

    https://doi.org/10.15836/ccar2016.421

    Full Text

    **Background**: Multiple studies have demonstrated that implantable cardioverter-defibrillators (ICD) provide significant mortality and morbidity benefits to eligible patients irrespective of gender. However, female patients are less likely to receive this life-saving therapy and are significantly under-represented in cardiac device trials. (1, 2) We aimed to analyze the data on sex differences in our patients with ICD. **Patients and Methods:** This retrospective study included patients who were implanted with an ICD between 2011 and 2016. Demographic characteristics, clinical information, shock features and complications were analyzed. The study population was divided into two groups: early-era patients implanted before 2013, and late-era patients implanted after 2013. **Results:** Twenty-six patients (mean age 57.61 years, women 30.76%, median follow-up 32.37 months) were implanted with an ICD. Diagnostic categories were ischemic cardiomyopathy (57.69%; women 20%), non-ischemic cardiomyopathy (42.30%; women 45.45%). We performed implantation for primary prevention in 19.23% (0% in early-era and 27.77% in late-era patients; women 33.33%). 38.46% patients received shocks, 70% appropriate shock. Two patients died during the follow-up period. **Conclusions**: A significant increase in ICD therapy use was observed over time in all sex. The previously described sex disparities in ICD use were less significant by the end of the study period.

    Literature

    1. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015;36(41):2793–867. https://doi.org/10.1093/eurheartj/ehv316
    2. Wilcox JE, Fonorow GC, Zhang Y, Albert NM, Curtis AB, Gheorghiade M, et al. Clinical effectiveness of CRT and ICD therapy in men and women with heart failure: findings from IMPROVE HF. Circ Heart Fail. 2014;7:146–53. https://doi.org/10.1161/CIRCHEARTFAILURE.113.000789
    Cardiologia Croatica
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    Trends in use of implantable cardioverter-defibrillator therapy: have the previously observed sex disparities changed over time?

    Extended Abstract
    Issue10-11
    Published
    Pages421
    PDF via DOIhttps://doi.org/10.15836/ccar2016.421
    women
    implantable cardioverter defibrillator
    sex differences

    Authors

    Katica Cvitkušić Lukenda*ORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Marijana Knežević PravečekORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Ivica DunđerORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Anto LukendaORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Božo VujevaORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia

    *Correspondence email: kclukenda@gmail.com

    Full Text

    Background: Multiple studies have demonstrated that implantable cardioverter-defibrillators (ICD) provide significant mortality and morbidity benefits to eligible patients irrespective of gender. However, female patients are less likely to receive this life-saving therapy and are significantly under-represented in cardiac device trials. (1, 2) We aimed to analyze the data on sex differences in our patients with ICD.

    Patients and Methods: This retrospective study included patients who were implanted with an ICD between 2011 and 2016. Demographic characteristics, clinical information, shock features and complications were analyzed. The study population was divided into two groups: early-era patients implanted before 2013, and late-era patients implanted after 2013.

    Results: Twenty-six patients (mean age 57.61 years, women 30.76%, median follow-up 32.37 months) were implanted with an ICD. Diagnostic categories were ischemic cardiomyopathy (57.69%; women 20%), non-ischemic cardiomyopathy (42.30%; women 45.45%). We performed implantation for primary prevention in 19.23% (0% in early-era and 27.77% in late-era patients; women 33.33%). 38.46% patients received shocks, 70% appropriate shock. Two patients died during the follow-up period.

    Conclusions: A significant increase in ICD therapy use was observed over time in all sex. The previously described sex disparities in ICD use were less significant by the end of the study period.

    Literature

    1. 1.
      Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015;36(41):2793–867.DOI
    2. 2.
      Wilcox JE, Fonorow GC, Zhang Y, Albert NM, Curtis AB, Gheorghiade M, et al. Clinical effectiveness of CRT and ICD therapy in men and women with heart failure: findings from IMPROVE HF. Circ Heart Fail. 2014;7:146–53.DOI