Female gender is associated with a better outcome after cardiac resynchronization therapy.
Pacing Clin Electrophysiol
; 34(1): 82-8, 2011 Jan.
Article
en En
| MEDLINE
| ID: mdl-21214589
BACKGROUND: Some studies have suggested that women respond differently to cardiac resynchronization therapy (CRT). We sought to determine whether female gender influences long-term clinical outcome, symptomatic response as well as echocardiographic response after CRT. METHODS AND RESULTS: A total of 550 patients (age 70.4 ± 10.7 yrs [mean ± standard deviation]) were followed up for a maximum of 9.1 years (median: 36.2 months) after CRT-pacing (CRT-P) or CRT-defibrillation (CRT-D) device implantation. Outcome measure included mortality as well as unplanned hospitalizations for heart failure or major adverse cardiovascular events (MACE). Female gender predicted survival from cardiovascular death (hazard ratio [HR]: 0.52, P = 0.0051), death from any cause (HR: 0.52, P = 0.0022), the composite endpoints of cardiovascular death /heart failure hospitalizations (HR: 0.56, P = 0.0036) and death from any cause/hospitalizations for MACE (HR: 0.67, P = 0.0214). Female gender predicted death from pump failure (HR: 0.55, P = 0.0330) but not sudden cardiac death. Amongst the 322 patients with follow-up echocardiography, left ventricular (LV) reverse remodelling (≥ 15% reduction in LV end-systolic volume) was more pronounced in women (62% vs 44%, P = 0.0051). In multivariable Cox proportional hazards analyses, the association between female gender and cardiovascular survival was independent of age, LV ejection fraction, atrial rhythm, QRS duration, CRT device type, New York Heart Association (NYHA) class, and LV reverse remodelling (adjusted HR: 0.48, P = 0.0086). At one year, the symptomatic response rate (improvement by ≥ 1 NYHA classes or ≥ 25% increase in walking distance) was 78% for both women and men. CONCLUSIONS: Female gender is independently associated with a lower mortality and morbidity after CRT.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Terapia de Resincronización Cardíaca
/
Insuficiencia Cardíaca
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Hospitalización
Tipo de estudio:
Etiology_studies
/
Prevalence_studies
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Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Aged
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Female
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Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Año:
2011
Tipo del documento:
Article
Pais de publicación:
Estados Unidos