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Butters A, Arnott C, Sweeting J, Winkel BG, Semsarian C, Ingles J. Sex Disparities in Sudden Cardiac Death. Circ Arrhythm Electrophysiol 2021; 14:e009834. [PMID: 34397259 DOI: 10.1161/circep.121.009834] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The overall incidence of sudden cardiac death is considerably lower among women than men, reflecting significant and often under-recognized sex differences. Women are older at time of sudden cardiac death, less likely to have a prior cardiac diagnosis, and less likely to have coronary artery disease identified on postmortem examination. They are more likely to experience their death at home, during sleep, and less likely witnessed. Women are also more likely to present in pulseless electrical activity or systole rather than ventricular fibrillation or ventricular tachycardia. Conversely, women are less likely to receive bystander cardiopulmonary resuscitation or receive cardiac intervention post-arrest. Underpinning sex disparities in sudden cardiac death is a paucity of women recruited to clinical trials, coupled with an overall lack of prespecified sex-disaggregated evidence. Thus, predominantly male-derived data form the basis of clinical guidelines. This review outlines the critical sex differences concerning epidemiology, cause, risk factors, prevention, and outcomes. We propose 4 broad areas of importance to consider: physiological, personal, community, and professional factors.
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Affiliation(s)
- Alexandra Butters
- Cardio Genomics Program at Centenary Institute (A.B., J.I.), The University of Sydney.,Faculty of Medicine and Health (A.B., C.S., J.I.), The University of Sydney
| | - Clare Arnott
- Department of Cardiology, Royal Prince Alfred Hospital (C.A., C.S., J.I.), Sydney, Australia.,The George Institute for Global Health (C.A.), Sydney, Australia
| | | | - Bo Gregers Winkel
- Department of Cardiology, Copenhagen University Hospital, Denmark (B.G.W.)
| | - Christopher Semsarian
- Faculty of Medicine and Health (A.B., C.S., J.I.), The University of Sydney.,Agnes Ginges Centre for Molecular Cardiology at Centenary Institute (C.S.), The University of Sydney.,Department of Cardiology, Royal Prince Alfred Hospital (C.A., C.S., J.I.), Sydney, Australia
| | - Jodie Ingles
- Cardio Genomics Program at Centenary Institute (A.B., J.I.), The University of Sydney.,Faculty of Medicine and Health (A.B., C.S., J.I.), The University of Sydney.,Department of Cardiology, Royal Prince Alfred Hospital (C.A., C.S., J.I.), Sydney, Australia
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Pechmajou L, Marijon E, Perrot D, Jouven X, Karam N. [Out-of-hospital sudden cardiac arrest and COVID-19 pandemic]. Ann Cardiol Angeiol (Paris) 2020; 69:365-369. [PMID: 33071022 PMCID: PMC7543748 DOI: 10.1016/j.ancard.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 10/04/2020] [Indexed: 11/22/2022]
Abstract
Depuis l’apparition de la pandémie de la COVID-19, la mortalité due à l’infection à la COVID-19 a été tracée partout dans le monde, avec un recensement quotidien de nombre de décès. Des mesures ont été prises concernant le fonctionnement social et professionnel, et les systèmes de santé ont été réorganisés afin de limiter la propagation du virus, et permettre une prise en charge de l’affût de patients dans les hôpitaux. Des questions se sont posées quant à l’impact indirect de la pandémie, avec notamment des inquiétudes concernant les potentiels retards de prise en charge des maladies non liées à la COVID-19, avec le confinement, la diminution voire l’arrêt des consultations et interventions médicales non urgentes et la diminution des examens pour dépistage. La mort subite a pu être impactée par tous ces changements, et constitue généralement un bon marqueur de santé publique. Dans cet article nous détaillerons l’impact de la pandémie de la COVID-19 sur l’épidémiologie des morts subites.
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Affiliation(s)
- Louis Pechmajou
- Inserm, PARCC, université de Paris, 75015 Paris, France; Service de cardiologie, hôpital européen Georges-Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Eloi Marijon
- Inserm, PARCC, université de Paris, 75015 Paris, France; Service de cardiologie, hôpital européen Georges-Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - David Perrot
- Inserm, PARCC, université de Paris, 75015 Paris, France; Service de cardiologie, hôpital européen Georges-Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Xavier Jouven
- Inserm, PARCC, université de Paris, 75015 Paris, France; Service de cardiologie, hôpital européen Georges-Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Nicole Karam
- Inserm, PARCC, université de Paris, 75015 Paris, France; Service de cardiologie, hôpital européen Georges-Pompidou, 20 rue Leblanc, 75015 Paris, France.
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Boveda S, Garcia R, Defaye P, Piot O, Narayanan K, Barra S, Gras D, Providencia R, Algalarrondo V, Beganton F, Perier MC, Jacob S, Bordachar P, Babuty D, Klug D, Leclercq C, Fauchier L, Sadoul N, Deharo JC, Marijon E. Implantable cardioverter defibrillator therapy for primary prevention of sudden cardiac death in the real world: Main findings from the French multicentre DAI-PP programme (pilot phase). Arch Cardiovasc Dis 2019; 112:523-531. [PMID: 31471226 DOI: 10.1016/j.acvd.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/21/2019] [Indexed: 11/15/2022]
Abstract
This review summarizes the main findings of the French multicentre DAI-PP pilot programme, and discusses the related clinical and research perspectives. This project included retrospectively (2002-2012 period) more than 5000 subjects with structural heart disease who received an implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death, and were followed for a mean period of 3 years. The pilot phase of the DAI-PP programme has provided valuable information on several practical and clinically relevant aspects of primary prevention ICD implantation in the real-world population, which are summarized in this review. This pilot has led to a prospective evaluation that started in May 2018, assessing ICD therapy in primary and secondary prevention in patients with structural and electrical heart diseases, with remote monitoring follow-up using a dedicated platform. This should further enhance our understanding of sudden cardiac death, to eventually optimize the field of preventative actions.
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Affiliation(s)
| | - Rodrigue Garcia
- CHU de Poitiers, 86021 Poitiers, France; Université de Poitiers, 86073 Poitiers, France
| | | | - Olivier Piot
- Centre cardiologique du Nord, 93200 Saint-Denis, France
| | - Kumar Narayanan
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Maxcure Hospitals, 500081 Hyderabad, Telangana, India
| | - Sergio Barra
- Royal Papworth Hospital NHS Foundation Trust, Cambridge University Health Partners, CB2 0AY Cambridge, UK; Hospital da Luz Arrabida, 4400-346 Vila Nova de Gaia, Portugal
| | - Daniel Gras
- Hopital privé du Confluent, 44000 Nantes, France
| | - Rui Providencia
- Clinique Pasteur, 31076 Toulouse, France; Barts Heart Centre, Barts Health NHS Trust, EC1A 7BE London, UK
| | | | - Frankie Beganton
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France
| | | | | | | | | | | | | | | | | | | | - Eloi Marijon
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Unité de Rythmologie, Hôpital européen Georges Pompidou, 20-40, rue Leblanc, 75908 Paris cedex 15, France; Paris Descartes University, 75006 Paris, France.
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Madonna R, Balistreri CR, De Rosa S, Muscoli S, Selvaggio S, Selvaggio G, Ferdinandy P, De Caterina R. Impact of Sex Differences and Diabetes on Coronary Atherosclerosis and Ischemic Heart Disease. J Clin Med 2019; 8:jcm8010098. [PMID: 30654523 PMCID: PMC6351940 DOI: 10.3390/jcm8010098] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 12/30/2018] [Accepted: 01/11/2019] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVD) including coronary artery disease (CAD) and ischemic heart disease (IHD) are the main cause of mortality in industrialized countries. Although it is well known that there is a difference in the risk of these diseases in women and men, current therapy does not consider the sexual dimorphism; i.e., differences in anatomical structures and metabolism of tissues. Here, we discuss how genetic, epigenetic, hormonal, cellular or molecular factors may explain the different CVD risk, especially in high-risk groups such as women with diabetes. We analyze whether sex may modify the effects of diabetes at risk of CAD. Finally, we discuss current diagnostic techniques in the evaluation of CAD and IHD in diabetic women.
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Affiliation(s)
- Rosalinda Madonna
- Center of Aging Sciences and Translational Medicine-CESI-MeT, Institute of Cardiology, "G. d'Annunzio" University, Via dei Vestini 31, 66100 Chieti, Italy.
- Department of Internal Medicine, University of Texas Medical School in Houston, Houston, 77065 TX, USA.
| | - Carmela Rita Balistreri
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90134 Palermo, Italy.
| | - Salvatore De Rosa
- Division of Cardiology, Department of Medical and Surgical Sciences, University "Magna Græcia'' of Catanzaro, Viale Europa, 88100 Catanzaro, Italy.
| | - Saverio Muscoli
- Department of Cardiovascular Disease, Tor Vergata University of Rome, 00133 Rome, Italy.
| | - Stefano Selvaggio
- Geriatric Division, A.R.N.A.S. Ospedale "Garibaldi" Nesima, 95122 Catania, Italy.
| | | | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary.
- Pharmahungary Group, 6722 Szeged, Hungary.
| | - Raffaele De Caterina
- Institute of Cardiology, University of Pisa, C/o Ospedale di Cisanello, Via Paradisa 2, 56124 Pisa, Italy.
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[Emergency treatment of myocardial infarction in women]. REVUE DE L'INFIRMIÈRE 2017; 66:20-21. [PMID: 28865691 DOI: 10.1016/j.revinf.2017.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Acute myocardial infarction (MI) affects mainly men. In women, chest pain is less typical, delaying the diagnosis and increasing the time before treatment is delivered. Morbidity-mortality is greater notably due to a modification of the myocardial reperfusion strategy. The acute care of MI is almost identical for men and women. Knowing more about the epidemiology of women with MI enables prevention strategies to be targeted.
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Porlier M, Porlier L, Lefort H. [Cardiorespiratory arrest at the age of 30]. REVUE DE L'INFIRMIERE 2017; 66:26-27. [PMID: 28865694 DOI: 10.1016/j.revinf.2017.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The cardiovascular risk of women is specific and polymorphous. Delays in treatment in women are evident and caused by multiple social and anthropological factors as well as changes to lifestyle habits which are becoming similar to those of men. Young women thereby have a higher risk of sudden death than the rest of the female and general population. A nurse who experienced cardiorespiratory arrest at the age of 30 shares her story.
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Affiliation(s)
- Magali Porlier
- Centre de la mucoviscidose, Hôpital Armand Trousseau, 26 avenue du docteur Arnold Netter, 75012 Paris, France
| | - Ludovic Porlier
- Service de réanimation pédiatrique et néonatale, Hôpital Armand Trousseau, 26 avenue du docteur Arnold Netter, 75012 Paris, France
| | - Hugues Lefort
- Service d'accueil des urgences, Hôpital d'instruction des Armées Legouest, Rue des Frères Lacretelle, 57070 Metz, France.
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