Sex differences in outcomes of primary prevention implantable cardioverter-defibrillator therapy : combined registry data from eleven European countries |
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Author: | Sticherling, Christian1; Arendacka, Barbora2; Svendsen, Jesper Hastrup3; |
Organizations: |
1Department of Cardiology, University Hospital of Basel 2University Medical Center, Department of Cardiology and Pneumology, Robert-Koch-Str.40, Göttingen 37075, Germany 3Rigshospitalet, University of Copenhagen
4University Medical Center Utrecht
5Universitäts Herzzentrum Freiburg-Bad Krozingen, Klinik für Kardiologie 6Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München 7Semmelweiss University Heart Center 8University of Leuven 9Medical University Lodz 10Karolinska Institutet, Department of Cardiology 11Slovak Medical University 12Eberhards Karls Universität Tübingen 13University of Oulu, Institute of Clinical Medicine 14Attikon University Hospital |
Format: | article |
Version: | published version |
Access: | open |
Online Access: | PDF Full Text (PDF, 0.5 MB) |
Persistent link: | http://urn.fi/urn:nbn:fi-fe2018081433659 |
Language: | English |
Published: |
Oxford University Press,
2018
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Publish Date: | 2018-08-14 |
Description: |
AbstractAims: Therapy with an implantable cardioverter defibrillator (ICD) is established for the prevention of sudden cardiac death (SCD) in high risk patients. We aimed to determine the effectiveness of primary prevention ICD therapy by analysing registry data from 14 centres in 11 European countries compiled between 2002 and 2014, with emphasis on outcomes in women who have been underrepresented in all trials. Methods and results: Retrospective data of 14 local registries of primary prevention ICD implantations between 2002 and 2014 were compiled in a central database. Predefined primary outcome measures were overall mortality and first appropriate and first inappropriate shocks. A multivariable model enforcing a common hazard ratio for sex category across the centres, but allowing for centre-specific baseline hazards and centre specific effects of other covariates, was adjusted for age, the presence of ischaemic cardiomyopathy or a CRT-D, and left ventricular ejection fraction ≤25%. Of the 5033 patients, 957 (19%) were women. During a median follow-up of 33 months (IQR 16–55 months) 129 women (13%) and 807 men (20%) died (HR 0.65; 95% CI: [0.53, 0.79], P-value < 0.0001). An appropriate ICD shock occurred in 66 women (8%) and 514 men (14%; HR 0.61; 95% CI: 0.47–0.79; P = 0.0002). Conclusion: Our retrospective analysis of 14 local registries in 11 European countries demonstrates that fewer women than men undergo ICD implantation for primary prevention. After multivariate adjustment, women have a significantly lower mortality and receive fewer appropriate ICD shocks. see all
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Series: |
EP-Europace. The European Journal of Pacing, Arrhythmias and Cardiac Electrophysiology of the European Heart Rhythm Association of the European Society of Cardiology |
ISSN: | 1099-5129 |
ISSN-E: | 1532-2092 |
ISSN-L: | 1099-5129 |
Volume: | 20 |
Issue: | 6 |
Pages: | 963 - 970 |
DOI: | 10.1093/europace/eux176 |
OADOI: | https://oadoi.org/10.1093/europace/eux176 |
Type of Publication: |
A1 Journal article – refereed |
Field of Science: |
3121 General medicine, internal medicine and other clinical medicine |
Subjects: | |
Funding: |
EU-CERT-ICD is funded by the European Commission within the 7th Framework Programme under Grant Agreement n°602299. |
Copyright information: |
© The Author 2017. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
https://creativecommons.org/licenses/by/4.0/ |