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Primary prevention ICD yielded higher overall mortality in women than men
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Heart Rhythm Society 32nd Annual Scientific Sessions
SAN FRANCISCO — Women who received an implantable cardioverter defibrillator for primary prevention of sudden death experienced a similar arrhythmic death rate but a mortality rate nearly 10% higher than in men, according to findings presented at the Heart Rhythm Society’s 32nd Annual Scientific Sessions.
Data on the survival benefit of ICD for women with cardiomyopathy to prevent sudden death are unclear. The current retrospective analysis measured the effect of gender on the appropriate use of ICD therapy and associated mortality rates in 525 consecutive patients. Eligible patients had ischemic or nonischemic cardiomyopathy and had undergone ICD implantation for primary prevention of sudden death.
Overall, there were 160 deaths. The mortality rate was 38.9% among 121 women and 30% among 404 men.
Appropriate ICD therapies were administered to 14.9% of women and 17.1% of men. Four-year survival rates were different between the groups (P=.039), but there was no difference in the rate of appropriate ICD therapy, according to results of a Kaplan-Meier analysis.
Mortality was the primary endpoint, along with appropriate ICD therapy at the 4-year mark. The mean duration of follow-up was 3.8 years.
The researchers assessed demographic information and data for comorbid illnesses and medications for all patients. The 121 women in the study accounted for 23.1% of the population and had similar baseline characteristics as men. Women were aged 61 years and men were aged 62.5 years. Women also had similar ejection fraction (25%) and comorbidities and medication use as men.
Regarding baseline characteristics that were not similar, 81% of men were white vs. 63% of women (P<.001). The tobacco use rate was 63% among men and 43% among women (P<.001). Fifty percent of men had undergone prior coronary bypass surgery vs. 26% of the women (P<.001).
“Women who received an ICD for prevention of [sudden death] had a similar arrhythmic event rate as men,” the researchers wrote. “However, the impact of primary prevention ICD therapy is attenuated by increased mortality rate in female patients.”
For more information:
- Masrani S. Abstract PO3-36. Presented at: Heart Rhythm Society 32nd Annual Scientific Sessions; May 4-7, 2011; San Francisco.
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