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Noordman ABP, Rienstra M, Blaauw Y, Mulder BA, Maass AH. Sex Differences in Outcomes of Patients with an Implantable Cardioverter-Defibrillator for the Secondary Prevention of Sudden Cardiac Death. J Cardiovasc Dev Dis 2024; 11:116. [PMID: 38667734 PMCID: PMC11050510 DOI: 10.3390/jcdd11040116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Background: In patients with an implantable cardioverter-defibrillator (ICD) for secondary prevention, sex differences may exist in clinical outcomes. We sought to investigate sex differences in appropriate ICD therapy, appropriate and inappropriate shock, and all-cause mortality in this patient population. Methods: A total of 257 patients who received an ICD for a secondary prevention indication in the University Medical Centre Groningen (UMCG) between 1 January 2012 and 31 December 2018 were retrospectively included in a consecutive manner. Appropriate ICD therapy, comprising shock and antitachycardia pacing (ATP) for ventricular fibrillation (VF) or ventricular tachycardia (VT), was the primary outcome. Results: The patient population included 257 patients, of whom 45 (18%) were women and 212 (82%) were men. The median of the age was 64 (interquartile range (IQR) 53-72) years. During follow-up (median duration 6.2 (IQR 4.8-7.8) years), first appropriate device therapy took place in 10 (22%) patients for women and 85 (40%) patients for men. Female sex was negatively associated with the rate of appropriate ICD therapy, univariably (hazard ratio (HR) 0.48 [95% confidence interval (CI) 0.25-0.93]; p = 0.030) and multivariably (HR 0.44 [95% CI 0.20-0.95]; p = 0.036). Conclusions: Women with secondary prevention ICDs were less likely than men to receive appropriate ICD therapy.
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Affiliation(s)
| | | | | | | | - Alexander H. Maass
- Department of Cardiology, Heart Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (A.B.P.N.)
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Taborsky M, Skala T, Fedorco M, Doupal V, Sovova I, Jarkovsky J, Benesova K, Bezdekova M, Vicha M, Danek J, Kautzner J. Effectiveness of ICD therapy in real clinical practice. The Olomouc ICD Registry. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:225-235. [PMID: 34916673 DOI: 10.5507/bp.2021.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Clinical parameters linked to a low benefit of ICD implantation and increased mortality risks are needed for an individualized assessment of potential benefits and risks of ICD implantation. METHODS Analysis of a prospective registry of all patients hospitalized from 2009 to 2019 in a single centre for a first implantation of any type of ICD. RESULTS A total of 2,681 patients were included in the registry. Until the end of follow-up (38.4 ± 29.1 months), 682 (25.4%) patients died. The one-year mortality in all patients, the one-year CV mortality, the three-year mortality in all patients, and the three-year CV mortality were 7.8%, 5.7%, 20.6%, and 14.8%, respectively. There was a statistically significant difference when the subgroups were compared according to the type of cardiomyopathy. No significant difference was found between primary and secondary prevention and between the types of devices. Male gender, age ≥ 75 years, diabetes mellitus, and atrial fibrillation were associated with a significantly increased mortality risk. CONCLUSION In an analysis of a long-term follow-up of 2,681 ICD patients, we found no mortality difference between patients with ischemic or non-ischemic cardiomyopathy and in the device type. A higher mortality risk was found in men, patients older than 75 years, diabetics, and those with atrial fibrillation.
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Affiliation(s)
- Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Tomas Skala
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Marian Fedorco
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Vlastimil Doupal
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Ingrid Sovova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Jiri Jarkovsky
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O. BOX 60, 128 01 Praha 2, Czech Republic
- Institute of Biostatistics and Analyses at the Faculty of Medicine of the Masaryk University (IBA FM MU) in Brno, Czech Republic
| | - Klara Benesova
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O. BOX 60, 128 01 Praha 2, Czech Republic
- Institute of Biostatistics and Analyses at the Faculty of Medicine of the Masaryk University (IBA FM MU) in Brno, Czech Republic
| | - Monika Bezdekova
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O. BOX 60, 128 01 Praha 2, Czech Republic
| | - Marek Vicha
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Josef Danek
- Department of Cardiology, Central Military Hospital Prague, U Vojenske nemocnice 1200, 169 02 Praha 6, Czech Republic
| | - Josef Kautzner
- Institute for Clinical and Experimental Medicine, Videnska 1958, 140 21 Praha 4, Czech Republic
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Crea F. Past and future of channelopathies and a focus on cardiac arrest. Eur Heart J 2021; 42:1053-1056. [PMID: 33715005 DOI: 10.1093/eurheartj/ehab131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Filippo Crea
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
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