1. Comparative Effectiveness of Implantable Cardioverter Defibrillators for Primary Prevention in Women
- Author
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Zeitler, Emily P, Hellkamp, Anne S, Schulte, Phillip J, Fonarow, Gregg C, Hernandez, Adrian F, Peterson, Eric D, Sanders, Gillian D, Yancy, Clyde W, and Al-Khatib, Sana M
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Heart Disease ,Prevention ,Cardiovascular ,Aged ,Aged ,80 and over ,Centers for Medicare and Medicaid Services ,U.S. ,Chi-Square Distribution ,Comparative Effectiveness Research ,Defibrillators ,Implantable ,Electric Countershock ,Female ,Heart Failure ,Hospitalization ,Humans ,Kaplan-Meier Estimate ,Logistic Models ,Male ,Markov Chains ,Monte Carlo Method ,Primary Prevention ,Propensity Score ,Proportional Hazards Models ,Registries ,Risk Assessment ,Risk Factors ,Sex Factors ,Stroke Volume ,Time Factors ,Treatment Outcome ,United States ,Ventricular Function ,Left ,comparative effectiveness research ,heart failure ,implantable cardioverter-defibrillators ,morbidity ,mortality ,women ,Biochemistry and Cell Biology ,Cardiorespiratory Medicine and Haematology ,Medical Physiology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Medical physiology - Abstract
BackgroundClinical trials of implantable cardioverter defibrillators (ICDs) for primary prevention enrolled a limited number of women. We sought to examine clinical practice data to compare survival rates among women with heart failure with or without a primary prevention ICD.Methods and resultsWe linked data from 264 US hospitals included in the Get With The Guidelines for Heart Failure registry with data from the Centers for Medicare and Medicaid Services. From these sources, we propensity score matched 430 women with heart failure who received a primary prevention ICD to 430 women who did not; we further adjusted using a Cox proportional hazards model. Median follow-up was 3.4 and 3.0 years. For comparison, we matched 859 men receiving an ICD with 859 who did not; median follow-up was 3.9 versus 2.9 years. In the matched cohorts, an ICD was associated with similarly better survival in women (hazard ratio, 0.78; 95% confidence interval, 0.66-0.92; P=0.003) and men (hazard ratio, 0.76; 95% confidence interval, 0.67-0.87 P
- Published
- 2016