Cited 20 times since 2013 (1.8 per year) source: EuropePMC Heart (British Cardiac Society), Volume 99, Issue 17, 30 5 2013, Pages 1244-1249 Gender-specific differences in clinical outcome of primary prevention implantable cardioverter defibrillator recipients. van der Heijden AC, Thijssen J, Borleffs CJ, van Rees JB, Höke U, van der Velde ET, van Erven L, Schalij MJ
Objective
To assess differences in clinical outcome of implantable cardioverter-defibrillator (ICD) treatment in men and women.
Design
Prospective cohort study.
Setting
University Medical Center.
Patients
1946 primary prevention ICD recipients (1528 (79%) men and 418 (21%) women). Patients with congenital heart disease were excluded for this analysis.
Main outcome measures
All-cause mortality, ICD therapy (antitachycardia pacing and shock) and ICD shock.
Results
During a median follow-up of 3.3 years (25th-75th percentile 1.4-5.4), 387 (25%) men and 76 (18%) women died. The estimated 5-year cumulative incidence for all-cause mortality was 20% (95% CI 18% to 23%) for men and 14% (95% CI 9% to 19%) for women (log rank p<0.01). After adjustment for potential confounding covariates all-cause mortality was lower in women (HR 0.65; 95% CI 0.49 to 0.84; p<0.01). The 5-year cumulative incidence for appropriate therapy in men was 24% (95% CI 21% to 28%) as compared with 20% (95% CI 14% to 26%) in women (log rank p=0.07). After adjustment, a non-significant trend remained (HR 0.82; 95% CI 0.64 to 1.06; p=0.13).
Conclusions
In clinical practice, 21% of primary prevention ICD recipients are women. Women have lower mortality and tend to experience less appropriate ICD therapy as compared with their male peers.
