1. Sex differences in outcomes of primary prevention implantable cardioverter-defibrillator therapy: combined registry data from eleven European countries
- Author
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Bert Vandenberk, Gábor Széplaki, Michael Scharfe, Sofieke C. Wijers, Leonard Bergau, Christian Eick, Emilia Kowalczyk, Béla Merkely, Frieder Braunschweig, Georg Schmidt, Juhani Juntilla, Barbora Arendacká, Martin Svetlosak, Anton E. Tuinenburg, Panagiota Flevari, Heikki V. Huikuri, Jesper Hastrup Svendsen, Tim Friede, Jochem Stockinger, David Conen, Rik Willems, Christine S. Zürn, Markus Zabel, Andrzej Lubiński, Beat Schaer, Caspar Lund-Andersen, Eu-Cert-Icd Investigators, Christian Sticherling, and Michael Dommasch
- Subjects
Male ,Cardiac & Cardiovascular Systems ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,RISK STRATIFICATION ,Sudden cardiac death ,Toxicology ,0302 clinical medicine ,APPROPRIATE ,Implantable defibrillator ,030212 general & internal medicine ,Cardiac resynchronization therapy ,Primary prevention ,Ejection fraction ,Defibrillators, Implantable/adverse effects ,Hazard ratio ,DEATH ,Registries/statistics & numerical data ,Middle Aged ,Implantable cardioverter-defibrillator ,Primary Prevention/methods ,3. Good health ,Arrhythmias, Cardiac/complications ,Female ,Registry data ,Electric Countershock/adverse effects ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,PACKAGE ,Sex characteristics ,medicine.medical_specialty ,Heart failure ,Europe/epidemiology ,EVENTS ,03 medical and health sciences ,Sex Factors ,Physiology (medical) ,Internal medicine ,Sex differences ,cardioverter-defibrillator ,medicine ,Humans ,Women ,Ventricular fibrillation ,Mortality ,Death, Sudden, Cardiac/epidemiology ,Aged ,Retrospective Studies ,Science & Technology ,Ischemic cardiomyopathy ,CONGESTIVE-HEART-FAILURE ,business.industry ,medicine.disease ,Cardiovascular System & Cardiology ,INAPPROPRIATE THERAPY ,Equipment Failure/statistics & numerical data ,business - Abstract
AIMS: 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
- Published
- 2017
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